Far too many people in this world ignore or reject the idea that depression is a very real disease. This first article in the “Depression Disbelief” series aims to draw attention to the people of the distant past who studies this disorder and common theories about its cause.
One of the most common ailments of modern society is major depressive disorder, more commonly known as depression. Depression is “a mood disorder that causes a persistent feeling of sadness and loss of interest”. (Source 1) The vast majority of people in the United States have heard of it and/or have some connection to someone afflicted with it. About 9.5 %, 20.9 million, American adults suffer from depression each year, making it a clear issue in the United States. However, the World Health Organization announced that less than 25% of people with depression receive the necessary treatment. (Source 6)
A very common misconception is that depression is a recent occurrence, that it did not exist five hundred years ago. (Source 5) This may be because the suicide rates in young adults have nearly tripled in the past sixty years. However, this is not the case. As early as the second millennium B.C., scholars, mainly healers, philosophers, and writers of Mesopotamia, have identified what they called “melancholia”. It was observed as an ailment that caused listlessness and a lack of interest in life in general. They attributed it to demon possession, and priest were often called in to perform exorcisms, which shows modern historians that even as far back as 2000 B.C., people have understood depression to be a mental, or in this case spiritual, ailment instead of a physical one, hence the priests instead of the physicians that were used to heal physical wounds. (Source 2)
As time went on, later civilizations built onto this prior knowledge in order to formulate their own theories on melancholia. The Babylonians, Chinese, and Egyptians all believed that it was caused by evil spirits possessing a person and frequently used exorcisms in order to heal the person afflicted. The Greeks also believed that depression was caused by demonic possession, however, as their civilizations progressed, their beliefs became similar to those of the Romans in that depression was “both a biological and psychological disease” and required various treatments, such as music, massage, gymnastics, baths, special diets, and certain herbal medicines in order to help the victims of this disease. (Source 2) Hippocrates was the person who came up with the idea of the four humors, though the Ayurvedic physicians in India had come up with a similar theory (Source 4), which are “the metabolic agents of the Four Elements in the human body”, the right balance of which is necessary to maintain proper health. The black bile was the one that supposedly caused melancholia when in excess. (Source 3) However, later on in Rome, Cicero believed that the cause of melancholia was more mental than physical and was caused by rage, fear, or grief. Unfortunately, as more time past, the people of Rome grew to believe the theory that depression was an ailment sent by the gods, and beatings, shackles, and starvation were used as “treatment”. Thankfully, Cicero’s ideas were not lost as the Persian physicians continued his view of melancholia as a mental illness and developed kinder treatments than the Romans had, such as baths and an early form of behavioral therapy. (Source 2)
During the Middle Ages of Europe, scientific thinking on the matter of depression was similar to that of the later Romans, that it was a form of possession by witches or demons and that this affliction was contagious. Few of the doctors believed in any sort of physical treatment, such as blood-letting or locking up the depressed people in “lunatic asylums”. The Church dominated early Christendom and spread ideas that people with melancholia should be, if not exorcised, then drowned or burned. As the Renaissance began to spread throughout Europe, the influence of the Church lessened, and some doctors returned to Hippocrates’ beliefs on depression and mental illness in general. This wave of enlightenment in regards to mental illness and depression was described in Robert Burton’s book, Anatomy of Melancholy. (Source 4) In this book, Burton described the causes of depression, which he saw to be both social and psychological. He came up with his own treatments, recommending exercise, diet, bloodletting, travel, purgatives, marriage, herbal remedies, and music therapy. (Source 2)