How Depression was Treated during Renaissance?

The Renaissance (1350s–1650s) was a period in the late Middle Ages which saw a rebirth of culture, arts, science and learning. The Renaissance included artists such as Leonardo da Vinci and Michelangelo and scientists such as Galileo and Copernicus.

Overview

The most noteworthy development in the realm of philosophy during the Renaissance was the rise of humanism, or the worldview that emphasizes human welfare and the uniqueness of the individual. This helped continue the decline of supernatural views of mental illness. In the mid to late 1500s, Johann Weyer (1515-1588), a German physician, published his book, On the Deceits of the Demons, that rebutted the Church’s witch-hunting handbook, the Malleus Maleficarum, and argued that many accused of being witches and subsequently imprisoned, tortured, hung, and/or burned at the stake, were mentally disturbed and not possessed by demons or the Devil himself. He believed that like the body, the mind was susceptible to illness. Not surprisingly, the book was met with vehement protest and even banned from the church. It should be noted that these types of acts occurred not only in Europe but also in the United States. The most famous example was the Salem Witch Trials of 1692 in which more than 200 people were accused of practicing witchcraft and 20 were killed.

Richard Napier was a clergyman, medical practitioner and astrologer who treated thousands of patients worried about their mental health between 1597 and 1634. Servants, beggars, butchers, university dons, lawyers and nobility flocked to his practice in the hamlet of Great Linford in Buckinghamshire.

Their symptoms included suicidal thoughts and self-harm, refusal to pray, inability to feel pious, sexual urges, visions, weeping, 'too much talk' and 'hatred of spouse'. Using religious, psychological, astrological and traditional healing remedies, Napier treated them all using a wide range of treatments.

Responses to mental illness at this time included everything from listening and humane intervention to incarceration in a building or ill treatment.

Writer Arthur Ashley Sykes in 1737 published ‘An enquiry into the meaning of demonjacks in the New Testament’, which rejected any belief in the existence of demons. He and others, including Richard Mead physician to King George II, understood that those afflicted by demons referred simply to those suffering from a variety of illnesses including mental illness. Mead started prescribing treatments commonly used for physical illness such as bloodletting, emetics, purgatives, drugs, diet and exercise, to individuals suffering with mental illness.

The number of asylums, or places of refuge for the mentally ill where they could receive care, began to rise during the 16th century as the government realized there were far too many people afflicted with mental illness to be left in private homes. Hospitals and monasteries were converted into asylums. Though the intent was benign in the beginning, as they began to overflow patients came to be treated more like animals than people.

The Bethlem Asylum

When Henry VIII dissolved the religious orders, he seized the Bethlem Hospital in London, England's only asylum for the mentally ill. However, shortly before he died in 1547 he transferred its control to the Corporation of London. It then became a civic rather than a religious institution.

But the City aldermen struggled to keep it running and in 1574, they handed its management to the Bridewell, a hospital for the 'idle poor'. The Bethlem at this time could only hold a maximum of 40 people and was often only half full.

The new governors had a strict admission policy, taking in only those who were 'raving and furious and capable of cure, or if not yet are likely to do mischief to themselves or others'.

In 1619, Helkiah Crooke became the Bethlem's first medically qualified 'keeper'. He was a controversial character who had accused the previous keeper of irregularities and who was constantly at odds with the Royal College of Physicians.

Unfortunately, his medical qualification was all that distinguished him from previous keepers. In 1632, a Royal Commission found that he had been falsifying accounts and stealing donations while depriving his patients of food and basic comforts.

Crook was dismissed in 1633, but his influence was long-lasting. His appointment reflected changing attitudes to treating the mentally ill. It was no longer felt to be a matter for lay people using traditional methods - from now on, the hospital would always be run by a medical officer with a team of medical staff.

It was only the handful of people living in the Bethlem who received any sort of institutional care in the 16th and early 17th centuries. In a population of five million, this meant that large numbers of mentally ill people lived in their communities, usually cared for by their family. Some were on the streets - mentally ill beggars were nicknamed 'Tom o'Bedlams'.

In the eyes of the law, mentally ill people lacked the capacity to reason, so a Court of Wards would hand the responsibility for their affairs to someone else. King James I (1603-1625) instructed the court that 'lunatics be freely committed to their best and nearest friends, that can receive no benefit by their death.' The care of the mentally ill was essentially a domestic matter and on the whole, it seems that people were not exploited by the system.

Bristol Lunatic Asylum

Bristol Lunatic Asylum was, by today's standards, cruel and inhumane. They used not only electroshock therapy but also padded cells. However, the asylum was actually considered progressive, because it was clean and new and it banned straitjackets.

Treatment Options

Mental illness could be seen as both a natural and a supernatural event - a sickness or something caused by devils or astronomical events. People had no difficulty accepting both these explanations at the same time.

Most could not afford to pay a physician or surgeon, but Tudor England had a vibrant medical marketplace from which illness, including mental illness, could be treated. There was an array of other practitioners - bone setters, 'wise women', 'cunning men', herbalists, astrologers - who offered treatments.

But most mental illnesses at the time were looked at in fear. The public was convinced that the only cure for the people suffering with the illnesses was through strange rituals.

For a mentally ill person from a rich family, there were more humane options to be had. A physician could be hired to come in daily and handle the person, or (if the family got too tired of having to deal with them) they could send them off to a private caretaking home.

There weren't many options for a mentally ill person from a poor family. They could either go to Bedlam or Bristol, and if they chose not to go to either of those asylums, then they ended up on the streets until they were either thrown in jail or adopted by the community.

The Rush Chair was used to limit motion and reduce sensory stimulation. To do so, they would cover the head.

The Crib was an invention used to strap a mentally insane person into a crib, not allowing movement of any kind.

By the 1800s, the mentally ill had started to be seen as ‘curable sufferers’. Psychiatry began to be thought of as a medical field.

While scientific understanding of what physicians called ‘lunacy’ had increased little since 1600, there was a better understanding of how to support those who suffered. The sciences and religion were increasingly seen as separate and distinct. Charles Darwin’s theory that humans had evolved over time supported the subtle shift in attitudes; releasing people’s lot in life from the will of God.

This did not mean Victorians were not religious, but some used their faith to explore moral and social responsibility. French physician and writer Phillipe Pinel had pioneered ‘moral therapy’ – an approach which recognized the emotions and awareness of patients and placed an importance on social interactions.

The new route to provide sanctuary, moral therapy, and a daily regime was introduced in asylums across Europe. In England, Parliament set about dictating reform through a series of acts. The Country Asylums Act of 1808, encouraged Justices of the Peace in every county to build an asylum to look after the mentally ill paupers. When this did not have the desired results, further acts followed including one in 1845 which made it mandatory for every county to have a safe place for their mentally ill.

Herbal Remedies

Herbal medicine was commonly used during the Renaissance to treat various ailments, including depression. Certain herbs and plants were believed to have mood-altering properties, and these were sometimes administered to alleviate symptoms. Here are some herbal remedies that were used during the Renaissance to treat depressive symptoms:

1. St. John's Wort (Hypericum perforatum): St. John's Wort has a long history of use for treating mood disorders, including depression. It was used during the Renaissance and later periods to alleviate symptoms of sadness and melancholy. Its potential mood-enhancing properties made it a popular herbal remedy.

2. Lavender (Lavandula spp.): Lavender has been used for its calming and soothing effects on the nervous system. During the Renaissance, lavender may have been used in various forms, such as in herbal teas or sachets, to promote relaxation and reduce feelings of anxiety or melancholy.

3. Chamomile (Matricaria chamomilla): Chamomile was utilized for its calming properties and as a mild sedative. It was often brewed into teas to help alleviate stress and promote better sleep, which could indirectly benefit those experiencing depressive symptoms.

4. Valerian (Valeriana officinalis): Valerian was known for its sedative effects and was used to treat conditions related to anxiety and sleep disturbances. It may have been employed to help individuals with depression who also experienced insomnia or restlessness.

5. Lemon Balm (Melissa officinalis): Lemon balm was used to improve mood and reduce anxiety. It was often consumed as a tea or used in herbal preparations to provide a sense of calm and emotional relief.

6. Rosemary (Rosmarinus officinalis): Rosemary was believed to have stimulating and mood-enhancing properties. It was sometimes used in herbal remedies to combat feelings of fatigue and melancholy.

7. Mugwort (Artemisia vulgaris): Mugwort was considered a remedy for nervous disorders during the Renaissance. It was thought to have mild sedative effects and may have been used to alleviate anxiety and depressive symptoms.

8. Ginkgo Biloba (Ginkgo biloba): Although ginkgo biloba is native to China, its seeds were introduced to Europe during the Renaissance. It was occasionally used in herbal remedies for its potential cognitive-enhancing effects and its ability to improve mood.

Beginning of Psychotherapy

Although psychological theories were in their infancy during the Renaissance, some early forms of psychotherapy were emerging. Humanist philosophers like Marsilio Ficino and Giovanni Pico della Mirandola emphasized the importance of self-reflection and introspection as a means to achieve emotional balance and personal growth. These ideas laid the groundwork for later developments in psychology.

Marsilio Ficino (1433-1499) was an Italian philosopher, scholar, and humanist who lived during the Renaissance period. He is best known for his work on reviving the philosophy of Plato and for his contributions to the development of humanism. While Ficino's writings focused more on philosophy, religion, and the human soul rather than clinical approaches to mental health, some of his ideas and writings may have been indirectly relevant to the understanding of depression during his time.

Ficino's key ideas that could be related to depression include:

· Soul and Spirituality: Ficino believed in the soul's significance and its connection to divine and cosmic forces. He promoted the idea that the soul could be elevated and purified through contemplation, philosophy, and spiritual practices. While not specific to depression, his emphasis on the soul's well-being and its relationship with the divine could resonate with individuals seeking spiritual or philosophical solace during periods of emotional distress.

· Neoplatonism: Ficino was a proponent of Neoplatonism, a philosophical system that emphasized the ascent of the soul towards higher levels of reality and the unity of all existence. His teachings could offer a perspective on the pursuit of higher truths and wisdom as a means to alleviate existential or emotional suffering.

· Self-Reflection and Contemplation: Renaissance humanism, which Ficino embraced, encouraged self-reflection and the pursuit of knowledge. Some individuals may have turned to self-examination and introspection as a way to cope with emotional difficulties, including symptoms of depression.

Giovanni Pico della Mirandola (1463-1494) was an Italian Renaissance humanist philosopher known for his wide-ranging and innovative ideas. While his writings did not specifically address the treatment of depression, his philosophical and humanistic perspectives could offer insights and inspiration for individuals dealing with depression or seeking philosophical and existential meaning in life.

Some aspects of Pico's philosophy that may be relevant in the context of depression include:

· Human Dignity: Pico's "Oration on the Dignity of Man" (also known as the "Manifesto of the Renaissance") emphasized the idea that humans have inherent dignity and limitless potential. He believed that humans could shape their own destinies and become masters of their own lives. This message of human potential and the pursuit of personal excellence can be empowering for individuals struggling with depression.

· Free Will and Self-Improvement: Pico's belief in the power of human free will and choice is central to his philosophy. He argued that individuals have the freedom to choose their own paths and determine their own moral and intellectual development. This notion of personal agency and the ability to work on oneself through self-improvement can be relevant to those seeking to overcome depressive thoughts and behaviors.

· Philosophical and Spiritual Quest: Pico was deeply interested in the synthesis of various philosophical and religious traditions. He believed in the possibility of reconciling seemingly conflicting ideas and finding greater meaning through philosophical and spiritual exploration. For individuals grappling with existential questions or seeking a sense of purpose, Pico's ideas about the pursuit of wisdom and knowledge may resonate.

While Pico's writings and philosophy do not provide a direct treatment for depression, his emphasis on human potential, free will, and the quest for knowledge and meaning can serve as sources of inspiration and motivation for those dealing with depressive symptoms. It's important to note that depression is a complex mental health condition, and individuals experiencing it may benefit from a combination of evidence-based treatments, including psychotherapy and, in some cases, medication.