exploring the origins of hysteria and its legacy in mental health treatment

Dating as far back as Ancient Greece, hysteria has been considered an exclusively female ailment, with the Greek word “hystera” literally meaning womb or uterus. The first use of the word hysteria was in the 5th century BC when Hippocrates determined that hysteria was madness caused by unusual movement in the uterus. Even before then, in Ancient Egypt, there were accounts of women’s mental disorders being attributed to the uterus. According to Greek mythology, this madness was caused by a lack of sexual activity, and figures like Hippocrates, Plato, and Aristotle agreed. The cure to this supposed ailment? Marriage. 

By the middle ages, this idea of hysteria mingled with medieval Christianity, strengthening the then-pervasive idea that women were inherently sinful and weaker than men, which caused them to be more sensitive to disease and madness. This eventually led to “hysterical” women being treated with exorcism, as well as symptoms of mental illness being linked with sorcery and demonic presence (Salem Witch Trials, anyone?)

The idea of hysteria would continue to permeate the western understanding of women’s mental health for centuries and wouldn’t even come close to the unisex meaning it has today until after Freud. Even then, it would continue to be used as a catchall for women’s mental health issues, as well as a tool for maintaining women’s obedience. Hysteria only began to be understood as linked to brain function rather than the uterus in the 18th century, and in the 19th century, women who wished to study, read, or step outside of their roles as housewives or obedient daughters were often deemed hysterical, and treated as such, until they conformed to society’s rigid standards for women. 

The late 19th century also marked the beginning of the existence of psychiatric asylums, completely changing the dynamic of western mental health treatment. Continuing into the 20th century, psychiatric asylums became the norm for mental health treatment, though the level of care varied based on whether they were public or private asylums. Public asylums often had much poorer conditions and harsher treatment, whereas private asylums were available for the wealthy to avoid the harsh treatment of public asylums and receive more personal care. Still, asylums both public and private elected to use newly emerging therapies around this time, such as hydrotherapy and electric shock therapy, which we now know to be dangerous and ineffective. 

Just as troublesome is the justification of many women’s admission to asylums where these treatments were used. Records from the Mendota Mental Asylum in Madison, Wisconsin between 1869 and 1872 reveal that women were admitted based on diagnosed insanity due to things like suppressed menses, domestic troubles, childbirth, abortion, nymphomania, and so on. Even though the records don’t show any use of the word hysteria, it’s clear that these qualifiers of insanity and the qualifiers of female hysteria throughout history are frighteningly similar. 

The early 20th century and the effects of both WWI and WWII prompted the field of mental health treatment to change once again with the recognition of PTSD and the glaring realization that somatic treatments weren’t working. Though treatments like electric shock and lobotomies continued well into the ‘50s, over time they were replaced by the more modern approach of psychotherapy. By the 1960s, effective psychiatric medications were widely introduced to patients as well, drastically changing the way mental illness was treated. At the same time, the role of women as submissive, sexually inhibited, housewives pervaded and caused those who strayed from this role to either continue to be deemed hysterical or to actually develop symptoms of mental illness due to their limited circumstances and opportunities based on their gender. 

Second-wave feminism in the late 20th century led to an upheaval in the roles and expectations of women in the home, as well as women’s sexual liberation, taking women’s discontent to the forefront of feminism. At the same time, psychology and mental health treatment continued to advance and be taken more seriously as a science and medical practice. This led to groundbreaking changes in the way women’s mental health was treated and the purging of notions of female madness or hysteria. 

In 1980, hysteria was finally removed from the DSM and since that time, mental health treatment has advanced and grown into what it is today. Today, mental health treatment and therapy are largely accepted and normalized, and women are actually more likely to seek mental health treatment than men. Unfortunately, mental health disorders like depression and anxiety still largely affect women more than men as well, but with marked advances in medication, the availability of therapy, and opportunities for women outside of marriage and motherhood, especially in the western world, there is certainly hope for advances and improvements to continue.

April 6, 2022

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