The World Health Organization estimates about 280 million people globally suffer from depression and around one billion experience some form of mental health issue. Mental health concerns were also present in ancient times. How did ancient people manage these issues? Although we might question some of their methods, their insights are still relevant today. In ancient times, conditions like depression were well known. The poet Homer, famous for the Iliad and the Odyssey and living around the eighth century BC, is believed to have died from depression. By the late fifth century BC, Greek physicians understood that health is partly influenced by our mental state. In the Epidemics, a medical text from around 400 BC, an anonymous doctor noted that our mental habits, lifestyle, clothing, living situations, physical activity, and sexual practices are major determinants of health. Within the same text, a patient named Parmeniscus is described as having been so mentally distressed that he became delirious and lost his ability to speak, staying in bed for 14 days until he recovered; the method of recovery, however, is not mentioned.
Later, the renowned doctor Galen of Pergamum (129-216 AD) observed that poor mental states often lead to illness. He noted that “thinking” can influence health or disease, as those who frequently feel anger or distress over minor concerns tend to fall ill and struggle to recover. Galen also detailed cases where mental health challenges led to serious illness or death. One such case involved a man who lost money and subsequently developed a prolonged fever and delirium, ultimately dying in that state. In ancient times, various approaches were used to prevent or treat mental illnesses. Philosopher Aristippus in the fifth century BC advised focusing on the present moment to avoid mental disturbances, suggesting that only the present truly belongs to us. Clinias, a philosopher from the fourth century BC, would play music to calm himself when he felt anger rising. Physicians recommended lifestyle changes to influence mental states, such as adopting new exercise routines, altering diets, traveling, attending philosophical lectures, playing games like checkers, and doing mental exercises akin to modern crossword puzzles or sudoku. For instance, the physician Caelius Aurelianus in the fifth century AD suggested that patients with insanity could benefit from a varied diet including fruit and mild wine.
Plant-based medications were also used, with hellebore being a treatment for paranoia, though it could be dangerous and sometimes lethal. Galen had a different approach, believing that mental ailments stemmed from a dominating idea. He thought curing these issues required removing the false idea from the mind rather than relying on food, drink, or other physical solutions. Galen would introduce new ideas and emotions to patients to redirect their thoughts, using fear or indignation about various subjects to shift patients’ mental focus. Generally, the ancients believed maintaining mental health required effort. Counteracting negative emotions with activities that provoke the opposite feeling was key. For example, Caelius Aurelianus suggested that those suffering from depression should engage in activities that make them laugh, like watching comedies at the theater. Nonetheless, they understood that a single activity was not enough for mental well-being; rather, a comprehensive change in lifestyle and thinking was necessary. Ancient people’s experiences with mental health issues have much in common with ours today, and many of their ideas are still applicable, even though we now use different methods and treatments.