History of mental disorders

The history of mental disorders have long been a process of trial and error guided by public attitudes and medical theory with each society developing its own responses. By tracking these developments, a deeper understanding of human interaction and acceptance of this disability can be gathered.

Ancient Egypt

With the first "great civillization," that of the Ancient Egyptians, came the first signs of change in the treatment of the mentally ill. Egypt, like the early stone-age societies (and indeed most societies for the next 3-and-a-half millennia), regarded mental illness as magical or religious in nature. Egyptian psychiatric theory was deeply rooted in the Egyptian conception of the self – the khat (the body), the ka (one’s guardian spirit, who guides the individual to the afterlife), and the ba (symbolized by a bird carrying the key to eternity, which leaves the body after death and resides in heaven), all playing their part in the cyclical nature of life and death. The societal obsession with death and life after death meant that the health of the mind or soul played an essential part in one’s overall health. In Ancient Egypt the first known psychiatric text (written around 20th century BC which explains the causes of "hysteria"), the first known mental hospital (a temple complex near modern Saqqara which is thought to be meant for the treatment of the mentally ill), and the first known mental physician are found in history. The Egyptian focus on the well-being of the soul is embodied in the Temple of Imhotep at Memphis in the 29th century BC, a popular center for the treatment of mental illness. Methods used to attempt to cure the mentally ill included using opium to induce visions, performing rituals or delivering prayers to specific gods, and "sleep therapy," a method of interpreting dreams to discover the source of the illness. Egyptian society, with its fixation on the health of the soul, is the first major example of mental healthcare as a major priority for a society in history.

Ancient Judaism

The concept of a single God as articulated in Judaism paved the way for a shift in views on mental health. While still almost completely religious in nature, the adoption of monotheism allowed for the idea that mental illness was not a problem like any other, caused by one of the gods, but rather caused by problems in the relationship between the individual and God, in some sense (to put it in modern terms) self-conflict or repressed guilt. Although the origin of the Israelite tribes have been dated to the late 2nd millennium BC, the májor period of growth for Judaism occurred in the 6th century BC, when the Kingdom of Judah was conquered by Babylon and exiled to the Babylonian kingdom. On the waters of the Euphrates, the rabbis of the remaining tribes formulated for the first time a cohesive Jewish identity and doctrine, revitalizing monotheism in the face of ideological opposition. To the Hebrews, mental health (spiritual health), was the key to righteousness and to God. By formulating this new concept of a monotheistic, and in many ways, personal deity, the ancient Hebrews moved the idea of mental health away from mysticism and into organized religion.

Medieval Islam

Main article: Muslim psychology

Muslim psychology

More than a thousand years later, Islam was beginning to spread across the Arabian Peninsula and across Asia and into Africa and parts of southern Europe. Like Judaism, Islam stressed the need for individual understanding of their mental situation. Unlike most ancient and medieval societies which believed mental illness to be caused by either demonic possession or as punishment from a God, Islamic neuroethics held a more sympathetic attitude towards the mentally ill, as exemplified in Sura 4:5 of the Qur'an:

"Do not give your property which God assigned you to manage to the insane: but feed and cloth the insane with this property and tell splendid words to him."

This Quranic verse summarized Islam's attitudes towards the mentally ill, who were considered unfit to manage property but must be treated humanely and be kept under care by a guardian, according to Islamic law. This positive neuroethical understanding of mental health consequently led to the establishment of the first psychiatric hospitals in the medieval Islamic world, and an early scientific understanding of neuroscience and psychology by medieval Muslim physicians and psychologists, who discovered that mental disorders are caused by dysfunctions in the brain.

Important medieval Muslim psychologists included Muhammad who discussed mental health and mental illness; al-Kindi (Alkindus) who was a pioneer of psychotherapy and music therapy; Ali ibn Sahl Rabban al-Tabari who was a pioneer of clinical psychiatry and clinical psychology, Ahmed ibn Sahl al-Balkhi who was a pioneer of medical psychology, cognitive psychology, cognitive therapy, psychophysiology and psychosomatic medicine; al-Farabi (Alpharabius) who was a pioneer of social psychology; Ali ibn Abbas al-Majusi (Haly Abbas) who was a pioneer of neuroanatomy and neurophysiology; Abu al-Qasim al-Zahrawi (Abulcasis) who was a pioneer in neurosurgery; Ibn al-Haytham (Alhazen) who was a founder of experimental psychology and psychophysics; Abū Rayhān al-Bīrūnī who was a pioneer in experimental psychology for accurately describing reaction time; Avicenna (Ibn Sina) who was a pioneer of physiological psychology and neuropsychiatry; Ibn Zuhr (Avenzoar) who was pioneer of neurology and neuropharmacology; and Averroes who accurately described Parkinson's disease.

Psychiatric hospitals

As a result of the new positive Islamic understanding of mental illness, the first psychiatric hospitals and insane asylums were built in the Islamic world as early as the 8th century. The first psychiatric hospitals were built by Arab Muslims in Baghdad in 705, Fes in the early 8th century, and Cairo in 800. Other famous psychiatric hospitals were built in Damascus and Aleppo in 1270.

The Arabic physician Rhazes wrote the landmark texts El-Mansuri and Al-Hawi in the 10th century, which presented definitions, symptoms, and treatments for many illnesses, including mental illnesses, and also ran the psychiatric ward of a Baghdad hospital. Such institutions could not exist in Europe at the time because of fear of demonic possessions. In the centuries to come, Islam would eventually serve as a critical way station of knowledge for Renaissance Europe, through the Latin translations of many scientific Islamic texts.

Medieval Europe

Middle Ages

Mental illness in the Middle Ages was very often diagnosed as witchcraft. Those found acting irrationally or suffering hallucinations were thought to be possessed and were subsequently tortured and usually killed. The definitive guide to diagnosis at the time was the Malleus Maleficarum. Recent psychologists have read case studies of proposed witchcraft and have suggested explanations like ergot poisoning.

Asylums

Occurring with the Renaissance, the legislation of witchcraft diminished and was replaced with insane asylums. Treatment in asylums was very poor, often secondary to prisons. The most well known of these asylums was Bedlam where at one time spectators could pay a penny to watch the inmates as a form of entertainment.

Moral reform in Europe

Nearing the turn of the nineteenth century, psychologists and activists began the reform to treat the mentally ill humanely. Notable people include Phillipe Pinel, Johann Guggenbuhl, William Tuke, and Dorothea Dix. Providing a supportive environment for the mentally ill saw great success and these individuals are credited with the development of clinical psychology.

Modern medicine

By the turn of the twentieth century, psychologists were in seeking medical treatments for most mental illness. Early forms included bloodletting, and spinning; later forms included electro convulsive therapy, and lobotomies. Walter Freeman wrote in the 1940’s, that lobotomies would: “Make good American citizens of society’s misfits, schizophrenics, homosexuals, and radicals”. Psychoactive drugs began being administered in the middle decades of the twentieth century. Chlorpromazine was widely used in Europe and the United States to treat schizophrenia. Lithium began being used in the 1960s to treat manic depression. The use of medical drugs has greatly decreased the need for asylums.

See also

• Asylums, Bedlam and mental hospitals
• Sigmund Freud and psychoanalysis
• Neurology
• Development of psychiatric medications
• Care in the community
• Eugenics and the targeting of the mentally ill for extermination
• Psychiatric survivors movement
• DSM-IV Codes
• Structured Clinical Interview for DSM-IV (SCID)

External links

• Ohio University - The History of Mental Illness