Jared Wilson
Biol 4500
Paper 2

The history of mental illness or associated disorders is one that I believe cannot be said to say that we have learned from our mistakes. While the saying “learn from the past, or we are doomed to repeat it” is one which seems to rarely apply in any political / social standpoint, so too does it rarely apply in mental illness stigmatisms. However despite the millennia which have passed for humans on this planet, we still know very little about certain mental disorders. While substantial progress has been made in the diagnosis and treatment of most illnesses, there are still a few practices, stereotypes, and behaviors associated to mental depravities.

Looking into the past, references and dialogues of mental illness can be found throughout the ages. Interestingly, certain behaviors during different eras were considered abnormal or normal depending on the context surrounding the individual. In 2016 nearly anything is possible, but we are probably unlikely to see the return of bonnets and other pilgrim clothing. Yet this stark example highlights a trend in fashion, the cyclical nature of history doomed to repeat itself. Certain fads are appropriate, lose popularity, and then regain their former glory. So too are mental illnesses often scattered throughout history as being of extreme importance, to falling as little more than a nuisance. However, this cultural relativist view has become less and less regarded in the modern science era.

Today, rather than diagnosing the mentally ill as those whose behavior deviated from the sociocultural norm and expectation; we instead focus on whether that behavior poses a threat to oneself or others via pain or suffering to provide important life relationships.

Generally speaking there have been three theories which have emerged throughout history. Mental illness etiology has either been supernatural, somatogenic, and/or psychogenic. Supernatural theories suggest that mental illness and accompanying symptoms were related to the ‘spirits’ in some way. Whether it be evil possession, godly displeasure, planetary alignment, curses, magic, or other ritualistic beliefs, people were concerned for the individual’s ‘soul’. The other two theories, while both have correct concepts were not widely accepted until the turn of the early centuries for many societies. Somatogenic theories explain that physical malfunctions are a cause of sickness, genetic inheritance, brain injury or the inability to maintain homeostasis during stress. Lastly, psychogenic views focus on traumatic or extreme situations, learned associations and beliefs or imbalanced perceptions.  Depending on the learning of the society, and the era in which the individual was born determine which etiological approach would provide treatment.

For example, in ancient Mesopotamia, priests and doctors were often one in the same. These men treated the mentally ill with rituals believed to mask demonic possession. Exorcisms, incantations, summoning, and other mystical practices were used to ward off the evil spirits. While mysticism failed, bribery, threats, bible reading and even self-harm were other forms of appeasing or destroying the invaders. Not far from Mesopotamia the Hebrews held similar beliefs, however, rather than believing that illness was caused by evil spirits, they felt it was punishment by God. These sicknesses were given both as trials of faith as well as punishment for sin.

While intensive improvements to the diagnosis, treatment, and understanding of mental illnesses weren’t made until much later, the ancient Egyptians seemed to be on the right path. Their treatment of mental disorders recommended the afflicted should be integrated into society. They believed that engaging in recreational activities would provide the spirit ample opportunities to cure the body. They felt that individuals with these disorders were at a form of physiological imbalance, and wished to provide them as much extrovert normalcy as possible. This is a view held similarly by the Chinese. Their medicine was a concept of “yin and yang”, complementary positive and negative energy which were attributed to mental and physical forces and the intricate balance between them.   However, the Egyptians were also very advanced during their time for thinking in terms of medicine, surgery, and their understanding of the human body. Early papyri have been identified as early as 1600 B.C. which detail treatments of wounds, surgical techniques, and maps which centered mental functions on the brain. However, given their polytheistic views, magic and other religious practices were also used to treat illnesses of unknown origin.

Yet these civilizations eventually began to merge from mysticism and spiritual diagnoses to physiological. Trephination is an early example of the shift from magical to surgical, as it was focused on one by using the other. Trephination in simple definition is the drilling of holes in a skull to provide an exit for trapped spirits within the mind. Other “medical” diagnoses were mental illnesses resulting from a wandering uterus. This was later named hysteria by the Greeks, and obviously only occurred in women. (While its medical significance is completely inaccurate, the term hysteria and women seems a correct pairing to me.) This wandering uterus disorder was believed to detach and become stuck to other organs in the body. To prevent this Egyptians and Greeks employed a somatogenic treatment of smoke. They believed that in proper conjugation with each other pleasant incenses and pungent smokes could move the uterus to a desired location.

When these treatments routinely proved ineffective, a return to supernatural theory was almost inevitable. However Greek physicians began to set the bar higher just a few hundred years before the turn of the millennia. Their efforts were focused on systemizing the belief that deficiency in or excess in bodily energies were responsible for bodily malfunctions. Attempting to separate religion from science they believed the body was comprised of four major fluids (humors), blood, yellow bile, black bile, and phlegm. These four substances were responsible for maintain homeostasis in mental and physical attributes. Whether you were deficient or overabundant in a certain substance would determine your symptoms and treatment.  Until this point in time, those who were mentally ill were deemed a shame to the family or a dishonor upon a household. However the Greek philosopher Hippocrates and many others of his time did not believe that mental illness was shameful or that ill individuals should be responsible for their actions. Mentally ill individuals began to be cared for by families, rather than hidden away. The philosophy of humorism remained a recurrent theme even until the 18^th century.

However, as early as the 16^th century the modern treatment of the mentally ill patients began to emerge.  Hospitals and asylums both private and public were beginning to crop up all over the world. These institutions were often nothing more than a prison to confine the ill, poor, homeless, unemployed, and destitute.  Confinement laws were in placed in efforts to protect the public from the mentally ill. They saw these people as undesirables within society and commonly exhibited deplorable living conditions for those they housed.

So what has changed? In today’s world of hospitals, tests, modern science, experiments, and ‘learned’ men, how are we diagnosing and treating the mentally ill?

Well, while the history is both entertaining and abhorring to study, the present isn’t always much better. A mental health diagnosis today involves a variety of steps. If no underlying other illness is found by an evaluating physician then an individual is sent to another mental health professional. Typically evaluations consist of questions about symptoms and relevant medical history. While we still do not have many tests to provide evidence for mental illness, doctors often use a variety to make sure another sickness isn’t causing the symptoms. Providing this information is important for the next step as individuals will be assessed by professionals who are trained to treat mental disorders, such as psychiatrists and psychologists.

Where in ancient times, spiritual, religion, and other forms of bodily belief were used to provide insight to the mind; we have at least gotten this right that many problems with the mind, originate in the mind. Yet in my mind, and in many of the things we see in today’s society, while our diagnosis and treatment has improved, our behavioral stereotypes have not. We may provide ample care, and cushy living conditions for those afflicted by the disorders but we still have the same problem, what to do with it, and them? Mentally illnesses are rarely predicted, whether they be behavioral or genetic. Extra chromosomes, deleting telomeres, or other forms of degenerative brain disease such as Alzheimer’s, dementia, Huntington’s disease, are still incurable. We are just as confounded by how to help them as the ancient Egyptians, Mesopotamians, and Greeks!

While we are able to advance upon the scientific ideas once held by societies thousands to hundreds of years ago, we have still so much time to go. History can teach us much about the present and even the future. However, while it can illuminate the mistakes, it cannot provide the answers. Science has been able to do so much, such as isolating the genomes of certain disorders, such as Huntington’s disease. This particular degeneration of an individual is extensive, fatal, and inevitable to one who is diagnosed. Alzheimer’s, a dreaded degeneration of the mind by all who know of it, is something that scientists are still working to research. While plausible mechanisms and causes are often found for mental disorders, degenerations, and other illnesses, we struggle to find a solution. This is to be expected, it may take many years, decades, centuries, who knows? However, I believe that connecting our history to our science is important because we can learn from the mistakes. Given that it may take us many years before we eliminate the disorders and illnesses of the mind, we should work to improve the behavior of those who are NOT afflicted.  Sociocultural norms are always changing. Just as fashion and fads was used as an example before, let us turn that to a perspective on mental health. Until recently many disorders such as addiction, depression, or ADD/ADHD were considered to be behavioral choices / learned personalities. We now recognize them and many others for what they truly are. Of those just mentioned, we have learned through research that chemical imbalances within the brain are easily found and manipulated resulting in a plethora of symptoms.

 However, the sciences will work themselves out as researchers and studies continue to shed light into the causes, symptoms, and possible cures. I think it is our duty to change the sociocultural norms affixed to the mentally ill and degenerate. They are still our family, friends, and loved ones, and despite the conditions they are in I think the Egyptians had it right when they incorporated them into their daily lives. Let us not build institutions and facilities for each individual we deem ‘undesirable’ by a society addicted to success. I think it is important to redefine our terms of success, by caring for those who can’t care for themselves, both scientifically and behaviorally.