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Friday, 6 May 2016

Mental Illness

Ancient civilizations described and treated a number of mental disorders. The Greeks coined terms for melancholy, hysteria and phobia and developed the humorism theory.

Mental disorders were described, and treatments developed, in Persia, Arabia and in the medieval Islamic world. The first psychiatric hospitals were was built by the Muslims including ones in Baghdad in 700AD, Cairo in 800 AD and in Damascus in 1270 AD. The physicians of the Islamic world invented and used a variety of treatments, including occupational therapy, music therapy, as well as medication.

In medieval Europe a mentally ill person was considered to be suffering from demonic possession. Treatments include exorcism, flogging, or torture to drive the evil spirits from the body.

By the end of the 17th century and into the Enlightenment, madness was increasingly seen as an organic physical phenomenon with no connection to the soul or moral responsibility.

In the 18th century in the western world the mentally ill were split into two categories: maniacs and melancholics.

The maniacs were referred to as "lunatics" from the adjective word "lunar" meaning,"to do with the moon." The belief was that insanity was caused by a full moon at the time of a baby's birth or a baby sleeping under the light of a full moon. Arising from this they were possessed by the devil, so they needed to be removed from society and locked away in specialist institutions. A number of asylums, such as St Luke's Hospital in London, were built to cater for these unfortunates.

The melancholics it was believed suffered from a continual depression of spirits due to an excess of black bile. The treatment for this was to cleanse and purify the downcast individual. This was done by immersing the unfortunate patient in an ice bath until he lost consciousness. Other methods included inducing vomiting and the infamous "bleeding" practice.

1857 lithograph by Armand Gautier, showing personifications of dementia, megalomania, acute mania, melancholia, idiocy, hallucination, erotomania and paralysis in the gardens of the Hospice de la Salpêtrière

Placed in charge of a Parisian insane asylum by the revolutionary government in 1793, the forward-thinking French physician Philippe Pinel treated the inmates as people sick in mind, to be treated with the same humane consideration as the sick in body rather than with cruelty and violence. Consequently he released the insane from their chains and maintained well-documented case studies of mental ailments.

The term psychiatry was coined in 1808, though medical superintendents were still known as alienists.

German psychiatrist Emil Kraepelin (February 15, 1856 – October 7, 1926) was a pioneer in the psychological study of serious mental diseases. After studying patterns of symptoms among hospitalized patients and classifying them into separate disorders, he divided them into two groups, "dementia praecox" (schizophrenia) and "manic-depressive insanity". He first published his findings in 1883 in Compendium der Psychiatrie (Compendium of Psychiatry).

Emil Kraepelin in his later years
Clifford Whittingham Beers (March 30, 1876 – July 9, 1943) was the founder of the American mental hygiene movement. Born in New Haven, Connecticut, USA, he trained as a scientist at Yale and suffered severe episodes of depression. Beers was maltreated and abused during his confinement at various private and state mental institutions. As a result of indignities and violence Beers experienced, he determined to reform the mental health system. His autobiographic book, The Mind That Found Itself, created a sensation, calling for a true therapeutic approach to mental illness instead of just custodial care.

Title page of "A Mind That Found Itself", 

Sigmund Freud's Psychoanalysis method aimed to bring to the surface the conflicts of the unconscious mind to help find the reason for their disturbance. Patients revealed their unconscious conflict through communicating. The Austrian psychoanalyst's work changed the whole approach to mental illness, as for the first time symptoms had meaning and the mentally unwell were seen as sick rather than strange.

Freud by Max Halberstadt, 1921

The actor Alan Alda's upbringing was difficult, as his mother had paranoid schizophrenia. The first line of his autobiography reads: "My mother didn’t try to stab my father until I was six."

The parents of Brazilian author Paulo Coelho were so concerned about his stated dream of being a writer that they put him in a mental institution three times. He wrote a book about it, Veronika Decides To Die, 35 years later.

A study found that rates of mental illness in New Orleans doubled after Hurricane Katrina, largely due to PTSD.

13.6 million Americans live with a serious mental illness.

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