The history of depression is inseparable from the history of mankind, its philosophy, medicine and culture.
It is of interest to study the evolution of the views of psychiatrists on depression and those conditions close to it, which are described in the special literature under the term “melancholia”. Studies of psychiatrists on the biographies of prominent people, as well as work relating to the creativity of the mentally ill, can also be used as sources of information for studying the disease. At the same time, it should be emphasized that it is probably impossible to study the history of depression without taking into account the social social relations of each specific historical period, the views of philosophers most characteristic of a particular era. Note that psychiatry as a field of medicine was formed relatively late. Prior to that, healers, shamans, theologians and philosophers were more concerned with mental illness.
Before proceeding to the presentation of views on the history of ideas about depression, it should be recalled that this term hides in itself a wide range of different mental disorders related to emotional states that are opposite to positive feelings: joy, happiness, fun, etc.
One of the first deep descriptions of depression is found in the writings of the doctors of the Hippocratic Circle, an ancient Greek physician from the island of Kos, whose father was the priest of Asclepius. In part, the modern view of depression corresponds to what Hippocrates called melancholia, the cause of which he considered a congestion of black bile.
In the books of Hippocrates, melancholy was treated as a relatively calm state, but it was emphasized that people suffering from this disease are afraid of light, avoid people, are full of all sorts of fears, complain of pain in the stomach, as if they are pricked with many small needles ^ , and in reality they see images of dead people. By melancholy, Hippocrates understood two states: a disease with characteristic symptoms and a special temperament or constitution with a certain humoral basis (“sadness from black bile”). The psychological characteristics of melancholic were considered sadness, timidity and silence. It was assumed that such a temperament presupposes the development of the disease itself – melancholia (Yu.V. Kannabikh, 1928).
The views of Plutarch on melancholy are interesting, in many respects of a religious nature. Aristotle, poured out the foundations of the four temperaments, also gave a detailed description of melancholy. He noted that all negative feelings can be regulated with the help of directed thought and, in fact, was the forerunner of modern. cognitive therapy of depression. Aristotle wondered: “Why are people who were brilliant in philosophy, or in government, or in poetic art, or in arts, why they all seemed to be melancholic?” Some of them suffered from black bile for example, Hercules; it was he who was believed to be a man of melancholic nature, and the ancients by his name called the holy disease “Heracles”. There is no doubt that many other heroes suffered from the same disease; later indications of melancholia were noted in Socrates, Plato and Empedocles (Cannabih Yu.V., 1928).
Many Roman doctors considered themselves students of Hippocrates, but at the same time they adhered not only to its traditional humoral views on the genesis of melancholia, but also attached great importance to the mental factor. In particular, the Roman doctor Aretey, in addition to the somatic genesis of melancholia, believed that it also developed as a result of the emergence of some kind of depressing or sad thought. He believed that melancholy is depressed condition that develops in the presence of one or another wrong idea and in the absence of fever. Patients suffering from this disease, in his opinion, begin to retire, suffer from insomnia, abhor life and passionately dream of death (Wellman M., 1825). Observing mental disorders, he noticed: depressive states often recur, and there are light gaps between manic and depressive episodes.
The description of the melancholy in another Roman doctor – Soran – differed little from the statements of Aretea. The symptoms of melancholia also manifested themselves in two groups of symptoms: mental and physical. To the first, he referred to sadness, anxiety, fear, unsociation, thirst for death, suspicion, fear of imaginary intrigues; to the second – cold extremities, sweating, heaviness in the head, weight loss, dark or pale complexion (Kannabikh Yu.V., 1928). One of the brightest representatives of Roman medicine – the former doctor of gladiators Galen believed in the teachings of Hippocrates about four fluids. He developed the idea that mood swings often indicate brain damage. Another Roman physician, Celsus, distinguished three types of madness, one of which was melancholy. Celsus believed that melancholy seizes a person for a long time, begins almost without fever, and later gives light signs of the latter. In his opinion, the main manifestation of melancholy was sadness, the cause of which was the spreading of black bile. Celsus proposed to treat melancholy with bloodletting, and if it was contraindicated for a patient due to weakness, then with emetic means. For the treatment of melancholy, he also proposed rubbing the whole body, active movements and laxatives. Particular importance was attached to the suggestion to the patient of pep, to the amusement of his talk on those topics that were pleasant for him before (Kannabikh Yu.V., 1928).
The development of ideas about melancholy was influenced by two directions of Roman philosophy – Stoicism, which made adaptation to the inevitable course of events, and Epicureanism, distinguished by the desire to get as much pleasure from life as possible. The philosophical direction developed by Epicurus preferred refined higher forms of pleasure to short-term pleasures of bodily pleasures. Epicureans believed that happiness is freedom from emotional stress. The philosopher Cicero, speaking of methods of treating depression, emphasized the fundamental importance of theoretical views on this mood disorder.
Of all the medieval thinkers, the brightest discoveries in the field of the psychology of melancholy were made by St. Augustine, who himself probably survived a vivid episode of depression at the age of 32 years. After the adoption of Christianity in the famous “Confession”, he described his condition in this way: “Inexpressible sadness filled my heart to the point that I was ready to pour out my grief in streams of tears.” St. Augustine emphasized the importance of self-observation for a detailed description of subjective emotional experience, thereby anticipating the birth of psychoanalysis. From his point of view, such negative emotions as anger and fear can be observed only subjectively.
Probably the first scientific studies on depression appeared in the Renaissance. For example, the doctor of that time D. Merkuriali published an interesting book on melancholia, where he delimited various forms of it. Mercuriali believed that melancholia, although it develops mostly from material causes (improper digestion), often begins to manifest itself under the influence of blows of fate (poor treatment of children leads to the fact that, as adults, they become closed, immune to the joys of life depressed).
Original ideas about the feelings of the Spaniard X. Vives, who carefully studied the “logic of emotions” of a person or, as he called them, passion, described not only the manifestations of melancholia, but also erotomania. The personal doctor of the Kiev Duke – German scientist I. Weier – in his works paid attention not only to the treatment of chronic depression, which the Duke and his family members suffered, but also noted that women who were considered witches often show symptoms of melancholia (“False Demons” ).
In the XVII century, speaking of studies of disorders of the depressive spectrum in their modern sense, it should be noted the names of two English doctors: W. Garvey and T. Sydenham. The first described the impact of emotional stress on the activity of the heart, the second is the clinical manifestations of hysteria, including mood patterns in this disease. Interesting ideas about the melancholy of the doctor, lawyer and artist P. Zakkias, who in his classification of mental disorders attributed to the varieties of melancholy its hypochondriacal form with partial delusion, hypochondria without delusion and hallucination without delusion. He believed that melancholy, the main symptoms of which should be considered melancholy and immobility, are close to such states as falling in love and fanaticism, and also that melancholic people can walk around at night – “to be noctambulums”.
Of particular interest is the book “The Anatomy of Melancholia” by the English professor of theology of the XVII century, R. Barton, who suffered from this ailment. In his work, Bartrn summarized everything that was known about melancholy. He was close to the psychoanalyst’s current view of depression, believing that it was the result of a hostile attitude toward the world and excessive demands on himself, ultimately leading to loneliness and directed aggression towards himself. Barton’s literary work is characterized by endless ideas of self-accusation. He noted the jealousy, rivalry and inconsistency of a person suffering from depression. He also described possible methods of treating melancholia for that time: physical exercises, sports events (especially fencing), watching sports events, chess, baths, reading specially selected books, music therapy, traveling, diet therapy, taking special medicines, laxatives.
This also included various games: billiards, cards, philosophical games, dice, and others. One of the principles of the therapy of melancholy R. Barton considered moderation in sexual life. During the depression, I recommended to visit carnivals more often, to entertain myself with singing, dancing, fairy tales and everything that gives pleasure. The theologian considered communicating with a reliable and loving friend, with whom you can share your suffering and secrets, as the most effective means of treating melancholy. Such a friend, according to R. Barton, can become a doctor.