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Mood Disorders and the Brain: Depression, Melancholia, and the Historiography of Psychiatry

Published online by Cambridge University Press:  17 May 2012

Åsa Jansson
Åsa Jansson
Affiliation:
Åsa Jansson, PhD student, Centre for the History of the Emotions, School of History, Queen Mary, University of London, Mile End Road, London E1 4NS, UK. Email: [email protected]
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Despite the increasingly widespread availability of psychotropics believed to restore biochemical equilibrium in the brains of persons diagnosed with mood disorders, the number of people suffering from such medical conditions appears to be increasing. According to The Royal College of Psychiatrists, ‘by 2020 it is estimated that depression will be the second most common disabling condition in the world’, a figure it derives from the World Health Organization. Depression is, it seems, rapidly becoming a global threat. In a trend that is mirrored in much of the West, the number of prescriptions dispensed for antidepressants in the UK has doubled in the last decade and is continuing to rise. The need for a critical perspective on mood disorders is growing.

Keywords

Mood DisorderMelancholiaDepressionWilhelm GriesingerMental Reflex
Type
Articles
Information
Medical History , Volume 55 , Issue 3 , July 2011 , pp. 393 - 399
Copyright
Copyright © The Author(s) 2011. Published by Cambridge University Press

References

1 As presently defined in Anglo-American psychiatry, the category ‘mood disorders’ incorporates various depressive disorders, as well as bipolar disorder. See, for example, Diagnostic and Statistics Manual of Mental Disorders (DSM-IV-TR) (Arlington, VA: American Psychiatric Association, 2000), 345–7.

2 ‘A joint statement by the Royal College of General Practitioners (RCGP) and the Royal College of Psychiatrists (RCPsych)’, ‘Patients and Antidepressants’, Royal College of Psychiatrists (March 2008), <http://www.rcpsych.ac.uk/ mentalhealthinfoforall/problems/depression/ patientsandantidepressants.aspx>, accessed 2 February 2011.

3 Mikkel Borch-Jacobsen, ‘Making Psychiatric History: Madness as Folie à Plusieurs’, History of the Human Sciences, 14, 2 (2001), 23–4.

4 I broadly follow Adrian Wilson’s approach in this regard: Adrian Wilson, ‘On the History of Disease-Concepts: The Case of Pleurisy’, History of Science, 38, 3 (2000), 271–319.

5 Examples abound, such as Rebecca Fox-Spencer and Alan Young, A Simple Guide to Depression (Long Hanborough: CFS Medical Communications, 2005), 34–5; Michael Alan Taylor and Max Fink, Melancholia: The Diagnosis, Pathophysiology, and Treatment of Depressive Illness (Cambridge: Cambridge University Press, 2006), 1–7; Allan V. Horowitz and Jerome C. Wakefield, The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder (Oxford: Oxford University Press, 2007), 53–4: 61–71; Dan J. Stein, David J. Kupfer and Alan F. Schatzberg (eds), The American Psychiatric Publishing Textbook of Mood Disorders (Washington, DC: American Psychiatric Publishing, 2006). This claim for continuity is presented in unusual detail in a collaborative project between an historian and a psychiatrist: Conrad M. Swartz and Edward Shorter, Psychotic Depression (Cambridge: Cambridge University Press, 2007). It should be noted that the 'discovery' of depression is usually traced further back than the 1800s, often to Antiquity. There is, however, insufficient space here to address the many problems arising from attempts to link modern depression to a multitude of pre- and early modern afflictions.

6 For example, Stanley W. Jackson, Melancholia and Depression: From Hippocratic Times to Modern Times (New Haven: Yale University Press, 1986); Judith Misbach and Henderikus Stam, ‘Medicalizing Melancholia: Exploring Profiles of Psychiatric Professionalization’, Journal of the History of the Behavioural Sciences, 42, 1 (Winter 2006), 41–59; Janet Oppenheim, ‘Shattered Nerves’: Doctors, Patients, and Depression in Victorian England (Oxford: Oxford University Press, 1991).

7 German E. Berrios, The History of Mental Symptoms: Descriptive Psychopathology since the Nineteenth Century (Cambridge: Cambridge University Press, 1996), 299.

8 See Karin Johannisson, Melankoliska rum: om ångest, leda och sårbarhet i förfluten tid och nutid (Stockholm: Albert Bonniers, 2009); Barbara H. Rosenwein, ‘Worrying about Emotions in History’, American Historical Review, 107 (June 2002), 821–45.

9 Thomas Dixon, From Passions to Emotions: The Creation of a Secular Psychological Category (Cambridge: Cambridge University Press, 2003). See also Roger Smith, ‘The History of Psychological Categories’, Studies in History and Philosophy of Science, Part C: Studies in History and Philosophy of Biological and Biomedical Sciences, 36, 1 (March 2005), 55–94.

10 Historians have noted the significance of the mental reflex for developments in nineteenth-century psychopathology, but its role in the creation of emotional disorders has not been considered in any detail. See L.S. Jacyna, ‘Somatic Theories of Mind and the Interest of Medicine in Britain, 1850–1879’, Medical History, 26 (1982), 235–40 and Roger Smith, Inhibition: History and Meaning in the Sciences of Mind and Brain (London: Free Association Books, 1992), 42–55.

11 For a history of the reflex in modern science see Georges Canguilhem, The Vital Rationalist: Selected Writings from Georges Canguilhem (New York: Zone Books, 1994): Ch. 8, ‘The Concept of Reflex’. For a different, but equally brilliant historical approach to reflex action, see Jean Starobinski, Action and Reaction: The Life and Adventures of a Couple (New York: Zone Books, 2003).

12 Johannes Müller, Elements of Physiology, Vol. I (London: Taylor and Walton, 1840), 765–95, and Vol. II: The Physiology of the Senses, Voice, and Muscular Motion, with the Mental Faculties (London: Taylor and Walton, 1848), 1354–64.

13 Wilhelm Griesinger, ‘Ueber psychische Reflexactionen: Mit einem Blick auf das Wesen der psychischen Krankheiten’, Gesammelte Abhandlungen, Erstes Band: Psychiatrische Abhandlungen (Amsterdam: E.J. Bonnet, 1968).

14 A important exception being: Edwin Clarke and L.S. Jacyna, Nineteenth-Century Origins of Neuroscientific Concepts (Berkeley, CA: University of California Press, 1987).

15 Griesinger, op. cit. (note 13), 11–12. [Author’s translation]

16 Ibid., 24.

17 Ibid., 24–5; see also Wilhelm Griesinger, Mental Pathology and Therapeutics, 2nd edn (New York: William Wood & Co, 1882), 23–4.

18 Henry Maudsley, The Physiology and Pathology of Mind (London: Macmillan, 1867) and ‘The Cerebral Cortex and Its Work’, Mind, 58 (1890), 161–90; Richard von Krafft-Ebing, Melancholie: Eine Klinische Studie (Erlangen: Ferdinand Enke, 1874), 1–6, 9–11. For instance, William Sankey used the model as early as 1863 to explain the aetiology of melancholia, and a similar explanation through the mental reflex was expressed by Thomas Clouston in the 1890s. Thomas S. Clouston, Clinical Lectures on Mental Diseases, 5th edn (London: J & A Churchill, 1898), 14–15, 27–30; W.H.O. Sankey, ‘On Melancholia’, Journal of Mental Science, 9 (1863), 193–4.

19 Griesinger himself addressed this problem in his textbook: Griesinger, Mental Pathology, op. cit. (note 17), 4–5, 409–12. For a discussion on the emergence of psychiatric autopsies, see Eric J. Engstrom, Clinical Psychiatry in Imperial Germany: A History of Psychiatric Practice (Ithaca: Cornell University Press, 2004), 96–8.

20 Griesinger, Mental Pathology, op. cit. (note 17), 209–72.

21 See, for example, the works referenced in op. cit. (note 18) above.

22 DSM-IV-TR, 349.

23 Danuta Wasserman, Depression: The Facts (Oxford: Oxford University Press, 2006), 63; DSM-IV-TR, 372; Fox-Spencer and Young, op. cit. (note 5), 30.

24 Fox-Spencer and Young, ibid., 14, 17, 72–5; Wasserman, ibid., 230–6.