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mental health mondays [rewind] :: historical perspective

i kind of hate myself for doing two re-posts in a row, but this one is over three years old and i do think that there's some interesting stuff in here. it's kind of frightening what we have allowed ourselves to think about our own brains. at some point, you'd think that the brain would just object to being characterised in such ways. nonetheless, we have had many, many bizarre ideas about ourselves and this is just a sampling. makes you wonder which current theories will be included in such a list fifty years from now. [note :: i do not expect i will be writing that list. even if i live that long, i'll be even crazier by that point and i'll probably be trying to sell you on some of the ideas listed below.]

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when thinking about the problems of mental illness, it's worth looking at how tenuous our understanding is of the workings of the human brain. keep in mind that it was not that long ago that trained professionals felt that the only way to deal with someone in the throes of mania was to forcibly submerge them- all of them- in a bath of ice water until they "became calm". i'll let you ponder the possible outcomes of that treatment for a moment.

doctors now believe that they have a much greater handle on the workings of the human brain, but keep in mind, that is exactly what those who came before them thought. and while it is indisputable that we do now have more information about the chemistry of the brain and the makeup of the various substances in it, a lot of professionals will begrudgingly [some less begrudgingly] admit that knowing what goes into the brain doesn't necessarily make it a whole lot easier to guess how those substances interact with each other.

here's a few weird facts from the history of mental illness that may make you scratch your head, if only to make sure that there isn't anyone else trying to poke around in there.

just what the doctor ordered
"female hysteria" was a condition often diagnosed and suspected to affect up to a quarter of women in the 19th century. its symptoms included "faintness, nervousness, insomnia, fluid retention, heaviness in abdomen, muscle spasm, shortness of breath, irritability, loss of appetite for food or sex, and 'a tendency to cause trouble'". to many of us, that sounds suspiciously like the symptoms of being alive, or at worst of having pms, but it was pretty serious psychological business in the nineteenth century. one of the main treatments, since it was seen as a sexual disorder, was through vaginal massage, with the aim of reaching "hysterical paroxysm" [basically a kind of moment after which the women seemed to forget their problems and become strangely calm and happy]. this technique proved exceptionally frustrating to physicians, who found that the time it took to reach paroxysm was excessive and that sometimes, no matter how long or how intense the massage, the great moment just never arrived.

fortunately, the medical aid industry came to the rescue by inventing a mechanical massager that didn't get tired and that seemed to get more reliable results.



through the twentieth century, diagnoses of female hysteria declined and the condition was eventually discredited. strangely, though, the cure is still a hot seller. it just isn't covered by public or private insurance anymore.

samuel cartwright was a lauded physician in his lifetime and was particularly considered an expert on the physiology and health of african americans. he is chiefly remembered now for "discovering" the mental disorder "drapetomania", a condition that made slaves want to escape their masters and live as free men. because, of course, anyone seeking to leave the conditions of slavery must clearly be insane...

cartwright theorised that one of the causes of the disorder was the type of slave owners who tended to make the slave feel like an equal, a peer, someone who was a familiar and not merely property.

sigmund freud, whose work and theories still largely shapes our understanding of psychology today, was for years a great advocate of cocaine as a cure for depression and as an analgesic. like aspirin. but not really.

"you won't feel a thing. no, wait WE won't feel a thing."
in the 1920s and 30s, psychiatrist manfred sakel developed a treatment for schizophrenics known as "insulin shock therapy". this involved essentially forcing patients into an insulin coma and sakel claimed remarkable results- an almost 90% success rates. of course, it came out that the rates were exaggerated and those who did recover were suspected to have been patients who would have been likely to recover on their own and sakel had actually been pretty suspiciously selective about who got the therapy to begin with, as if he might have had some interest in skewing the results to make him look like a medical genius. and then, of course, there were the after-effects, because a lot of the patients who underwent insulin shock therapy developed hypoglycemia and became obese because, magically, their blood sugar seemed to go a little screwy after they were briefly turned into a giant mound of rock candy. some people insisted on poking holes in studies that claimed ist success, by pointing out that the newly calm, gentle and very relaxed "success stories" had in fact been brain damaged by the procedure. then there was that wee problem of the almost 5% mortality rate of the procedure, a rate that makes taking your chances healing morning sickness with thalidomide look like a good plan.

despite the fact that questions about the treatment and about sakel's data started to surface almost as soon as he went public, i.s.t. continued to be used as late as the 1970s. behold the speed of informed progress.

these are just a few cautionary anecdotes from the historical archives. the good news is that we are getting better at figuring out how our grey matter works. the bad news is, that's what these guys told their patients, too.

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