A history of mental health

It would be almost impossible to give an entire history of mental health, but I will give it my best shot. It’s important to know our history and what we may face today because of it. I hope this is insightful and promising.

Ancient civilizations

In Ancient India, mental health was viewed as a balance between body, mind, and spirit. Ancient China believed it was harmony between yin and yang, Qi (vital energy), and the body’s organ systems. Ancient indigenous and tribal societies believed mental well-being was connected to community, family, nature, and a spiritual life. Mental illness was often understood as the result of angry gods, demons or evil spirits, and curses or broken religious principles. In ancient Greece, Hippocrates did believe that mental illness was part of the brain and not evil spirits. In ancient India, it was believed that imbalances in bodily energies, emotional excess, trauma, and spiritual causes caused mental illness. Treatment usually involved rituals or prayers, exorcisms, and herbal remedies. In Ancient Egypt, treatment also included relaxation and music. Ancient Greece did recognize that diet changes, exercise, and sleep improved mental illness. In Ancient Rome, Galen emphasized healthy routines, emotional balance, physical health, and education. There was also some form of talk therapy. In Ancient India, meditation and yoga were also recognized. Ancient China also used acupuncture and breathing exercises. Medical texts in this age did detail depression, anxiety, confusion, and memory problems. In Mesopotamia, healers documented symptoms and acknowledged patterns.

The Middle Ages (500-1500)

Many of the strategies and beliefs about mental health varied based on the region. Most mental health cases were attributed to demonic possession and people were treated harshly. Even though religious beliefs were influential, there were medical traditions from Ancient Greece and Rome. During this time, physical health was considered in mental health treatment. Patients may seek clergy for prayer or spiritual guidance, physicians for herbal remedies, and family or community for care. In later years (11th-15th centuries), universities and medical schools became more common. Physicians started to treat patients with dietary changes, rest, herbal medicines, and baths. Alongside this, there were still religious beliefs that believed in demonic possession, spiritual struggle, and divine punishment. During this time, you started to see hospitals that took in mental health patients, but they were mostly mistreated. Care depended on the severity of symptoms, family resources, local customs, and religious institutions. In Europe, if not taken in by a hospital or monastery, patients could be excluded or punished. During the Islamic Golden Age, scholars described mental illness in medical terms, and treatment included conversation, music therapy, baths, medications, and structured daily routines.

The Renaissance and Early Modern period (1400-1800)

There was a really big change in the perception of mental health during this period. Physicians began to document symptoms, compare different mental disorders, and look for natural rather than supernatural causes. Mental disorders like depression and mania were viewed as medical conditions, but there was still a strong religious belief. Treatments included dietary changes, exercise, herbal medicines, rest, and baths. In the 15th and 17th centuries, there was the rise of the witch trials where many with mental illness symptoms were thought to be witches and killed. This was driven by religious conflict, social tensions, political pressures, personal disputes, and gender bias. In the 16th and 17th centuries, specialized institutions called asylums began to form and it was documented that most patients were treated poorly. There was overcrowding, physical restraints, little effective treatment, and loss of personal freedom. During this time, there was a scientific revolution that encouraged observation, experimentation, and skepticism of traditional beliefs. By the late Early Modern period, enlightenment reforms promoted reason, science, and human rights. This is when many started advocating for mental health patients and humane treatment.

Late 1800s to early 1900s

In the late 1800s and early 1900s, psychiatry became a recognized medical specialty, psychology became a scientific discipline, and researchers began developing ways to diagnose and treat mental illness. At the same time, institutions still had poor conditions for patients, and unethical practices were still used. Individuals against institutions advocated for better hospital conditions, public education, prevention of mental illness, and community-based care. Psychiatrists began to classify different mental disorders, study patients over a long period of time, look for biological, psychological, and environmental causes, and develop specialized hospitals and clinics. Famously, Sigmund Freud developed psychoanalysis and proposed that much of human behavior is influenced by unconscious thoughts, childhood experiences shape adult personality, and talking about thoughts and emotions can relieve symptoms. During this time, World War I also had an impact on the understanding of mental health. Soldiers came home with tremors, anxiety, nightmares, emotional numbness, and difficulty functioning. This led psychiatrists to research and define PTSD. Treatments included rest and structured routines, occupational therapy, hydrotherapy, sedatives, and talk therapy. Controversial treatments included insulin coma therapy, ECT, and psychosurgeries. This period of time did investigate biological theories on brain function and heredity and led to behavioral and cognitive theories explaining how learning and thought patterns affect mental health.

1950s to the 1990s

This time period transformed mental health care more than any other era. It was the start of the psychiatric medication revolution. Antipsychotics, antidepressants, mood stabilizers, and anti-anxiety medications were all created. It was also a time of protecting patient rights, integrating patients into their community, and focusing on outpatient care. There was also a community mental health movement that opened health centers for patients with mental illness. Psychotherapy also expanded during this time and there was access to cognitive behavioral therapy (CBT). Other details of this time included advances in neuroscience, better diagnoses, and mental health advocacy.

21st century

It is now acknowledged that mental health rarely has a single cause, and there are biological factors (genes, brain chemistry, physical health), psychological factors (thoughts, emotions, coping skills), and social factors (relationships, trauma, poverty, discrimination, culture). Today’s approach includes psychotherapy, medication, lifestyle interventions, peer support, family involvement, social services, and treatment for co-occurring physical health conditions.

If you have a mental illness, please know that you are legally protected from discrimination, have employment protections, healthcare rights, and privacy protections.

xoxo