Did older civilizations, especially pre-industrial/tribal ones, recognize depression as a legitimate condition? Did they have a special term for the condition, and is treatment ever discussed in historical literature?
Or was it more “Get back to work, worthless peasant! No one cares how you feel!”?
There was some discussion of it as far back as the ancient Greeks:
Pre-industrial, yes. Tribal? Not what OP means, I think.
Fascinating question, nonetheless.
Regardless of the state of medical knowledge, I think this was probably the standard reaction for most of history.
The ancients and medievals called it melancholia. Much was written, over the centuries, about its possible causes and treatment, including this classic work from the 17th century. Usually, from the time of the Greek Hippocratic doctors of the 5th century B.C. (who were probably the first to clearly identify and name it), it was held to be caused by an excess of the bodily humor black bile (the “melan” bit comes from the Greek for black and the “cholia” bit from the Greek for bile).
I cannot be specific as to whether anything like depression or melancholia was or is recognized in any pre-literate tribal societies (which vary very widely in their belief systems, including their “medical” beliefs), but it seems very likely that it was and is recognized in at least some. In fact, much of the “medical” practice of most if not all pre-literate societies - what Westerners often refer to as magical practices, witchdoctoring, etc. - seems to be aimed at the relief of what we would think of as the psychological rather than the biological aspects of disease. (Sensibly enough, given that their understanding of, and ability to do anything much about, the biological aspects of disease is very limited.)
A lot of self-medicating with alcohol.
I think we had a thread about this a while ago. Depression certainly seems to be a lot more prevalent nowdays but it’s not new. In the old days it really was “get back to work peasant”, not a nice cozy bed in the mental ward paid for by your insurance or pop a Zoloft.
I you were a peasant, or a slave, that might indeed have been what you would have been told. However, in severe cases it would not have been effective. They would not be able to get back to work, any more than they could with with broken arms. Depression is a real disease, you know, it is not just malingering, and as I have already pointed out, it has been recognized as such since ancient times.
If you were rich or educated (such as a monk), not so much. As I said, much intellectual effort in ancient and medieval times went into trying to understand and treat melancholia.
DO you have any actual evidence that depression is any more prevalent now than it was in “the old days”, or is that just a prejudice?
Rich or poor, there were often much tighter social support systems. WHether you were a well-off monk or a poor peasant, you probably had friends and family who lived right nearby and might help take care of you. This wouldn’t end the depression, but I can personally attest that love and concern help a great deal, and can take you from “I’m going to kill myself” to “I can get through this”.
I have never experienced depression myself but have been surrounded by it most of my life. I believe that a small village type community may experience less than we do in the big cities. Having a niche in life we can share about and feel appreciated for is helpful as is general acceptance by our peers. Competition to create a niche for ourselves in modern society can be overwhelming. I can go back just 50 years and remember men sitting around talking about how they solved a specific problem in a factory or made an emergency car repair etc. The conversations would go in a circle and everyone would share and feel somewhat validated. We seem to have bi passed this tradition today.
Mental health services in developing countries is a hot field right now. Aid agencies are just coming to terms with the fact that these services need to be part of the health programs they offer. But this comes with all kinds of complexities.
Basic mental illness of all sorts does show up fairly universally. How they manifest themselves is often different. Many societies tend to somatize, and experience mental illness as aches and pains and other physical symptoms. Things like anorexia may not show up in a culture that doesn’t value thinness, but the underlying problem will probably manifest in a different way. Diagnosing mental illness can be complicated, because it shows up in so many different forms. Different societies will also put things in very different contexts. What we’d call a mental illness may be categorized as normal variation, a spiritual affliction, a spiritual gift, or something else entirely. For example, a pre-industrial farming society may not see a learning disability as a major problem.
Finally, treatment needs to involve the context. One of the “great mysteries” of mental illness is that schizophrenia has much better outcomes in impoverished Tanzania than it does with our most cutting edge mental health care in the US. Treating someone who is in the context of a close-knit community that believes in family care is a very different thing that in our society that emphasizes independence above all things. You can’t just translate what we do to over there.
So yes, depression does and did exist in pre-industrial societies. But you may not recognize it immediately, and a lot about it is going to be pretty different than how it is here.
I just finished the book The Book of Madness and Cures by Regina O’Melveny. Involves “physicks” in the late 1500’s. Along a geographical search it includes holistic (because that’s all they had) “cures” for things such as melencholia. Might be apropos.