In ancient Greek scholars
were of the opinion that mental diseases were caused by an imbalance in four
humors of the body. The three humors which influenced mental
disorders termed melancholia, mania and an acute mental
disorder accompanied by fever. This was contrary to the supernatural or divine
explanations of illness. The belief that disease was the product of
environmental factors, diet and living habits, not as a punishment inflicted by
the gods, and that the treatment
depended on which bodily fluid, or humor, had caused the problem. Around
427-347 BC the belief that there were two
types of mental illness: divinely inspired mental illness that gave the person
prophetic powers and a type that was caused by a physical disease. By 384 BC, the
divinely caused mental illness theory was abandoned and the proposal that
instead all mental illness was caused by physical problems.
In ancient Greece and Rome,
madness was associated the stereotype of pointless wandering and violence.
The Romans absorbed
many Greek ideas on medicine, as well as other cultures, through the conquering
of nations. The humor theory was discarded and scholars advocated humane
treatments, and had insane persons freed from confinement and treated them with
natural
therapy, such as diet and massages.
Playwrights described madmen
as being driven insane by the Gods, imbalanced humors or circumstances. Mania was
often used as a term for insanity; there were a variable range of terms for
delusion, eccentricity, frenzy, and lunacy. Some physicians argued that
insanity is really present when a continuous dementia begins with imaginings.
They suggested that people must heal their own souls through philosophy and
personal strength. Common practices were bloodletting, drugs, talking
therapy, incubation in temples, exorcism, incantations and amulets,
as well as restraints and torture to restore rationality; starvation, being
terrified suddenly, agitation of the spirit, and stoning and beating.
Most, of the mentally ill did not receive medical treatment but stayed with family
or wandered the street. The usual symptoms of delusions of the time included
people who thought them to be famous actors or speakers, animals, inanimate
objects, or one of the gods.
By the middle Ages, Persian and Arabic
scholars were involved in translating, analyzing and Greek texts and beliefs.
With the expansion of the Muslim world, these ideas were joined together with
religious thought. New ideas and concepts were developed over time. Arab texts contained
whole discussions of melancholia. Mania and other disorders including
hallucinations and delusions were also described. Mental disorder was thought
to be caused by reason gone being lost, and diseases of the as well as to spiritual
or mystical meaning. Fear and anxiety, anger and aggression, sadness and
depression, and obsessions were recorded.
Under Islam, the mentally
disordered were considered incapable but deserved humane treatment and
protection. The first psychiatric hospital ward was created in Baghdad in
and insane asylums were built in Fes, Cairo in and in Damascus around
1270. Insane patients were compassionately treated using baths, drugs, music
and activities. For centuries to come, translations of many scientific
Islamic texts, Canon of Medicine became the standard of medical science in
Europe together with works of Hippocrates.
European Christianity in the middle Ages in
Europe the basis of mental illness were a mixture of the divine diabolical magical and transcendental.
The four humors black bile, yellow bile, phlegm, and blood were employed, some
physicians promoted trepanning as a cure to let demons and excess humors
escape. Other remedies in general use included bloodletting and whipping.
Madness was often seen as a moral issue, either a punishment for sin or attest of
faith. Christian theology supported various therapies, fasting and prayer
for those who turned away from God and exorcism of those possessed by
the devil. Mental disorders were thought to be due to sin although the
belief those other factors could be taken in consideration. Mass dancing
mania is reported from the middle Ages. This was one kind of mass
delusion or mass hysteria that has occurred around the world through the millennia.
The care of lunatics was the
responsibility of the family. In England, if the family were unable or not
willing to take custody , representatives of the courts with a local jury and
all interested persons, with the individual.
Those considered lunatics had the support and involvement from the
community more often than those who have a mental illness today. Visions
were interpreted as meaningful spiritual and prophetic insights.
During the 16th to 18th centuries some
mentally disturbed people may have been victims of the witch-hunts that
spread in early modern Europe, but those judged insane were admitted to workhouses, poorhouses
and jails especially the paupers, some went to the new private madhouses. Restraints
and confinement were used for those thought dangerous or harmful to themselves,
others or property.
Madness was commonly depicted in
literary works, such as the plays of Shakespeare
By the end of the 17th century
and into the Enlightenment, madness was increasingly seen as an organic physical
occurrence, not involving the soul or moral responsibility. The mentally ill were
viewed as wild animals. Restraint in chains was seen as helping contain the animal
furies. Treatment in the few public asylums was harsh, inferior only to prisons.
The most well known is Bedlam where at one time spectators could pay
to watch the inmates as entertainment. Towards the end of the 18th century,
a moral treatment movement developed, that implemented more humane,
psychosocial and personalized methods.
The 19th century, with industrialization and
population growth, saw an expansion of the number and size of insane asylums. However, very little therapeutic activity
occurred in the new asylum system, the little more there was seldom medical attention
to patients, except for other physical problems.
Reports of many mental disorders
and irrational uncontrolled behavior are common in historical records back to
ancient times, some disorders; they were relatively rare prior to the 19th
century.
By the 1870s in North America,
officials who ran Lunatic Asylums renamed them Insane Asylums.
The 20th century brought about psychoanalysis.
Asylum administers attempted to
improve the image of the asylums. Asylum inmates were referred to as patients and
asylums renamed as hospitals. Referring to people as having a mental illness
began during this period of the early 20th century.
In Nazi Germany, the
institutionalized mentally ill were the earliest victims of sterilization it
has been estimated that over 200,000 individuals with mental disorders of all
kinds were put to death.
Funding was often cut for
asylums, during periods of economic decline, and wartime and many patients
starved to death.
Previously restricted to the
treatment of severely disturbed people in asylums, psychiatrists cultivated
clients with a broader range of problems, and between 1917 and 1970 the number
practicing outside institutions swelled from 8 percent to 66 percent. The
term stress was become popular and was linked to mental disorders.
Lobotomies, insulin shock therapy,
electro convulsive therapy became commonly used in the mid-century.
In the 1960s deinstitutionalization gradually
occurred, with isolated psychiatric hospitals being closed down with
the advanced opening of community mental health service.
With the medical advances and
newer more effective medications there is still little improvement in the
stigma and shame of having a mental disorder. The closure of many of the state hospitals have brought a about the
problem that has had little impact on the people with mental disorders. Instead of learning from the past it seems
that there is a revolving door of returning to the past.