How were mental disorders regarded before officially classified?

Disorders or conditions such as autism, Aspergers, depression, OCD, narcissism, bipolar, Munchausen or Munchausen by proxy obviously existed long before there was a clinical name for them. But how were they regarded in ancient or medieval eras - was there any term for such behavior, or how did society regard such people?

Those with psychological or mental disorders were apparently often believed to be possesed by demons or evil spirits, had made a pact with an evil spirit or were practitioners of (or victims of) witchcraft, or perhaps cursed by an angry god.

As per this article:

For a short time there was a treatment where they pulled all the teeth of a person who was mentally ill . As you might have guessed that doesn’t work.

Long after the medieval period, Samuel Johnson probably suffered from what we nowadays call depression and Tourette syndrome. He was worried that he was in the grip of generic “madness”. Other people thought his verbal and physical tics were the sign of rudeness, and he was quoted as saying he behaved the way he did “from bad habit”.

Mental retardation. The terms mildly, moderate or profoundly/seriously were often added. Later terminology included intellectually disabled or intellectual disability.

They could be understood in several different ways, even in the same person. For example, the fifteenth-century mystic Margery Kempe (author of what is often considered the first autobiography in English) had at least one episode of what would now probably be diagnosed as postpartum psychosis, and engaged in a lot of weird behavior that usually makes modern-day readers perceive her as mentally ill – having visions, holding long conversations with God, experiencing frequent, public episodes of crying and weeping over which she claimed to have no control. Pretty much everybody in her narrative, including Margery herself, understood her first episode of illness after childbirth to be a sign of demonic possession, though with a certain layer of moral choice (in her words, she “went out of her mind and was wonderly vexed and labored with spirits … she desired all wickedness; like as the spirits tempted her to say and do she said and did”). But most of her other odd behavior could clearly be interpreted and classified in various ways, within the context of her society – Margery herself, along with many other people, understood it as a sign of special favor from God, while others interpreted it variously as possession by wicked spirits, drunkenness, or a bodily illness, and at several points in her life she was accused of heresy (a sin which requires the mental capacity to make rational choices – if you are a heretic, you are not insane, and vice versa).

She got off, by the way, in large part thanks to her rhetorical cleverness as well as the fact that her theological beliefs genuinely were orthodox, and she seems to have been perfectly functional through most of her life – raising fourteen children, running a couple of businesses, and embarking on a remarkable set of pilgrimages to destinations that included Rome, Jerusalem, Santiago de Compostela, and Sweden.


OK, more seriously, there were, and are, patterns of cognition and behavior. Since they do form patterns, we, observing them, recognize their reoccurrence. It’s not just “Gee this person thinks and behaves kinda weirdly”, it’s “Gee, this person’s weirdness sure does remind me of that person I knew a couple years ago, very similar pattern…”

But for the most part, that’s all we’ve done so far: categorize them, put a name on the patterns that we’ve observed. We don’t know very much—hardly anything, actually—about what causes it or what it means. We don’t know in a real, legitimate, scientific sort of way, which of these various patterns is a pattern that you, or I, or the person down the block would exhibit under certain circumstances, versus which ones are patterns that only those individuals who have a neurological or hormonal (or other) fundamental difference from the rest of us will be prone to. Or (just to avoid the excluded middle) which of these differences are modes that anyone can fall into but which some people are much more susceptible to being thrown into by circumstances than other people are.

At any rate, recognizing a pattern and giving it a name is not the same thing as understanding it or explaining it. The degree to which we’ve improved over “that person is possessed by demons” as an explanatory viewpoint is greatly exaggerated. If those medieval folk had developed a typology of which demons made you inert and withdrawn when they possessed you and which ones made you frenetic and antsy instead, we’d be hard pressed to show that we understood it any better than they did.

What I’ve just described may not bear a close resemblance to what you’ve been led to believe. It is an unfortunate fact that a lot of the claim about the state of our knowledge of mental disorders has never been validated and doesn’t qualify as factual.