Nineteenth-Century Society: (Insanity of) Adolescence

In 1892, sixteen-year-old Harry Dearman was admitted to Bethlem with a very specific diagnosis: “Melancholia of Adolescence”. This, the teenager’s first episode of mental ill-health, had apparently commenced just three days before his admission. Harry was described as having become very reticent, refusing food and praying excessively: he had also made an attempt at suicide. The causes of the young man’s illness were thought to be both psychological and physiological: four months earlier, he had been present at the “unusually painful death scene” of a friend and fellow workman which, his relatives noted, he had frequently talked about since. In addition, however, his doctors assumed that puberty was a cause.

In the late nineteenth century, “insanity of adolescence” became a frequent feature of psychiatric texts. Primarily diagnosed by the age of the sufferer (most agreed on a more extended period than we might perhaps have expected, from the age of 14 to 25), the concept emerged from more general attention to adolescence as an important – and potentially difficult – period of development. This interest might appear obvious to a modern audience. However, prior to this period, distinctions between childhood and adulthood had often been drawn without any reference to an in-between, developmental state.

There were several reasons for this new focus within psychiatry, in addition to external cultural shifts, such as the increasing age of marriage. In particular we can see the influence of evolutionary theories of mind and the associated interest in hereditary theories of insanity. Developmental psychology thus assumed a close association between physical and mental development. As T.S. Clouston put it in Tuke’s Dictionary of Psychological Medicine:

At puberty and adolescence … the affective faculties, the social instincts, the altruistic organic cravings, the delight in poetry and romance, the sense of duty, all arise in so different and definite a form as compared with their previous existence, that we must conclude that great tracts of brain substance, which had before lain dormant, have now awakened into activity.[1]

Clouston thus correlated psychological development with physical changes in the brain. These were also thought to be associated with alterations taking place elsewhere in the body, in particular those of sexual development. Similarly, it was assumed that both physical and emotional shocks might arrest mental and physiological development. Sometimes, these might be behaviours under the patient’s control (frequent masturbation, for example, was a common charge). On other occasions, it might include pressures imposed from without, with particular reference to education, work or marriage: “disappointment in love”, for example, was a frequently cited cause for mental illness, in young men as well as women in this period.

Harry Dearman was discharged well after just over four months at Bethlem: insanity of adolescence was widely considered one of the most curable forms of mental illness, with 65% or more deemed to recover. The very existence of the diagnosis, however, points to the increased emphasis being placed on development within psychology in the late nineteenth century, and the introduction of a transitionary phase between childhood and adulthood.


[1] T.S. Clouston, “Developmental Insanities” in Daniel Hack Tuke, ed. A Dictionary of Psychological Medicine (London: J. & A. Churchill, 1892), p. 360.

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