History of mental illness

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The History of mental illness has long been a process of trial and error guided by public attitudes and medical theory with each society developing its own responses. By tracking these developments, a deeper understanding of human interaction and acceptance of this disability can be gathered.

1 Prehistoric times
2 Ancient Egypt
3 Monotheism and Mental Health
- 3.1 Ancient Judaism
- 3.2 Ancient Islam
4 Middle ages
5 Asylums
6 Moral reform
7 Medical science
8 See also
9 External links

[edit] Prehistoric times

In prehistoric times, mental illnesses were assumed to stem from magical beings that interfered with the mind. Individual tribes and groups of shamans had their own spells and rituals that they used to attempt to cure such mental illnesses. Often, such rituals took the form of exorcisms, in which the shaman would attempt to coax the evil spirit that was causing the disorder from the body. In some prehistoric societies, a primitive form of surgery was used to attempt to exorcise the malignant spirits. Trepanation (also spelled trephination), the practice of drilling a hole through part of the skull without damaging the brain, was believed to allow the spirits trapped inside the skull to release. Skulls with trepanning holes dating back more than 10,000 years have been found in Neolithic Europe and South America. In fact, the presence of calluses on the surfaces of many skulls recovered showed that the operation had a surprisingly high recovery rate.

[edit] Ancient Egypt

With the first "great civilization," that of the Ancient Egyptians, came the first signs of change in the treatment of the mentally ill. Egypt, like the early stone-age societies (and indeed most societies for the next 3-and-a-half millennia), regarded mental illness as magical or religious in nature. Egyptian psychiatric theory was deeply rooted in the Egyptian conception of the self – the khat (the body), the ka (one’s guardian spirit, who guides the individual to the afterlife), and the ba (symbolized by a bird carrying the key to eternity, which leaves the body after death and resides in heaven), all playing their part in the cyclical nature of life and death. The societal obsession with death and life after death meant that the health of the mind or soul played an essential part in one’s overall health. In Ancient Egypt the first known psychiatric text (written around 20th century BC which explains the causes of "hysteria"), the first known mental hospital (a temple complex near modern Saqqara which is thought to be meant for the treatment of the mentally ill), and the known mental physician are found in history. The Egyptian focus on the well-being of the soul is embodied in the Temple of Imhotep at Memphis in the 29th century BC, a popular center for the treatment of mental illness. Methods used to attempt to cure the mentally ill included using opium to induce visions, performing rituals or delivering prayers to specific gods, and "sleep therapy," a method of interpreting dreams to discover the source of the illness. Egyptian society, with its fixation on the health of the soul, is the first major example of mental healthcare as a major priority for a society in history.

[edit] Monotheism and Mental Health

[edit] Ancient Judaism

The concept of a single God as articulated in Judaism paved the way for a shift in views on mental health. While still almost completely religious in nature, the adoption of monotheism allowed for the idea that mental illness was not a problem like any other, caused by one of the gods, but rather caused by problems in the relationship between the individual and God, in some sense (to put it in modern terms) self-conflict or repressed guilt. Although the origin of the Israelite tribes have been dated to the late 2nd millennium BC, the májor period of growth for Judaism occurred in the 6th century BC, when the Kingdom of Judah was conquered by Babylon and exiled to the Babylonian kingdom. On the waters of the Euphrates, the rabbis of the remaining tribes formulated for the first time a cohesive Jewish identity and doctrine, revitalizing monotheism in the face of ideological opposition. To the Hebrews, mental health (spiritual health), was the key to righteousness and to God. By formulating this new concept of a monotheistic, and in many ways, personal deity, the ancient Hebrews moved the idea of mental health away from mysticism and into organized religion.

[edit] Ancient Islam

More than a thousand years later, Islam was beginning to spread across the Arabian Peninsula and into Asia and Africa. Like Judaism, Islam stressed the need for individual understanding of their mental situation. Those afflicted with a mental illness were thought to be possessed by jinn, supernatural spirits that can be either good or bad. The Qur'an mentions the idea of the spirit or soul constantly, preaching the idea that only though radical change of one’s conception of the universe can one move closer to God. Unlike the Jewish conception of mental illness as sin, the Islamic viewpoint interpreted mental illness as a sign of supernatural intervention that was not necessarily malignant. Changes in the psyche could be either good or bad – the Sufi movement of Islam, for instance, teaches spirituality though near-mysticism, using song, dance, and narcotics to induce an altered mental state and a closer connection of God. This new attitude towards the mind, freeing mental illness from implications of wrongdoing, paved the way for a more scientific examination of the causes and symptoms of mental illness. The first such advances were made by Islamic scholars. The Arab physician Rhazes wrote the landmark texts El-Mansuri and Al-Hawi in the 10th century, two which presented definitions, symptoms, and treatments for illness, including mental illnesses, and also ran the psychiatric ward of a Baghdad hospital. Such institutions could not exist in Europe at the time because of fear of demonic possessions. In the centuries to come, Islam would eventually serve as a critical waystation of knowledge for Renaissance Europe – however, at this point in history their time had not yet come, and conquest was a higher priority to Islamic society of the period than medicine.

[edit] Middle ages

Mental illness in the Middle Ages was very often diagnosed as witchcraft. Those found acting irrationally or suffering hallucinations were thought to be possessed and were subsequently tortured and usually killed. The definitive guide to diagnosis at the time was the Malleus Maleficarum. Recent psychologists have read case studies of proposed witchcraft and have suggested explanations like ergot poisoning. From the early decades of the fifteenth century until the middle of the seventeenth century, between 200,000 and 500,000 witches were executed in Europe.^{[citation needed]}

[edit] Asylums

Occurring with the renaissance, the legislation of witchcraft diminished and was replaced with insane asylums, the most well known of these asylums being Bedlam. Treatment in asylums was very poor, often secondary to prisons.

[edit] Moral reform

Nearing the turn of the nineteenth century, psychologists and activists began the reform to treat the mentally ill humanely. Notable people include Phillipe Pinel, Johann Guggenbuhl, William Tuke, and Dorothea Dix. Providing a supportive environment for the mentally ill saw great success and these individuals are credited with the development of clinical psychology.^{[citation needed]}

[edit] Medical science

By the turn of the twentieth century, psychologists were in seeking medical treatments for mental illness. Early forms included bloodletting, and spinning; later forms included electro convulsive therapy, and lobotomies. Walter Freeman wrote in the 1940’s, that lobotomies would: “Make good American citizens of society’s misfits, schizophrenics, homosexuals, and radicals”.^{[citation needed]} Psychoactive drugs began being administered in the middle decades of the twentieth century. Chlorpromazine was widely used in Europe and the United States to treat schizophrenia. Lithium began being used in the 1960s to treat manic depression. The use of medical drugs has greatly decreased the need for asylums. In 1955 there were 560,000 mental patients in the United States. In 1984 there were less than 150,000.^{[citation needed]}