Time Traveling with Depression: Stigma’s Story, Pt 2

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Stigma is a problem for many people with depression or other mental health diagnosis. Even if we intellectually know it is not a fault or weakness, we still may react to the diagnosis as if it were. Taking a quick peek at the perception of depression through history helps make it clear why the stigma of mental illness is so darn stubborn.


Part 1 of this article scanned attitudes about depression from the ancient world up to the Age of Enlightenment. Now, onward . . .

Age of Enlightenment

The Age of Enlightenment refers to the 18th century, give or take 50 years, in Europe and the colonies on North America. This was a time in history when human reason, and science challenged the inequality and superstitions of religion and government.

Some enlightened doctors and scientists considered depression to be the result of an inner battle between a person’s conscience and their immoral or unethical impulses. Medical advances led others to suspect physical causes.

There was also a group that believed aggression was the source of depressive symptoms. Their suggested treatments were music, exercise, medicine, healthy diet, and talking to someone trustworthy about the problems (imagine that).

As the 18th century was ending several new treatments were being used such as spinning people on a stool to make them dizzy, causing elements of the brain to slosh back to their original, healthy positions.

Another likely terrifying intervention was holding people underwater until they were just short of drowning. Ben Franklin put his kite experiment to good use and came up with a form of electroshock treatment.

Unfortunately, most people who needed help were kept at home or housed in abysmal institutions and received no treatment, enlightened or otherwise.

The 19th and 20th Centuries

In 1895, Emil Kraepelin created a spot for himself in history. This German psychiatrist defined the mental illness schizophrenia after determining its cluster of symptoms. Sigmund Freud introduced the world to his psychodynamic theory of mental illness that suggests internal conflicts within an individual are the source of psychological problems.

While some doctors considered depression a physical brain disorder, Freud thought it was a person’s unconscious angry reaction to loss that ultimately weakened their ego and resulted in self-deprecation. Freud’s recommended treatment was talk therapy which he practiced.

Even into the 20th century, some treatments for severe depression and other mental illnesses were barbaric from our perspective. Lobotomies, the surgical destruction of the frontal cortex, were performed because they effectively calmed difficult patients. Though it also ruined patients’ higher executive and emotional brain functioning, it was considered a medical advance at the time by many physicians.

Electroshock therapy was used to treat people with schizophrenia and depression. Although there was some success, it also proved to be debilitating when used frequently. It is still administered today although in a kinder and gentler form.

The 1950s can be considered the dawn of a new age for mental health treatment. The use of medication was gathering steam, and new psychological theories and therapies were being developed that focused on behavior and thought process; much still relevant today.

And Now

Underneath the slow advances in depression and mental illness treatment, many people suffered from other’s fear, ignorance, superstition, ill-fated medical treatments, poverty, or lack of funding for adequate services. While the situation has improved, fear, ignorance, and the lack of treatment availability (in some areas) continues.

Historically, changes in attitude happen slowly and are only evident when looking at differences from one generation to the next. Although change is not always apparent, today's treatments for mental health problems may someday appear archaic and the stigma of having a diagnosis will be history.

Source:
Nemade, Rashmi PhD, Staats Reiss, Natalie PhD, and Dombeck, Mark PhD. 2007. Historical Understandings of Depression.http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=12995&cn=5

 
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