People in all occupations, regardless of age, gender, wealth, or religion, have been challenged by depression-like symptoms for thousands of years. Understanding the origin of how people came to recognize it continues to inform a wide range of treatment options, including counseling and ketamine therapy.
What Is Depression?
Depression (also known as clinical depression or major depressive disorder) is a widespread but severe mental health condition. It leads to severe symptoms which affect your feelings, thoughts, and ability to manage daily activities like sleeping, eating, or going to work or school. Diagnosis depends on symptoms being present for two or more weeks. It’s the most well-known of many psychiatric conditions called mood disorders, including bipolar disorder and substance use disorder.
An Abbreviated History
When talking about depression, it’s important to understand that its meaning, definition, symptoms, and treatment options have gradually evolved over the course of human history. Low energy, mood swings, and other symptoms of the condition have always existed, but recognition has taken time. But the term “depression” wasn’t known until the 20th century.
Thousands of years ago, dating back to the time of ancient Greece, symptoms of what we know as depression was then described as a sort of melancholia – which means black bile. It was thought that disease of the body and mind was triggered by an imbalance of four bodily fluids, or humors. It also related to the four seasons, which may be extrapolated as the origin of seasonal affective disorder – present in the colder seasons when there’s less daylight and can lead to low moods. The philosopher Hippocrates was convinced that depression was caused by excess bile, giving rise to the idea that there was a genetic or inherited component to such feelings.
Key milestones in the discovery and history of depression
- Galen (129–216 AD) expounded on Hippocrates’ beliefs with “his theory of temperaments,” noting four kinds of temperament driven by excess bile: melancholic (black bile), optimistic (blood), choleric (yellow bile), and phlegmatic.
- Aretaeus of Cappadocia (First Century AD) identified this illness as having two central dimensions: an emotional phenomenon, characterized by anguish; and as an intellectual marvel made of a delusional origin that grips and takes hold of the mind.
- Andreas Laurentius (1560–1609) gave even more meaning to the concept of melancholia, defining it as the occurrence of “delirium with no fever, but with fear and sadness.”
- Bright (1551–1615), in his Treatise of Melancholy, says in respect to melancholic patients that they are mostly sad and fearful, prone to bouts of distrust, hesitation, or despair.
- Burton (1577–1640), inspired by Bright, tried to summarize all the meanings of melancholia known at that time, with his efforts focused on unifying the descriptions of those who came before him.
- Thomas Willis (1621–1675) divided melancholia into two: the universal type, where delusion is general to nearly anything, and the type, where the judgment of the person is only questionable in one or two areas.
- William Cullen (1710–1790) may have coined the phrase “partial insanity” to outline the monothematic misunderstanding in melancholia, distinct from “universal insanity,” which he said was the equal of mania.
- Sigmund Freud stakes his claim as the father of psychoanalysis in the early 20th century, relying on elements of his personality to inform his diagnosis and treatment options for people experiencing depression.
It wasn’t until the mid-19th century that doctors and psychiatrists arrived at a clearer understanding of mental illnesses such as depression, including its symptoms and potential causes. Between then and the turn of the century, luminaries such as French psychiatrist Jean-Pierre Falret, French psychiatrist and neurologist Jules Baillarger, German psychiatrist Karl Kahlbaum, and others, began looking into separate mood disorders and how one could influence the other and a person’s behavior in daily life.
The early 20th century featured decades of stagnation in the understanding of depression until 1952, when the first edition of The Diagnostic and Statistical Manual of Mental Disorders was published and tried to standardize and classify mental illness. The manual gave more definition to manic-depressive insanity.
Depression was never discovered but rather uncovered, slowly, with each small shovelful of removed dirt clarifying our picture and understanding of its effects on daily life. Hippocrates would likely recognize it today when we describe its symptoms as low moods, loss of interest in things once enjoyed, low energy, feelings of worthlessness, and many others – many of which are treatable with ketamine, certain medicine, self-help, and other therapies.