Depression is a mental illness that has been around for centuries. It is characterized by feelings of persistent sadness, hopelessness, and a negative outlook on life.
People with depression tend to lose interest in activities they once enjoyed and may have difficulty functioning in their everyday lives. According to the World Health Organization (WHO), depression is one of the leading causes of disability globally.
The Earliest Accounts Of Depression
The earliest documented cases of depression can be traced back to Mesopotamia in the 2nd millennium B.C.E. According to these ancient writings, mental illness was, at the time, thought to be caused by evil spirits or demonic possession. As a result, the mentally ill were subjected to beating, bloodletting, starvation, and other harsh punishments.
Ancient Greeks, on the other hand, believed that depression (or melancholia as they called it), was the result of humoral imbalance, in this case – too much black bile in the body. This theory was developed by Hippocrates, an ancient Greek physician, and became widely accepted for centuries.
The rise of Christianity in the 11th century popularized the belief that mental illness was caused by demonic possession, witchcraft, or evil spirits. This notion fueled further ill-treatment of persons with mental illness, as they were considered pariahs or outcasts. Burning, exorcism, and drowning were standard practices at the time.
The Renaissance and the Age of Enlightenment
During the renaissance era, some experts began to challenge the idea that mental illness was spiritual. One of the first people to suggest an alternative theory was Thomas Willis, an English physician and one of the pioneers in neuroanatomy.
According to Willis, melancholia was caused by pathological brain morphology or other physical conditions. In 1621, English scholar Robert Burton theorized that melancholia was caused by psychological and physical factors – in his book “Anatomy of Melancholy.”
Despite these more progressive theories, the treatment for melancholia remained largely archaic. It was not until the 19th century that attitudes towards mental illness began to change. This period saw a rise in scientific thinking, and a greater emphasis was placed on reason and evidence.
This led to new theories about melancholia and new ways of treating the condition. One of the most influential figures during this period was French physician Philippe Pinel, who challenged the treatment of melancholia through humoral treatments such as purging and bloodletting in favor of psychological-based treatments.
Benjamin Rush, the so-called father of American psychiatry, also popularized the idea that mental illness was caused by neurological problems and advocated for psychological treatments.
The 20th Century and Beyond
In the early 20th century, German psychiatrist Emil Kraepelin played a key role in advancing the understanding of mental illness. His dual-factor theory proposed there were two types of melancholia: manic-depression (now known as bipolar disorder) and dementia praecox (now known as schizophrenia).
Around the same time, Austrian neurologist Sigmund Freud published his theory stating that melancholia was caused by the loss of a loved one or some other significant event. Freud’s theory was based on his clinical observations and is still influential today.
But it was Adolf Meyer – a Swiss psychiatrist, who observed that depression resulted from a combination of biological, psychological, and social factors. He would go on to become the first director of Johns Hopkins Hospital’s Department of Psychiatry and later the president of the American Psychiatric Association.
Meyer’s work was not only instrumental in laying the foundation for the modern understanding of depression, but also in the development of the biopsychosocial model, which forms the backbone of modern healthcare.
The Development of a Mental Health Classification System
With so many theories about depression and other mental illnesses towards the mid-20th century, it was clear that there was a need for a way to classify different types of mental illness.
This led to the publication of the first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-I) in 1952. The DSM is a classification system used by mental health professionals in the United States to diagnose mental illnesses.
Since then, the DSM has been updated periodically to reflect recent research and findings about mental illnesses, including various forms of depression.
We’ve come a long way since depression was first recorded in Mesopotamia and other ancient civilizations. However, there is still much to learn about this complex mental illness and its treatments.