Mental Health Basics


Timeline

History tells us that mental illness has existed since early times of
civilization. While we are still learning much about psychiatric
disorders, such as bipolar disorder, we certainly have come a long way
with a greater understanding and more treatment options.




Ancient Greece and Rome


* Mood disorders were described by the ancient Greeks and Romans,
who coined the terms "mania" and "melancholia"

* Treatment by Greek and Roman physicians consisted of rest,
refreshment, and making new emotional connections

* The waters of northern Italian spas were used to treat agitated
or euphoric patients. These waters were later found to contain lithium
salts. (Lithium is a mood stabilizer in use today to treat bipolar
disorder)


400-300 BC


* Contrary to popular belief in magical or supernatural causes of
mental illness, Hippocrates supported the physical origin of mental
disorders. His theory was based on the imbalance of the 4 humors (blood,
yellow bile, black bile, and phlegm). Excess of black bile was thought
to cause melancholia; excess of blood was thought to cause mania

* Aristotle attributed the creative qualities of artists, poets,
and philosophers to melancholia



AD 150


* Aretaeus of Cappadocia (a city in ancient Turkey) recognized the
symptoms of mania and depression and linked them together. He suggested
that the end stage of melancholia was mania. He described cyclothymia, a
form of the illness with alternating periods of depression and mania

* After the fall of the Roman Empire, manic-depressive patients
were thought to be possessed by the devil and had to be restrained and
chained. Treatments also included euthanasia, exotic potions,
bloodletting, and electric eels applied to the skull


Middle Ages

* During this time of religious fervor, mental illness was
considered a punishment for wrongdoing



1621

* The religious theories of the Middle Ages grew less important
and the practice of clinical observations began

* Robert Burton wrote Anatomy of Melancholy, a review of 2000
years of medical and philosophical wisdom. Burton linked certain forms
of depression with some forms of the manic temperament



1854

* Jean-Pierre Falret coined the term "folie circulaire" (circular
insanity). He recognized that depressed and heightened moods were
different from simple depression


1875

* Because of the work of Falret, the disorder became known as
Manic-Depressive Psychosis. Falret is also thought to have discovered a
genetic link-the disorder seemed to run in certain families

1881-1882

* Hypomania and cyclothymia described as subtypes of bipolar
disorder

1904

* Treatments used by Emil Kraepelin for people in maniacal states
included: bed rest, whole-day or half-day warm baths, or eating meals
while bathing. It was considered calming to separate patients from other
people. Medication included bromide of sodium


1913

* Extensive study by Emil Kraepelin established manic depression
as a separate category, differentiating it from dementia praecox (known
today as schizophrenia)

* Kraepelin introduced the concept of psychological stresses. He
proposed that psychological, social, and biological components together
played a role in the onset of an episode. His approach to mental illness
became the main theory of the early 1930s



1917

* Sigmund Freud used psychoanalysis with manic-depressive
patients, believing that childhood trauma and unresolved developmental
conflicts contributed to the illness

1952

* The first conventional antipsychotic drug, chlorpromazine, was
introduced to treat patients with schizophrenia and other major mental
disorders


1957

* Karl Leonhard initiated the classification system that led to
the term "bipolar"


1960s

* Conventional antipsychotic drugs, such as haloperidol, were
first used to control outward ("positive") symptoms of psychosis,
bringing a significant measure of calm and order to previously noisy and
chaotic psychiatric wards

* Lithium revolutionized the treatment of manic depression


1980
* "Bipolar disorder" replaced "manic depression" as the official
diagnostic term found in the Diagnostic and Statistical Manual (DSM-III)
of the American Psychiatric Association

1989

* The first serotonin/dopamine antagonist (clozapine) was
introduced for patients with treatment resistant/intolerant
schizophrenia



1994



* The 1st first-line atypical antipsychotic drug, RISPERDAL(
(risperidone), was introduced to treat schizophrenia. It was the 1st new
first-line antipsychotic drug in almost 20 years


1997

* Researchers identified genetic links to bipolar disorder,
suggesting that the disease is inherited


2003

* The atypical antipsychotic RISPERDAL( (risperidone) is approved
to treat Bipolar Mania in acute manic or mixed episodes associated with
bipolar I disorder




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