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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To wonder what people did before antidepressants?

146 replies

dottypotter · 02/01/2023 21:33

Don't know how long anti depressants have been around for depression and anxiety etc, but what happened before they were invented does anyone wonder?
Did people go mad?
Put up with it, but never get better.
Did their depression etc just go away. Intrigued.

OP posts:
JoyPeaceSleep · 03/01/2023 09:13

It's a scary thought. Life may be more stressful now but I'm glad I live now not 1923

I have been on anti-Depressants and they did help me. They don't have to be a magic wand to earn their right to play a part.

bippit · 03/01/2023 09:16

Worth looking at the table in this article. It’s short and easy to read. 53% of adults with depression improve without treatment in twelve months vs 54% of those treated with antidepressants! So basically no difference. It’s eye-opening.

www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30036-5/fulltext#tbl1

CaptainMyCaptain · 03/01/2023 09:19

JoyPeaceSleep · 03/01/2023 09:13

It's a scary thought. Life may be more stressful now but I'm glad I live now not 1923

I have been on anti-Depressants and they did help me. They don't have to be a magic wand to earn their right to play a part.

I doubt if life is more stressful now (we don't have bombs dropping on us - in the UK at least, we don't have the threat of the workhouse, we are unlikely to die in childbirth and our children tend to survive infancy) but expectations are much, much higher. Mostly rightly so but some of the posts on MN make me despair.

JustAnotherManicNameChange · 03/01/2023 09:22

There you go OP.

www.verywellmind.com/who-discovered-depression-1066770

Sounds fun,doesn't it?

Onnabugeisha · 03/01/2023 09:23

bippit · 03/01/2023 09:16

Worth looking at the table in this article. It’s short and easy to read. 53% of adults with depression improve without treatment in twelve months vs 54% of those treated with antidepressants! So basically no difference. It’s eye-opening.

www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30036-5/fulltext#tbl1

A pretty significant difference is that ‘improvement’ is defined differently for both groups. Another significant difference is the ‘untreated depression’ group consists of the ‘wait list control group’ which would include not just people with undiagnosed depression, but also all those with suspected depression that do not actually have depression.

So it’s an apple to banana comparison.

Squamata · 03/01/2023 09:30

Depends on the symptoms, I should think. If you could carry on with normal life but just felt terrible, you'd crack on. Perhaps with a lot of drink or harsh treatment of family members.

If you were incapable of normal life, but had means or a supportive family - you'd be given a bit of peace and reduced stress to see if it helped, packed off to a spa or the countryside. If you didn't have money and couldn't cope with normal life, you'd be on a downward spiral of bad housing, little income, alcoholism and prostitution etc ending with homelessness and the workhouse, your family maybe along with you.

If you read things like Dickens thinking about depression, lots of the 'bad' characters could be seen as having mental health conditions - Bill Sykes for example. He's tormented and miserable.

bippit · 03/01/2023 09:44

@Onnabugeisha can you explain in what way improvement is defined differently in the two groups?

Babdoc · 03/01/2023 09:47

May I caution against using suicide statistics to prove anything. They are very inaccurate. Due to the perceived stigma of suicide, doctors were often pressured by bereaved relatives to record the death as something else.
My own medical colleague and friend, whose death was clearly suicide (left a note, injected himself with anaesthetic drugs in his locked office) - had his death recorded as “chemical poisoning” instead.

Dotjones · 03/01/2023 10:01

Other drugs were more freely available - opiates and cocaine were in products that could be freely purchased.

Many towns had an asylum or "madhouse" where people with depression or other mental illnesses could be locked away out of public view (or, in some cases, be exhibited to a curious public for a fee).

Otherwise people did what they still do when suitable treatment isn't available - have a poor quality of life and/or die.

FurryDandelionSeekingMissile · 03/01/2023 10:06

Babdoc · 03/01/2023 09:47

May I caution against using suicide statistics to prove anything. They are very inaccurate. Due to the perceived stigma of suicide, doctors were often pressured by bereaved relatives to record the death as something else.
My own medical colleague and friend, whose death was clearly suicide (left a note, injected himself with anaesthetic drugs in his locked office) - had his death recorded as “chemical poisoning” instead.

Of course — for one thing, they're not always measuring the same thing, even if everyone's scrupulously honest. And in any case, they're a very dodgy proxy for depression rates since most depressed people don't kill themselves, some people kill themselves without being depressed, and there are lots of factors affecting whether a depressed person might kill themselves.

I posted the historical graph because Puffin87 said If SSRIs worked as well as this thread suggests, the suicide rate wouldn't be so high, and for the purposes of showing that, compared to pre-SSRI (and pre-antidepressant) numbers, suicide rates aren't currently that high (well, kind of currently — couldn't find one that showed C19–2022), the graph is adequate. If anything, it's likely that stigma preventing the accurate recording of suicides was even stronger in the 19th to mid-20th century, because of more prevalent religious beliefs about suicide, which would falsely depress the earlier rates and make current rates look higher than they are comparatively.

Onnabugeisha · 03/01/2023 10:07

bippit · 03/01/2023 09:44

@Onnabugeisha can you explain in what way improvement is defined differently in the two groups?

It’s in the table we were linked to:
“50% reduction in symptoms” vs. “Study-defined remission rates”

www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30036-5/fulltext#tbl1

10HailMarys · 03/01/2023 10:13

Same as with any other illness for which no drugs were available: they suffered unnecessarily, self-medicated with harmful substances, and/or died.

pifflesticks · 03/01/2023 10:50

My great grand mother put her head in her gas oven according to my mum

Redebs · 03/01/2023 11:05

I remember family members of previous generations suffering with 'nerves'. It was a shameful thing. It was considered a moral failing. It was always, so-and-so suffering with HIS or HER nerves. People talked about their 'nerves being bad' for periods of time and would plead for company or family help.

Sometimes mental health conditions were excused under other medical issues like 'bad heart'; often these were co-morbalities anyway.

Knowing what I know now, it must have been truly horrible for them.
Most people with depression or anxiety got by miserably, coping from one crisis to another. Some used alcohol, but not so much in my family.

ItMustBeBedtimeSurely · 03/01/2023 11:27

SSRI’s are not as effective as people on this thread seem to think they are. The evidence behind the chemical imbalance theory of depression has been pretty roundly debunked and the efficacy of SSRIs is actually not much better than placebo, and not as good as exercise.

I suspect that in the past people dealt with depression in much the same way they do now - some people just lived with it, which often involves self- medicating, poor relationships, and a generally unhappy life, while others recovered, probably through a combination of activity, good social and emotional support, or improving situational causes of depression.

NameIsBryceQuinlan · 03/01/2023 11:27

There is a lot of jumping around historical periods on this thread. The treatment of mental health was different through the centuries from medieval, early modern, Victorian to 20th century. From what I read, each period had ideas about "melancholy" or "depression" but the treatments were wildly different.

highfidelity · 03/01/2023 11:30

I believe mental health issues (and trauma for that matter) are in our bloodlines, so many of us are more predisposed than others, but of course, life can also thrown things at us which cause us to struggle and throw ourselves and mental health into crisis.

A PP mentioned Ruby Wax's appearance on Who Do You Think You Are.
Wax's experiences echo my own families - my mother's mother was in and out of asylums, had electric shock therapy and was so strung out on medications, often couldn't even recognise her own family. My mother suffered severely with manic depression was prone to fits of pure rage. She was on valium and a myriad of other pills to get her 'through the day'. I do think many women like my mother were highly medicated as a way of helping them cope with the boredom and unfulfilled potential of their lives - my mother was highly intelligent and well-educated yet was expected to be a housewife, as so many others like her were at that time.

I think it is often overlooked that at one time, huge swathes of women were medicated to keep them docile, not that it was presented like that. My mother was a drug addict, although a socially acceptable one as her drugs were prescribed by a doctor.

I too had bouts of mental health issues - much of my problems echo my mother's, and after a horrible spell on SSRIs where I felt nothing and wanted to do even less, I refused to take any further medication and have learnt to manage myself, and recognise the triggers. Therapy (straightforward counselling), helped, but my mood properly levelled and stabilised once I went on HRT. (Thank you premature menopause for being a magic bullet in so many respects).

I am so thankful that I have managed to find peace in ways my mother and grandmother did not.

Sockwomble · 03/01/2023 11:37

People like my son (profoundly autistic) would have been hospitalised long term and would probably never have been allowed out. Taking SSRI's is enabling him to have a life.

Redebs · 03/01/2023 11:55

SSRIs have saved my life. I would not be here without them.

Redebs · 03/01/2023 12:03

bippit · 03/01/2023 09:16

Worth looking at the table in this article. It’s short and easy to read. 53% of adults with depression improve without treatment in twelve months vs 54% of those treated with antidepressants! So basically no difference. It’s eye-opening.

www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30036-5/fulltext#tbl1

No, those are completely different studies. You can't compare them like that

ivykaty44 · 03/01/2023 13:24

Op, if you are interested in looking further into this subject, a trip to your nearest archive/county record office ( check first they hold asylum records) and you can look, read the records from 100+ years ago.

it gives an insight into asylum life, why people were sectioned and what the doctors thought in their notes

records less than 100 years will not be open for access, so it would be records pre 1922

sometimes you’ll even find photographs of the patients

History of Warwickshire central hospital this book is written using older records and gives a view of how life was in this asylum ( which was better than many others)

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