A Brief History of Women’s Mental Health Care
Throughout history, women’s mental health has taken a bad rap. Diagnoses (such as they were) ran the gamut from hysteria to sorcery, and it’s only been relatively recently that women’s mental health issues have begun to be understood. As much as I’d love to be able to report that women are now routinely taken seriously when they seek help for mental health conditions, and never have those conditions used against them, it’s unfortunately not the case. I can say however, that we are making strides, and there are ways we can all advocate for women to get the mental health care we all deserve.
The History of Hysteria
Way back when, ancient Egyptians thought that women’s depression and anxiety could be attributed to problems with her uterus. Specifically, they thought mental health problems were because a woman’s uterus just couldn’t stay put. Yep, that’s right. They thought an unhappy uterus traveled around a woman’s body, looking for something to do, and that was what made her depressed and anxious (I mean, why wouldn’t it?) Versions of this theory persisted until at least the 16th century, and was picked up by the Greeks, including a philosopher named Plato, who claimed that the uterus wandered because it was unhappy. One of the recommended therapies for the ol’ “wandering uterus” included (believe it or not) aromatherapy. If the uterus moved up, the woman inhaled unpleasant smelling substances and held perfumes near her vagina. If the uterus had moved down, the situation was reversed and the perfumes were inhaled through the nose and mouth, while the bitter scents were held near the vaginal opening.
Obviously this raises a few modern questions, like how did they know which way the uterus had wandered? And how exactly did the vagina inhale the scent?
There was also a guy named Hippocrates (you may be familiar with him) who was the first to use the term “hysteria”. He determined that a woman’s biggest mental health problem was that she wasn’t getting enough sex, a condition that could only be solved within the confines of marriage.
Then along came another expert of the times, named Soranus, unsurprisingly a male physician, who decreed that while the uterus was, in fact, the source of all women’s mental issues, the cure was not sex after all. Matter of fact, just the opposite. Women needed to abstain from sex, and ideally remain virgins to be mentally healthy.
Thus began a long period of time where the prevailing wisdom was that women’s mental health issues were (ahem) NOT in her head, and that the only two options for relief were never having sex, or marrying and having lots of sex, and lots of babies, to keep that uterus filled, happy, and in place.
Which leads us to Victorian England, and orgasms. Under normal circumstances, anywhere that leads to orgasms could probably be considered a pretty good path, but this time that’s not the case. You see, in Victorian England, the doctors (who were of course, men) used pelvic floor massage to induce what they called “hysterical paroxysms” to women, because of course, women couldn’t be trusted to apply such powerful therapy to themselves. There may have been some help for the poor, dear doctors in the form of the first vibrators, but there is conflicting research as to whether the previously accepted information that these medical treatments led to their invention is accurate.
Obviously, all these methods of treatment had one thing in common, controlling the sexuality of women, particularly women who weren’t following the rules set for women at the time. These were women who may in fact have been perfectly healthy, if unsatisfied with the lives they were expected to lead. Women were considered hysterical if they weren’t willing to do what was expected of all women at the time, which was going right from the homes of their fathers, to the home of their husband, where they could blissfully spend the rest of their lives waiting on him and hand and foot, and popping out as many babies as physically possible. The very idea that a woman would want more than that out of her life, led to her being declared mentally unfit, and subjected to the treatment of the time.
And then things got worse.
After men got involved with the medical treatment of women, and their specific health concerns, the women who had traditionally cared for women’s gynecological or obstetric needs, were pushed out of those realms. The fastest way to do that was to declare those midwives and healers “witches” and accuse them of sorcery and devil worship. They were accused of casting spells, dallying with the devil himself, and any woman who was found to be a witch, was publicly killed. One of the most famous witchcraft trials was in Salem, Massachusetts in 1692, when 100 women were accused of witchcraft, and 19 of them were found guilty and hanged after a small group of girls, who were showing signs of hysterical behavior, claimed they’d been possessed by the devil and began accusing the women around them of witchcraft. (It’s important to note that while the Salem witch trials may be the most well known in the US, there is a much longer history of accusations of witchcraft, and over a period from the 1400s to the 1700s between 40,000 and 60,000 people, primarily women, were put to death as supposed witches. Remember that next time a male politician refers to any investigation of his wrongdoing as a “witch hunt”.)
The discrimination against women’s mental health continued into the 1800s and early 1900s, as women were confined to mental institutions with diagnoses like “melancholia” and “nymphomania” as well as hysteria, any time they expressed any sort of dissatisfaction with being servants to the men in their lives, and baby making machines, and dared to express any opinions that might show independent thought. Not only were women misdiagnosed when daring to think for themselves, but they were labeled by their male doctors with openly hostile terms such as egotistical, difficult, and morally reprehensible.
The early 1900s brought more exploration into mental health in general, particularly with the ideas of Sigmund Freud, long considered the father of psychoanalysis. Freud had some big (and wrong) ideas like penis envy, and the Oedipal complex (the idea that boys want to sleep with their mothers, and girls want to sleep with their fathers.) Freud also theorized that as women matured, their erogenous zones moved from the clitoris to the vagina, and if a grown woman preferred clitoral orgasms to vaginal orgasms, then she was attempting to act like a man, and ignoring her maternal obligations. Preferring clitoral stimulation was also claimed to be associated with other unacceptable behaviors like lesbianism, and feminism.
Fast forward to the 21st century, and we find that there is less stigma surrounding mental health in general, and for women in particular. Matter of fact, women are significantly more likely to seek mental health care than men are, but are we now being taken seriously for our mental health issues? If you’ve ever had someone suggest you get a new hairdo to deal with your depression, you know the answer to that. If you’ve ever suffered postpartum depression and had someone try to downplay it, you know the answer to that. If you’ve ever had anyone ask if you’re on period in response to any show of emotion, you know.
So what do we do? How do we fight the stigma surrounding women’s mental health? First of all, we recognize it, acknowledge it and name it. It’s easy to say that things are better now, and they are, but if we don’t acknowledge that we still have a long way to go, we can’t get where we need to be. If we write off any aggressions or microaggressions like the suggestion of a trip to the salon instead of the therapist as a one-off or isolated incident, we can’t stop that sort of behavior. If we don’t confront even the well-meaning friends and family that try to convince us what we’re feeling isn’t a big deal, we can’t teach them.
If we really want to stop the stigma, and become advocates for women, and their mental health issues, there are a few things we can do:
Stop casually labeling. How often do you use the word “crazy” in reference to another woman, or even yourself? Do you describe your own tendency toward keeping a clean house as “My OCD”? Do you and your friends talk about “bipolar” tendencies when anyone shows emotions? With all due love and respect, stop that. OCD and Bipolar Disorder are diagnosable mental health conditions, and I can guarantee you that those who deal with them, wouldn’t wish them on anyone. And “crazy” isn’t a cute thing to call yourself when your emotions get to you, and if someone else is calling you “crazy” or that old favorite “hysterical”? I can almost guarantee that’s shorthand for “She’s not doing what I want her to do.” Especially if it’s a man doing the name calling.
Reach out to women in your life. If you sense that a friend or family member is struggling, show them a little love and support. Don’t be afraid of asking them if they need help, if they’re struggling. If asking directly feels intrusive, just reach out, talk about anything, offer them an outing, or just your time. You never know what a difference you can make. Let them know you love them, and you care. They may need to hear it more than you know.
TAKE WOMEN SERIOUSLY. If she tells you that she’s suffering, hear her. While everyone loves a fresh haircut, or a massage, they’re not the answer to clinical depression, or anxiety, or any other mental health condition. Don’t insult women by suggesting her very real pain should be solved by a quick fix. Remember that if she’s opening up to you about the struggles she’s having, she trusts you. You probably have no idea of how hard it was for her to share, and the last thing she needs is for you to write off her very real feelings. Do what you can to help her get help. If she needs to find a therapist, help her explore options. If she needs childcare so she can see her therapist, and you can do that, do it. Do whatever you have the ability to do, or help her find someone who can give her that help.
We’ve come a long way in terms of women’s mental health, but we still have a long way to go. If you or someone you love needs some help with their mental health care issues, don’t hesitate to reach out.
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