History of mental illness

Historically, mental disorders have had three major explanations, namely, the supernatural, biological and psychological models. For much of recorded history, deviant behavior has been considered supernatural and a reflection of the battle between good and evil. When confronted with unexplainable, irrational behavior and by suffering and upheaval, people have perceived evil. In fact, in the Persian Empire from 550 to 330 B.C., all physical and mental disorders were considered the work of the devil. Physical causes of mental disorders have been sought in history. Hippocrates was important in this tradition as he identified syphilis as a disease and was, therefore, an early proponent of the idea that psychological disorders are biologically caused. This was a precursor to modern psycho-social treatment approaches to the causation of psychopathology, with the focus on psychological, social and cultural factors. Well known philosophers like Plato, Aristotle, etc., wrote about the importance of fantasies, dreams, and thus anticipated, to some extent, the fields of psychoanalytic thought and cognitive science that were later developed. They were also some of the first to advocate for humane and responsible care for individuals with psychological disturbances.

Ancient period

There is archaeological evidence for the use of trepanation in around 6500 BC.

Mesopotamia

Mental illnesses were well known in ancient Mesopotamia, where diseases and mental disorders were believed to be caused by specific deities. Because hands symbolized control over a person, mental illnesses were known as "hands" of certain deities. One psychological illness was known as ''Qāt Ištar'', meaning "Hand of Ishtar". Others were known as "Hand of Shamash", "Hand of the Ghost", and "Hand of the God". Descriptions of these illnesses, however, are so vague that it is usually impossible to determine which illnesses they correspond to in modern terminology. Mesopotamian doctors kept detailed record of their patients' hallucinations and assigned spiritual meanings to them. A patient who hallucinated that he was seeing a dog was predicted to die; whereas, if he saw a gazelle, he would recover. The royal family of Elam was notorious for its members frequently being insane. Erectile dysfunction was recognized as being rooted in psychological problems.

Egypt

Limited notes in an ancient Egyptian document known as the Ebers papyrus appear to describe the affected states of concentration, attention, and emotional distress in the heart or mind. Some of these were interpreted later, and renamed as hysteria and melancholy. Somatic treatments included applying bodily fluids while reciting magical spells. Hallucinogens may have been used as a part of the healing rituals. Religious temples may have been used as therapeutic retreats, possibly for the induction of receptive states to facilitate sleep and the interpretation of dreams.

India

Ancient Hindu scriptures-Ramayana and Mahabharata-contain fictional descriptions of depression and anxiety. Mental disorders were generally thought to reflect abstract metaphysical entities, supernatural agents, sorcery and witchcraft. The Charaka Samhita from circa 600 BC, which is a part of the Hindu Ayurveda ("knowledge of life"), saw ill health as resulting from an imbalance among the three body fluids or forces called Tri-Dosha. These also affected the personality types among people. Suggested causes included inappropriate diet, disrespect towards the gods, teachers or others, mental shock due to excessive fear or joy, and faulty bodily activity. Treatments included the use of herbs and ointments, charms and prayers, and moral or emotional persuasion. In the Hindu epic Ramayana, the Dasharatha died from despondency, which Shiv Gautam states illustrates major depressive disorder.

China

The earliest known record of mental illness in ancient China dates back to 1100 B.C. Mental disorders were treated mainly under Traditional Chinese Medicine using herbs, acupuncture or "emotional therapy". The Inner Canon of the Yellow Emperor described symptoms, mechanisms and therapies for mental illness, emphasizing connections between bodily organs and emotions. The ancient Chinese believed that demonic possession played a role in mental illness during this time period. They felt that areas of emotional outbursts such as funeral homes could open up the Wei Chi and allow entities to possess an individual. Trauma was also considered to be something that caused high levels of emotion. Thus, trauma is a possible catalyst for mental illness, due to its ability to allow the Wei Chi open to possession. This explains why the ancient Chinese believed that a mental illness was in reality a demonic possession. According to Chinese thought, five stages or elements comprised the conditions of imbalance between Yin and yang. Mental illness, according to the Chinese perspective is thus considered as an imbalance of the yin and yang because optimum health arises from balance with nature.

China was one of the earliest developed civilizations in which medicine and attention to mental disorders were introduced (Soong, 2006). As in the West, Chinese views of mental disorders regressed to a belief in supernatural forces as causal agents. From the later part of the second century through the early part of the ninth century, ghosts and devils were implicated in "ghostevil" insanity, which presumably resulted from possession by evil spirits. The "Dark Ages" in China, however, were neither so severe (in terms of the treatment of mental patients) nor as long-lasting as in the West. A return to biological, somatic (bodily) views and an emphasis on psychosocial factors occurred in the centuries that followed. Over the past 50 years, China has been experiencing a broadening of ideas in mental health services and has been incorporating many ideas from Western psychiatry (Zhang & Lu, 2006)

Greece and Rome

In ancient Greece and Rome, madness was associated stereotypically with aimless wandering and violence. However, Socrates considered positive aspects including prophesying (a 'manic art'); mystical initiations and rituals; poetic inspiration; and the madness of lovers. Now often seen as the very epitome of rational thought and as the founder of philosophy, Socrates freely admitted to experiencing what are now called "command hallucinations" (then called his 'daemon'). Pythagoras also heard voices. Hippocrates (470–) classified mental disorders, including paranoia, epilepsy, mania and melancholia. Hippocrates mentions the practice of bloodletting in the fifth century BC.

Through long contact with Greek culture, and their eventual conquest of Greece, the Romans absorbed many Greek (and other) ideas on medicine. The humoral theory fell out of favor in some quarters. The Greek physician Asclepiades (–40 BC), who practiced in Rome, discarded it and advocated humane treatments, and had insane persons freed from confinement and treated them with natural therapy, such as diet and massages.Stewart, Tanya. We Are Many.page 58, Arateus (–90 AD) argued that it is hard to pinpoint from where a mental illness comes. However, Galen (129–), practicing in Greece and Rome, revived humoral theory. Galen, however, adopted a single symptom approach rather than broad diagnostic categories, for example studying separate states of sadness, excitement, confusion and memory loss.

Playwrights such as Homer, Sophocles and Euripides described madmen driven insane by the gods, imbalanced humors or circumstances. As well as the triad (of which mania was often used as an overarching term for insanity) there were a variable and overlapping range of terms for such things as delusion, eccentricity, frenzy, and lunacy. Roman encyclopedist Celsus argued that insanity is really present when a continuous dementia begins due to the mind being at the mercy of imaginings. He suggested that people must heal their own souls through philosophy and personal strength. He described common practices of dietetics, bloodletting, drugs, talking therapy, incubation in temples, exorcism, incantations and amulets, as well as restraints and "tortures" to restore rationality, including starvation, being terrified suddenly, agitation of the spirit, and stoning and beating. Most, however, did not receive medical treatment but stayed with family or wandered the streets, vulnerable to assault and derision. Accounts of delusions from the time included people who thought themselves to be famous actors or speakers, animals, inanimate objects, or one of the gods. Some were arrested for political reasons, such as Jesus ben Ananias who was eventually released as a madman after showing no concern for his own fate during torture.

Israel and the Hebrew diaspora

Passages of the Hebrew Bible

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