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In the 2nd millenium BC, the Babylonians described classical symptoms of depression on clay tablets (1). These clay tablets were used to communicate and record important information.  These symptoms included insomnia, anorexia, general muscle weakness, weight loss, and concentration and memory problems (1). The interesting thing about this is that the Babylonians, in their tablets, did not have a specific name to describe this behavior disorder. The term "depression" was not even used in that time period (1).

One major omission from these tablets is the person-centric feelings and thought processes associated with a modern view of depression (1). According to historians, this can be attributed to the fact that in this specific time period, the subjective analysis associated with these mental health disorders was not really a part of the medical curriculum (1).

Sources:
1.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3842853/

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One of the early proponents of using exercise to treat a variety of health ailments, including depression, was Galen, a Roman physician who lived between 129 and 216 A.D (Picture credit: Britannica).

Galen believed that exercise was slow and violent and if it were to be prescribed to treat a health condition, then it should used in moderate quantities (1). His favorite exercises involved a "small ball". In fact, he is quoted as saying, "The form of exercise deserving our attention is therefore that which has the capacity to provide health of the body, harmony of the part, and virtue in the soul, and these things are true of the exercise with the small ball" (1).

Galen believed that the benefits of exercise were numerous (1). He thought that exercise would "thin the body" and "harden the muscles", and elevate blood volume (1). He prescribed exercise to weak patients suffering from disorders such as depression, arthritis, epilepsy, gout and vertigo (1).

Sources:
1.https://journals.physiology.org/doi/full/10.1152/advan.00136.2013

2.https://www.britannica.com/biography/Galen

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Some of the early treatments for depression were very unusual and in some ways, very cruel. A Roman philosopher named Aulus Cornelius Celsus who, in 47 CE, wrote the medical guide De Medicina, talked about various treatment for "melancholia", the term for depression in that time period (Picture credit: Amazon).

Some of his recommendations include using hellebore and trying to make the patient vomit (1). He also advised the use of "torture" such as subjecting the patient to starvation, flogging, or binding them by their limbs (1). His rationale to justify these treatments was to think of them as avenues in which to "shock the mind" and push it towards a "new mental direction" (1). In fact, Celsus is quoted saying, "It is good to be suddenly terrified and completely scared; so is anything that powerfully excites the mind" (1).

Sources:
1.https://qcurtius.com/2016/10/14/ancient-treatment-for-depression-and-melancholia/

2.https://www.amazon.com/Medicina-Latin-Celsus/dp/3849671410

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In 1621, Robert Burton published a book called the "Anatomy of Melancholy" (Picture credit: The British Library). This book dives into the subjective feelings associated with "melancholy", the era's term for depression (1). These feelings were not really addressed in the centuries prior. Melancholy is associated with a "sinking feeling" and can be caused by any number of problems one might experience throughout life (1). The examples that Burton gives are, "God to bad nurses, bad diet to overmuch study, self-love, praise, honor, immoderate applause to covetousness" (1).

In the second half of the book, Burton gives some possible remedies to help with this melancholy (1). He recommended a change in diet, doing physical activity, and an activity called bloodletting, which is the removal of blood from the body for therapeutic purposes (1).

Sources:
1.http://www.journals.aiac.org.au/index.php/IJALEL/article/view/719

2. https://www.bl.uk/collection-items/burtons-anatomy-of-melancholy-1628

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The Bethlem Asylum was the only hospital in England for the mentally depressed and mentally ill patients (1). This hospital signified a monumental shift in looking at depression and other mental disorders as ones that could be treated and helped, rather than shunned and ostracized (1).

This changing attitude was best exemplified by the hiring of Helkiah Crooke in 1619 (1). Crooke was a licensed physician, and frequently quarreled with the Royal College of Physicians over their respective visions (1). Although Crooke was ousted in 1633 over allegations of fraud, his initial hiring represented a change in attitude of how mental illness should be treated (1). It was to be treated by licensed medical professionals, not the common person using traditional methods that may not be suited for this specific kind of patient (1).

Source:
1.https://historicengland.org.uk/research/inclusive-heritage/disability-history/1485-1660/mental-illness-in-the-16th-and-17th-centuries/

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Klaus Schmiegel was a German physician who was born on June 28th, 1939, and is still alive today (Image credit: invent.org). His work in organic chemistry led to the discovery and invention of Prozac in 1988 (1). Prozac is in a class of drugs called SSRI's, which have been a revolutionary treatment for depression (1).

According to a report from the National Center for Health Statistics (NCHS), antidepressant use in the U.S among people ages 12 and older has gone up 400% in the last 30-40 years (2). Considered the first "wonder drug" for the treatment of depression, it has done significantly better than the other treatments through history in helping people who suffer from this disorder (2).

Sources:
1.https://www.invent.org/inductees/klaus-k-schmiegel

2.https://www.health.harvard.edu/blog/astounding-increase-in-antidepressant-use-by-americans-201110203624

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Unique treatments for depression: contemporary studies

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Unique treatments for depression: contemporary studies

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Over the last 50 years, research has been done to see what drugs can be useful in helping treat depression. Some drugs that have led the charge in this avenue of research are psilocybin and ketamine (1). A phase 2 clinical study done in 2019 showed depressive symptoms were reduced at 1 week and 3 month time points in patients with depression that had not responded to any treatment (1). These patients were treated with 2 oral doses of psilocybin in a clinical environment (1).

Ketamine has been shown to reduce depressive symptoms in mice (2). Following an administration of ketamine at antidepressant levels, there was a significant reduction in depressive symptoms compared to baseline (2).  Also, there was a decrease in anxiety as well (2).

These studies have proven that the neurochemistry of these drugs and the neurobiology of depression is linked in some way. Further research will shed more light on this connection and hopefully will provide a new avenue of treatment for patients struggling with depression.

1.https://www.psychiatryadvisor.com/home/topics/general-psychiatry/psychedelic-drugs-lessons-from-ketamine-and-psilocybin/

2.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6767816/