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Depression and Manic Depression

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History

History of the Disease

Manic-depressive illness has been with human beings since the beginning of recorded time. Throughout the centuries effective treatment of manic-depressive illness has been a formidable and largely unmet challenge. It is only in recent decades that certain discoveries have influenced diagnostic and treatment practices in such a way as to diminish the severity and frequency of manic-depressive episodes and in some cases, prevent such episodes altogether!

Over the past centuries, the quality of treatment for mental illness has ranged from humane to bizarre. Forty centuries ago, for example, people with a mental illness were treated harshly. Rarely seen as suffering a sickness, their illnesses were considered a punishment of the gods, or a possession by devils.

About 400 B.C., the Greek physician Hippocrates stated that mental disorders resulted from an imbalance of four body fluids: blood, phlegm, yellow bile, and black bile. For example, depression supposedly resulted from an excess of black bile. The ancient Greek name for this fluid, melan chole, is the origin of the word melancholy, which means sadness.

The earliest medical sources show an awareness that "excitement" and "depression" may have represented two aspects of a single disorder. Areteus, in the second century A.D., talked about "mania" as he described a group of euphoric patients who would "laugh, play, dance night and day, and sometimes go openly to the market crowned, as if victors in some contest of skill" only later to appear "torpid, dull and sorrowful." In 1686 Theophile Bonet coined the term, "manico-melancolicus', to denote the connection between mania and melancholia.

It was in the 1830's that two French physicians, Falret and Baillarger became the first to isolate and identify the symptoms of the disease Falret called "circular insanity." Remarkably, the signs and symptoms Falret described is almost exactly those which are described today. Falret even encouraged physicians to diversify medications used in the treatment of manic-depressive illness in the hopes that one of them might one day discover an effective drug therapy.

History of Treatment

-Early Greek and Roman physicians treated their patients by prescribing "rest, refreshment, and the forging of new emotional connections" Furthermore, they recognized the soothing effects of the waters in the spas in Northern Italy where they sent agitated or euphoric patients. Two thousand years later, these waters have been found to be rich in Lithium salts.

-300-400 A.D: treatment became more inhumane, reflecting the fears that manic-depressives were possessed by the devil and had to be forcibly restrained and chained. Treatments would also include euthanasia, exotic potions, bloodletting, and electric eels applied to the skull. Meanwhile, the Islamic world continued the Greko-Roman tradition for several centuries.

-In 1904 Emil Kraepelin described remedies to be found useful for those in "maniacal" states. These included: bed rest, prolonged warm baths for one-half or a whole day, taking meals while bathing, over a month at a time. Separation from other people served as a 'calmative" Medication included bromide of sodium.