A History of Antidepressants

Photo credit Moray's Muse; St Johns Wort

For our Paradise issue we have written about places we can go to escape our mind, and paradises to relax. Its Marcus Aurelius who wrote that 'Nowhere can man find a quieter or more untroubled retreat than in his own soul’. However, for many of us, who cope with mental health problems, this is not option. Antidepressant medication saves so many lives year after year .Paradise means peace of mind to many. Because we are a history magazine so we will look at a history of antidepressants.

The quest for alleviating symptoms of depression can be traced back to ancient times. Early treatments often involved herbal remedies, rituals, and philosophical approaches. One was St John's Wort. However before we dive in to St Johns Wort, lets talk about what thinkers of the past thought about depression. 

It was Hippocrates who coined the term ‘Melancholia’ and he attributed this to excess black bile being in ones system. Greek Physician Galen also believed in this theory. Aristotle linked melancholia to being a creative genius whereas Thomas Aquinas thought of despair as a sin.

Besides, it wasn’t just used in the Christian tradition. In the pre Colonial Americas  Native American tribes used local species of St Johns Wort for a variety of medical conditions. When America took over the ‘New World, early American herbalists used the plant. Pliny used the plant for snake bites and St Johns Wort was traditionally burnt during pagan celebrations like Beltane.

In Christianity mental illness was regarded as the state of being possessed by a devil (or devils). The parable of the Gadarene swine (the New Testament St. Luke, Chapter 8: verses 26 to 33) illustrates this. In the parable, Jesus casts the devils out of the man who was tormented and ‘they entered into the swine and the herd ran violently down a steep place into the lake and were choked’.

Therefore, in the age of the New Testament, it was logical to wear charms (or amulets) to ward off demonic assault. Certain plants were seen as being effective on doing this either at driving devils out or in preventing them entering into and taking possession of the soul. St Johns Wort was one of these. This is one of the reasons it got an early reputation for healing mental ailments. St Johns Wort has heavy Christian connotations. St Johns Wort got its name from John the Baptist in which its said the plant blooms on his birthday.

In the 17th century asylums started to appear.  The concept was to provide a place of refuge for individuals with mental illnesses, moving away from confinement in jails or homes for the poor. Renaissance era teachings of Hippocrates and Galen who were advocates of using herbs like St Johns Wort.

In the early 20th century, Sigmund Freud's psychoanalytic theory introduced the idea that depression might result from unconscious conflicts and unresolved issues. Freud’s work led to talking therapies and psychoanalytic approaches as early treatments for depression however it wasn't till the mid 20th century wherein treatments for depression came with less stigma. Post World War 2 was a catalyst for this. If we are discussing general mental health discourse; it was anxiety which was seen as the most common mental health problem. 

In the mid-20th century, anxiety was the dominant mental health concern, often attributed to the stresses of modern life, with symptoms like nervousness and physical ailments commonly treated with tranquillisers (such as barbiturates) . However, starting in the 1970s, depression gradually replaced anxiety as the primary focus in both clinical practice and public awareness. Once considered a rare and severe condition, depression became recognized as a more common issue, leading to a surge in diagnoses and the widespread use of antidepressants, particularly SSRIs. This shift was driven by changes in psychiatric classification, pharmaceutical marketing, and cultural attitudes. 

Klaus Schmiegel and Bryan Molloy co-invented a class of aryloxyphenylpropylamines named Prozac that were introduced to the American market in 1988.

Regarding St Johns Wort, it’s proven in different studies to have antidepressant qualities and  the ancients were right,  is a wound-healing agent. The isolation of hypericin, and its capacity to generate free radicals on photo-activation make this possible. However with so many antidepressant treatments, talking therapies, medication and counselling, we have come a long way from where we are wherein melancholia was thought as a bile problem.