Hysteria is a pejorative term that colloquially means ungovernable emotional excess and can refer to a temporary state of mind or emotion; however, in the 19th century hysteria was considered a diagnosable physical illness in females, and then in the 20th century shifted to a mental illness. Many influential psychiatrists such as Sigmund Freud and Jean-Martin Charcot dedicated research to hysteria patients. Currently, most doctors practicing Western medicine do not accept hysteria as a medical diagnosis. The blanket diagnosis of hysteria has been fragmented into myriad medical categories such as epilepsy, histrionic personality disorder, conversion disorders, dissociative disorders, or other medical conditions. Furthermore, social deviances, such as deciding not to wed, are no longer considered psychological disorders.
The word hysteria originates from the Greek word for uterus, hystera. The oldest record of hysteria dates back to 1900 B.C. when Egyptians recorded behavioral abnormalities in adult women on medical papyrus. The Egyptians attributed the behavioral disturbances to a wandering uterus—thus later dubbing the condition hysteria. To treat hysteria Egyptian doctors prescribed various medications. For example, doctors put strong smelling substances on the patients’ vulvas to encourage the uterus to return to its proper position. Another tactic was to smell or swallow unsavory herbs to encourage the uterus to flee back to the lower part of the female’s abdomen.
The ancient Greeks accepted the ancient Egyptians’ explanation for hysteria; however, they included in their definition of hysteria the inability to bear children or the failure to marry. Ancient Romans also attributed hysteria to an abnormality in the womb; however, discarded the traditional explanation of a wandering uterus. Instead, the ancient Romans credited hysteria to a disease of the womb or a disruption in reproduction (i.e. a miscarriage, menopause, etc.). Hysteria theories from the ancient Egyptians, ancient Greeks, and ancient Romans were the basis of the Western understanding of hysteria.
Between the fifth and thirteenth centuries, however, the increasing influence of Christianity in the Latin West altered medical and public understanding of hysteria. St. Augustine's writings suggested that human suffering resulted from sin, and thus, hysteria became perceived as satanic possession. With the shift in perception of hysteria came a shift in treatment options. Instead of admitting patients to a hospital, the church began treating patients through prayers, amulets, and exorcisms. Furthermore, during the medieval and Renaissance periods many patients of hysteria were prosecuted as witches and underwent interrogations, torture, and execution.
However, during the sixteenth and seventeenth centuries activists and scholars worked to change the perception of hysteria back to a medical condition. Particularly, French physician Charles Lepois insisted that hysteria was a malady of the brain. In addition, in 1697, English physician Thomas Sydenham theorized that hysteria was an emotional condition, instead of a physical condition. Many physicians followed Lepois and Sydenham's lead and hysteria became disassociated with the soul and the womb. During this time period science started to focalize hysteria in the central nervous system. As doctors developed a greater understanding of the human nervous system, the neurological model of hysteria was created, which further propelled the conception of hysteria as a mental disorder.
In 1859 Paul Briquet defined hysteria as a chronic syndrome manifesting in many unexplained symptoms throughout the body's organ systems. What Briquet described became known as Briquet's syndrome, or Somatization disorders, in 1971. Over a ten year period, Briquet conducted 430 case studies of patients with hysteria. Following Briquet, Jean-Martin Charcot studied women in an asylum in France and used hypnosis as treatment. He also mentored Pierre Janet, another French psychologist, who studied five of hysteria's symptoms (anesthesia, amnesia, abulia, motor control diseases, and character change) in depth and proposed that hysteria symptoms occurred due to a lapse in consciousness. Both Charcot and Janet inspired Sigmund Freud's work. Freud theorized hysteria stemmed from childhood sexual abuse or repression, and was also one of the first to apply hysteria to men.
During the 20th century, as psychiatry advanced in the West, anxiety and depression diagnoses began to replace hysteria diagnoses in Western countries. For example, from 1949 to 1978 annual admissions of hysteria patients in England and Wales decreased by roughly two thirds. With the decrease of hysteria patients in Western cultures came an increase in anxiety and depression patients. Although declining in the West, in Eastern countries such as Sudan, Egypt, and Lebanon hysteria diagnoses remained consistent. Theories for why hysteria diagnoses began to decline vary, but many historians infer that World War II, westernization, and migration shifted Western mental health expectations. Twentieth century western societies expected depression and anxiety manifest itself more in post World War II generations and displaced individuals; and thus, individuals reported or were diagnosed accordingly. In addition, medical advancements explained ailments that were previously attributed to hysteria such as epilepsy or infertility. After a gradual decline in diagnoses and reports, in 1980 hysteria was removed from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), which had included hysteria as a mental disorder from its second publication in 1968.
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In the late nineteenth century, French neurologist Jean-Martin Charcot, attempted to tackle what he referred to as, "the great neurosis" or hysteria. Charcot theorized that hysteria was a hereditary, physiological disorder. He believed hysteria impaired areas of the brain which provoked the physical symptoms displayed in each patient. While Charcot believed hysteria was hereditary, he also thought that environmental factors such as stress could trigger hysteria in an individual.
Charcot published over 120 case studies of patients who he diagnosed with hysteria, including Marie "Blanche" Whittman. Whittman was referred to as the "Queen of Hysterics," and remains the most famous patient of hysteria. To treat his patients, Charcot used hypnosis, which he determined was only successful when used on hysterics. Using patients as props, Charcot executed dramatic public demonstrations of hysterical patients and his cures for hysteria, which many suggest produced the hysterical phenomenon. Furthermore, Charcot noted similarities between demon possession and hysteria, and thus, he concluded "demonomania" was a form of hysteria .
In 1896 Sigmund Freud, Austrian psychiatrist, published "The Aetiology of Hysteria". The paper explains how Freud believes his female patients' neurosis, which he labels hysteria, resulted from sexual abuse as children. Freud named the concept of physical symptoms resulting from childhood trauma: hysterical conversion. Freud hypothesized that in order to cure hysteria the patient must relive the experiences through imagination in the most vivid form while under light hypnosis. However, Freud later changed his theory. His new theory claimed that his patients imagined the instances of sexual abuse, which were instead repressed childhood fantasies. By 1905 Freud retracted the theory of hysteria resulting from repressed childhood fantasies. Freud was also one of the first noted psychiatrist to attribute hysteria to men. He diagnosed himself with hysteria--writing he feared his work exacerbated his condition.
For the most part, hysteria does not exist as a medical diagnosis in Western culture and has been replaced by other diagnoses such as conversion or functional disorders. The term hysterical, applied to an individual, can mean that they are emotional, irrationally upset, or frenzied. When applied to a situation that does not involve panic, hysteria means that situation is uncontrollably amusing (the connotation being that it invokes hysterical laughter). Hysteria can also impact groups, medically and colloquially referred to as mass hysteria or mass psychogenic illness. Instances of mass hysteria have been recorded throughout history and continue to occur today.
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