From Melancholia to Prozac: Depression throughout History

As the new Bethlem Museum of the Mind will reflect on, Bethlem – or Bedlam – continues to loom large in the public imagination, often as a lens through which ideas about mental health care and treatment are cast. That this is the case for researchers as well as journalists is aptly illustrated in a recent book by Clark Lawlor, From Melancholia to Prozac.

Lawlor refers several times to the “enduring” image of public visiting to eighteenth-century Bethlem, which he describes as “a combination of prison and freak show”.¹ He uses this to contrast with nineteenth-century claims to offer “moral treatment” (as, indeed, asylum reformers did in the 1830s and ‘40s). Both ideas he seems to accept at face value, something that we at the Archives and Museum certainly remain wary of: championing or demonising the past can easily serve modern agendas.

Indeed, the main problem with Lawlor’s book is a frequent lack of critical historical thinking. As part of a project to explore depression before this modern label was applied, Lawlor retrospectively diagnoses various historical conditions as equating with modern depression. Many historians of psychiatry would argue against viewing clinical depression as the same as melancholia, hypochondriasis or neurasthenia (all terms used in the past to describe conditions that had some association with low mood). This is not to say that any of these states of illness are somehow imaginary: simply that prevailing cultural and medical concerns impact on not only the ways in which they are described, but also how they are experienced.

One particular example offered by Lawlor, acedia, is a case in point. When medieval monks were suffering from this condition, the low mood and lethargy they descibed might well be described as depression today. However, this was certainly not the most important component of acedia to these monks: most prominent was the loss of spiritual and religious feeling, something which had previously dominated every activity of their daily lives in an isolated monastery. Even the most devout person in the modern world is unlikely to put such an all-encompassing emphasis on spiritual connection today, and therefore cannot experience its loss in the same way that a thirteenth-century monk would have done.

Back to Bethlem, and Lawlor reproduces an image of Cibber’s famous statues, using them to claim the physiognomic emphasis on diagnosing depression in the late seventeenth and early eighteenth centuries. Yet, on viewing the original statues, school groups at the museum frequently comment that “Melancholy Madness” doesn’t look sad to them. Might different facial expressions have meant different things to people around 1700? Might they have associated other emotional experiences than sadness with melancholy, such as the fear highlighted in the Carnival of Emotions? We certainly cannot be certain that clinical depression is the culmination of one universal story of understanding extreme misery.

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1 Clark Lawlor, From Melancholia to Prozac (Oxford: Oxford University Press, 2012), p. 80

Sketch of a woman diagnosed as suffering from melancholia.

Lithograph, 1892, after a drawing made for Sir Alexander Morison (Wellcome Library, London).

Romancing the Stone

Last year we highlighted an opportunity for those with UK subscription television services to see Caius Gabriel Cibber’s statues of ‘Raving and Melancholy Madness’ on the small screen. These larger than life figures, which reclined on the gateposts of Bethlem Hospital from 1676 to 1815 and are now on display in the Archives and Museum, have since been featured on the British Museum’s History of the World project website.

Now they are to appear on BBC 4’s three-part documentary ‘Romancing the Stone: The Golden Age of British Sculpture’ . We are reliably informed that viewers will catch a glimpse of the statues in the first episode, scheduled for broadcast at 9pm today, Wednesday, 9 February, and an extended treatment in the episode to follow. All those with access to Freeview, take note!

The History of the World in 100 Objects

As the British Museum gears up to reveal their 100th object today, we have added several items from our collection to the History of the World site, incorporating elements of the history of madness and mental health treatment from the Hospital’s founding in 1247 up to the present day.

The life-size statues of “Raving and Melancholy Madness,” were displayed at the entrance to Bethlem Hospital from 1676, have already been mentioned on this blog (here and here). As significant London landmarks of their time, these statues became symbolic of “human mental misery” (as a nineteenth century news reporter described it) for visitors from around the globe. As one German travel writer wrote in the late eighteenth century, “These two figures show so much truth and expressiveness that they equal the best sculptures in Westminster Abbey.”

More difficult to present, perhaps, are the eighteenth century restraint devices pictured below: nonetheless, these form a significant aspect of the history of mental health treatment in many areas of the world. Until the Victorian era, hospital patients that threatened violence against themselves or others were physically restrained from acting on their threats by a panoply of devices and garments engineered for the purpose, usually applied temporarily but sometimes for prolonged periods. These gradually fell into disuse upon the advent of the non-restraint movement, which swept the public asylums of England in the 1840s, and were banned altogether from Bethlem in 1853. Interestingly, Bethlem retained what it had come to regard as the “revolting instruments of mechanical coercion” as material evidence both of its history and of its progress. Today, these objects remind of the ongoing debate concerning involuntary detention, seclusion and chemical restraint.

Find us on The History of the World website.

Chance Encounters in the Museum 1

Earlier this month this blog encouraged people to come to the Archives & Museum to see Caius Gabriel Cibber’s statues of Raving and Melancholy Madness for themselves. Well, last week we welcomed an impromptu visit from a scholar who had come over 8000 miles to do just that, following in the footsteps of Johann Wilhelm von Archenholz, a German travel writer of the eighteenth century whose memoirs she is translating into English for publication.

We got to talking in the Museum, and I discovered that Archenholz’s impressions of the Hospital, then at Moorfields (but nothing to do with the Eye Hospital), were published in 1785. “The mad hospital, Bedlam, has no equal in terms of its conveniences and provisions for this unfortunate category of people,” he wrote. “Its entrance is adorned by two statues by an English sculptor named Cibber that are among the greatest works of art in England. One is the image of a man in the deepest melancholy; the one opposite represents a raging person lying in chains. These two figures show so much truth and expressiveness that they equal the best sculptures in Westminster Abbey.” (Johann Wilhelm von Archenholz, England und Italien Vol. 1 (Leipzig: Verlag der Dikischen Buchhandlung, 1785), pp. 206f).

For those who can’t make the trip to the Archives & Museum, perhaps the next best thing is to go to www.bethlemheritage.org.uk/visitingbethlem, where other eighteenth-century accounts of visiting the Hospital (and much else besides) can be found.

Bedlam: History Channel Documentary 9 May

There’s another chance to catch the History Channel’s recent documentary “Bedlam – the History of Bethlem Hospital” this week. The show, first aired in March this year, will be repeated on Sunday 9 May at 8pm (repeated Monday 10 May at midnight and 9am) and features interviews with leading historians of psychiatry, as well as exhibits from the Museum and Archives.

Look out for the statues of “Raving and Melancholy Madness” in the background of some of the interviews. These magnificent stone figures, on display in the Museum, were made by sculptor Caius Gabriel Cibber and prominently displayed at the gates of seventeenth century Bethlem in Moorfields, where they were much admired in contemporary descriptions. When the Hospital moved to St George’s Fields in 1815, the graphic depictions of madness were moved to the entrance hall, but kept behind a curtain, presumably to avoid disturbing patients and their visitors! In 1858 the statues were moved to the South Kensington Museum (later the V&A), and only returned to Bethlem in 1970.

If you don’t have access to Sky TV, video excerpts from the programme are available on the History Channel website. Or come and see the statues in the Museum in person!