TREATMENT OF DEPRESSION THROUGHOUT THE AGES
The treatments for melancholia over the course of many centuries were numerous, often painful, and frequently ineffective. In fact, many of them may have actually caused more damage to the individual than the original ailments from which he or she suffered. For example, one treatment involved sticking the person’s head in an oven so that the exposure to extreme heat and sweating would cause the person’s “fantasy” (which encompassed a wide range of symptoms, including some that would be considered psychotic by today’s standards) to escape through the vent in the oven (Karp, 1984, p. 9). Other remedies for depression included fasting or making changes in one’s diet, purging through the use of hellebore and other plants that induced vomiting, clysters or enemas, the application of poultices to introduce moisture and heat to the body, and bloodletting through the use of leeches, venipuncture, and cupping with scarification, which used suction through the use of a cup and heat to draw out blood from the body (Jackson, 1986, p. 35).
Many of the more benign treatments caused less physical harm but were, nonetheless, infused with the moralistic undertones of the time. These barely concealed the ever-present accusation against the people suffering from psychic maladies of either cognitive ineptitude or moral depravity. Melancholy was categorized alongside folly, the implication being that the melancholic patient had lost intelligence, virtue, the capacity to reason, temperance, and memory. Therefore, many treatments were aimed at restoring these to the patient. These interventions are comparable to suggestions sometimes heard today that a person should “snap out of it” or stop dwelling in the past. In this way, melancholia and other mental states came to be viewed as a form of (sometimes intentional) social deviance rather than as a biological or psychological ailment over which the person had no control.
In an attempt to prevent this deviance from spilling over and defiling the rest of society, patients were frequently locked away in asylums. “Prior to the seventeenth century, hospitals were essentially ecclesiastical, concerned more with spiritual salvation than with the cure of disease” (Karp, 1984, p. 2).
What is more, hospitals were run by people with no medical training and their function was one of containment and moral, not mental, emotional, or physiological rehabilitation. Bedlam, as described by Karp (1984), was one such hospital. Karp says,
The doors of Bedlam were always open to the public, and the inmates were exhibited and treated before ‘the impertinent curiosity of sightseers at a mere penny at a time,’ making the viewers and inmates part of the same system. (1984, p. 12)
The use of the word inmate implies that the mentally ill were seen as criminals. They were exhibited as if they were animals in a zoo or spectacles in a circus and their “treatment” was horrendous. A note here is warranted on the conditions they faced, as it falls nowhere short of abuse. Madmen or lunatics—which also encompassed people considered to be melancholic—were forced to live in squalor. They were frequently chained or strapped down, naked, and living in their own filth. Karp describes the conditions in Bedlam as follows:
They were confined in airless and filthy cells, strapped down to their beds or chairs, or enclosed in cratelike boxes allowing almost no movement. They were abused and whipped, and this was seen as the only appropriate treatment at that time. (1984, p. 13)
It was not until much later that these conditions were recognized for what they were and reformed by people who were appalled by what they found.