“Everyone ‘these days’ has got depression.”
“We used to just call it being sad – I didn’t need to pop pills after [insert traumatic event].”
“People in America only think they’re depressed. Try being in a third-world country. I went to Africa on a mission trip and everyone was so much happier. Maybe it’s because everything is simpler there, or people are more grateful.”
“Americans eat too much fast-food and spend all their time on their phones. Want to be happy? Go outside and get some exercise!”
“People would rather take medicine than deal with their problems, and that’s really sad.”
Have you ever heard any of these lines?
Have you ever said any of these lines?
The number of people being treated for mental illness is on the rise. Now, science tells us that we can’t confuse incidence with diagnosis: just because a disease is being diagnosed more, it doesn’t mean it is actually happening more. We might just be more aware of it than we were. Our standard of living is better than it has been, and maybe we’re just less willing to put up with debilitating fear and depression than our forefathers were.
But if you read the comments on any article about anxiety, depression, or any other mental disorder, you get the sense that there’s a large group of people who just want you to get over it. They think that depression and anxiety and schizophrenia are modern conditions, caused by a society of smart-phones and easy answers and divorced parents and gay marriages. They think that doctors give out drugs like candy and that there is a cabal of psychiatrists and psychologists who profit from this new “American hypochondria.” They will tell you that people weren’t depressed during the Great Depression, that no one had anxiety during Vietnam, and that the cure for all ills is taking walks in the sunshine, turning your phone off, and being grateful for what you have. People who are not doctors will tell you that you don’t need medication. People who are not psychiatrists or psychologists will tell you that you don’t need therapy. In short, if you can’t manage your life, then it is your fault, and America is riddled by people who can’t manage their lives.
Let’s get one thing straight: mental illness is not new.
The Ancient Greek physician Hippocrates hypothesized that mental illness was a biological, not spiritual, condition in 400 BC. If the name Hippocrates sounds familiar to you, it’s because doctors to this day take the Hippocratic Oath. Hippocrates is possibly the most influential figure in Western medicine.
Anyone versed in medieval literature is familiar with the humors. I don’t mean Eddie Izzard. For those of you who aren’t gigantic nerds, the humors are bodily fluids that ancient and medieval doctors and scientists theorized were responsible for various aspects of personality. The big four are black bile, yellow bile, phlegm, and blood – they represent the four major temperaments, or moods. If a person is healthy, then Hippocrates theorized that all four humors are balanced. An imbalance in the humors caused any number of personality issues – what we now think of as mental disorders.
Melancholy or melancholia was one such condition. A person suffering from melancholia (comparable, though not completely, with modern-day depression) was thought to have an excess of black bile. They were often despondent and prone to uncontrollable mood swings. Now, modern medicine has punctured the theory that the body is made up of four fluids. We also no longer believe that blood causes anger or phlegm causes apathy. I think the hypothesized cause of mental illness is a lot less important than the fact that doctors were asking questions in the first place.
What does this mean? It means that even though ancient and medieval doctors weren’t able to see inside the body and the brain – like we can now – they accepted that there is a distinct link between our mental health and our physical one. The ancient Greeks also tried to treat mental illness using herbs and therapeutic activities.
The smartest people in the world have been treating mental illness as a biological condition for thousands of years.
Let that sink in.
Not only did ancient and medieval doctors try to treat mental illness, but authors also featured people with mental illness in some of the most famous works in the Western canon. You can’t read Hamlet without thinking the Prince of Denmark’s life would be better if Elsinore had a grief counselor on hand. Poets like Goethe explored the “melancholic” temperament that led young men to commit suicide for love or grief. People with mental illness are everywhere in literature and history. Abraham Lincoln wrote often of his depression and suicidal thoughts. Winston Churchill called his recurring depression his “Black Dog.” Leo Tolstoy suffered from “hypochondriasis,” a constant fear of illness. And there are more.
We live in a linked-up society, in which we know far more people than ever before. Our social networks are a web that stretches wider than the village or city block of our grandparent’s day. Of course we’re going to know more people who suffer from mental illness. Not only that, but we are privy to a host of information – constantly streaming – that makes it seem like we’re in the endtimes when it comes to mental health. But it’s simply not so. Go through any Southern family album with a grandparent. Do it. I dare you. You’ll hear all about Cousin Louis, the recluse (agoraphobia or social anxiety); Grandpappy Turner, who burned hot and cold all his life (bipolar disorder); Aunt Millie, the hypochondriac (acute anxiety). We have always been here.
And there have always been names for our diseases. In the 19th century, a person suffering from what we now call clinical anxiety would be called a “neurotic.” A person suffering from depression might be called “melancholic” or “depressive.” “Nervous illnesses” were considered to be a phenomenon of wealthy women, but now we know that biological factors – particularly childbirth – wreaked havoc on the physical and psychological wellbeing of women, particularly those without proper support. “Rest cures” were prescribed for the wealthy, but if you were of the working class, you were out of luck. We don’t know how many people in the pre-NIH era suffered from these ailments because people didn’t talk about them.
Well, now we do.
We talk about our breakthroughs and our breakdowns, but we didn’t invent them.
We’re just unwilling to simply live with them.