Madness Defined: ‘Loony’ And ‘Nuts’ Just Don’t Cut It

Mental illness, though real and often devastating, is subject to fashions and fads. Diagnoses seem to burst into popular consciousness and just as quickly sink into obscurity. A look at the au courant diagnoses of the past and present shows that what’s on our minds today might not be tomorrow.

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-- Michael Soller

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1700s-1800s: Melancholia 1990s: Depression

If John Keats were a citizen of Prozac nation, would he have still penned an “Ode on Melancholy”? Another early 19th century poet who caught the melancholy fever: Abraham Lincoln, who once imagined himself a “companion of the dead.” Melancholia, a disease of the spirit, reemerged in the 20th century as depression, a disease of the chemical brain. In popular culture, the bete noir of poets and at least one president became, with the publication of Elizabeth Wurtzel’s “Prozac Nation” in 1994, the pet rock of post-college slackers. For the millions who suffer from it, depression exists on a continuum from truly disabling to chronic but less disruptive.

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1880-1910: Hysteria

In the 1880s, hysteria was all the rage. Artists, dilettantes and a young Sigmund Freud crowded Jean-Martin Charcot’s famous Paris clinic, where the doctor paraded his weeping and wailing female patients. Hysteria “has so grand and so beautiful a history that it would be painful to give it up,” one psychiatrist wrote. By 1910, many psychiatrists had. And the much-criticized “female malady” lost its grip for good.

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1950s: Schizophrenia

No illness comes closer to matching the Victorian vision of howling madness than schizophrenia. Yet its reality is far less florid. “Schizophrenia” comes from the Greek roots for “split mind,” but it really refers to a broad category of psychic disturbances. It had a romantic flowering in 1950s fiction and film. But the spread of anti-psychotic drugs in the late 1950s, coupled with new understanding of the condition’s causes, has helped trim the thorns.

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1970s: Multiple Personality Disorder

Keep it together, Jim Carrey. The multiple-personality craze didn’t start with your two-faced antics in “The Mask” or “Me, Myself & Irene.” “Sybil,” a fictionalized 1973 account of a patient’s therapy (and the Sally Field TV movie in 1975) brought the concept wide fame. In 1980, multiple personality became an official diagnosis and was linked to childhood trauma. By 1986, the number of documented cases soared to an estimated 6,000. But after some patients were found to have falsely recalled their childhood abuses, the diagnosis came under attack from patients’ families and psychiatrists. The American Psychiatric Assn. now calls it dissociative identity disorder.

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1990s: Manic Depression

Virginia Woolf probably had it. So did Hemingway, Byron and Goethe. Psychiatrist Kay Redfield Jamison wrote in 1995 that her manias “were absolutely intoxicating states that gave rise to great personal pleasure.” But the depressions that followed, she added, “nearly killed me.” More than 2 million American adults suffer from the disorder, according to the National Institutes of Mental Health. Manic depression is now known broadly as bipolar disorder.

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1980s-1990s: Attention Deficit Disorder

Focus, people. I’ll try to keep this short. Children have had attention problems since long before “Sesame Street” was blamed for shrinking the pre-adolescent mind. But what was once known as “minimum brain dysfunction” morphed into “attention deficit disorder” in the 1980s, and “attention deficit/hyperactivity disorder” in the 1990s. According to the Drug Enforcement Administration, the number of prescriptions for such treatments as Ritalin spiked by 60% from 1995-2000, when it became a popular party drug.

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2000s: Obsessive- Compulsive Disorder

Monomaniacs of the world, relax. Your illness has never been neater. “I’m very OCD,” announced actor Alec Baldwin last year, and “Aviator” star Leonardo DiCaprio told reporters he spent several days with an obsessive-compulsive patient preparing to play troubled tycoon Howard Hughes. The disorder also has never been more treatable. Obsessive-compulsive disorder, which probably has a neurochemical basis, responds to depression-busting drugs and to cognitive-behavioral therapy. Considering OCD? Consider this: Most clean freaks don’t need Prozac. They just need to take a chill pill.