Hysteria: An Emotional State Or Something More Complex?

Hysteria is a term that has been used to mean ungovernable emotional excess and can refer to a temporary state of mind or emotion. The word hysteria originates from the Greek word for uterus, hystera. In the nineteenth century, hysteria was considered a diagnosable physical illness in women, believed to be caused by disturbances of the uterus. Hysteria was also associated with women's inability to bear children or their unwillingness to marry. Today, hysteria is no longer recognised as a medical diagnosis, and most physicians do not accept it as a medical condition. Instead, the symptoms that were once attributed to hysteria are now understood to be part of various other medical conditions, such as epilepsy, histrionic personality disorder, and dissociative disorders.

Is hysteria a diagnosable condition?

Hysteria is no longer considered a diagnosable condition by most physicians. However, its history as a diagnosable illness, particularly in women, has had a significant influence on the medical field and society's perception of women's health and behaviour.

Ancient Beliefs about Hysteria

The term hysteria is

What are the symptoms of hysteria?

The symptoms of hysteria have varied historically and are no longer recognised as a medical diagnosis. However, symptoms once associated with hysteria can be useful in understanding the evolution of medical and psychiatric understanding.

In ancient Egypt, hysteria was associated with "spontaneous uterus movement", or a "wandering uterus". Treatments for this included exposing women to different smells, placing bad-smelling substances near the woman's vulva or face, or having them swallow unsavoury herbs. The Greeks and Romans also attributed hysteria to abnormalities in the womb, with Plato and Aristotle believing that hysteria was caused by a lack of sexual activity.

In the early 1600s, anatomist Thomas Willis proposed that hysteria was not related to the uterus but to the brain, suggesting that men could also be affected by hysteria. Symptoms of hysteria in Victorian times included hallucinations, nervousness, and partial paralysis.

In the late 19th century, Jean-Martin Charcot, a French neurologist, described hysteria as "the great neurosis", theorising that it was a hereditary, physiological disorder impairing areas of the brain. Charcot's student, Sigmund Freud, believed hysteria was caused by a 'psychological scar' from trauma or repression. Symptoms of hysteria in Freud's patients included self-harm and immense guilt.

Today, symptoms once associated with hysteria might be diagnosed as somatic symptom disorder, dissociative disorder, or conversion disorder. These disorders can include symptoms such as:

• Histrionic behaviour (being overly dramatic or excitable)
• Increased suggestibility
• Feeling as though in a trance
• Experiencing paralysis
• Fainting or passing out (syncope)
• Having epileptic-like seizures
• Feeling increased pain sensations
• Rigid or spasming muscles

What are the treatments for hysteria?

Hysteria was once a common diagnosis for women, but it is no longer recognised as a medical disorder. The treatments for hysteria have evolved over the years, from ancient times to the modern era.

Ancient Treatments for Hysteria

In ancient times, hysteria was believed to be caused by a "wandering womb", with the first descriptions of hysteria found in the Kahun Papyri from ancient Egypt, dating back to 1900 BC. The ancient Greeks and Romans also believed in this theory, with Plato comparing a woman's uterus to a living creature that wanders throughout the body. The standard cure for this "hysterical suffocation" was scent therapy, where good smells were placed under a woman's genitals, and bad odours were placed near her nose. Fumigation with special fragrances was also believed to draw the uterus back to its natural spot. Galen, a 2nd-century physician, recommended rubbing ointments into the external genitalia, to be performed by midwives rather than physicians.

Medieval and Renaissance Treatments for Hysteria

During the Middle Ages, another cause of hysteria was believed to be demonic possession. After the 17th century, this idea was gradually discarded, and hysteria was described as a behavioural deviance or a medical issue. In the 16th and 17th centuries, hysteria was attributed to the retention of fluids in the uterus, sexual deprivation, or the wandering womb. Marriage and regular sexual encounters with a husband were recommended as a long-term treatment. If a woman was unmarried or widowed, manual stimulation by a midwife using certain oils and scents was suggested.

Modern Treatments for Hysteria

In the 18th century, hysteria became associated with the brain rather than the uterus, and it was acknowledged that both men and women could experience hysteria. During this time, French physician Philippe Pinel advocated for kindness and sensitivity in the treatment of hysteria patients. Another French physician, Francois de Sauvages de La Croix, identified common signs of hysteria, including tears, laughter, yawning, chest pain, shortness of breath, difficulty swallowing, delirium, a rapid pulse, a swollen abdomen, cold extremities, and abundant and clear urine.

In the 19th century, Jean-Martin Charcot argued that hysteria was a physical condition of the mind, not the body, and his use of photography influenced how women's health and distress were perceived. Hysteria began to be viewed as a psychological ailment rather than a physical one. During this time, treatments for hysteria included physical therapy, hydrotherapy, electrotherapy, and ovary compression, as well as 'moral' therapies such as rest, isolation, hypnosis, and suggestion.

In the early 20th century, the number of hysteria diagnoses declined due to advancements in psychology and the introduction of psychoanalysis by Sigmund Freud. Freud theorised that hysteria was an emotional, internal condition caused by previous trauma that affected the individual's ability to enjoy sex. He also developed the Oedipus complex, which associated femininity with a lack of masculinity. Hysteria was officially removed from the DSM in 1980.

Today, the treatment for hysteria, now recognised as functional neurological disorders, includes intensive physiotherapy, psychotherapy, and in some cases, psychoanalysis. Antidepressants and anxiolytics may also be prescribed, and cognitive and behavioural therapy is a more recent approach.

What is the history of hysteria?

The history of hysteria dates back to ancient Egypt, around 1900 BCE, when Egyptians recorded behavioural abnormalities in adult women on the Kahun Papyrus. They believed that hysteria was caused by a wandering uterus and treated it by placing strong-smelling substances on the patients' vulvas to encourage the uterus to return to its proper position. The ancient Greeks accepted this explanation, with Plato and Aristotle believing that hysteria was caused by a lack of sexual activity. They described the uterus as sad or melancholic when it had not joined with a male and failed to give birth.

In the 5th century BCE, Hippocrates first used the term 'hystera', derived from the Greek word for 'uterus'. He associated hysteria with abnormal uterus activity within the body and believed that a lack of sexual activity caused toxic fumes to travel around the body, resulting in various symptoms. The ancient Romans also attributed hysteria to an abnormality in the womb but discarded the idea of a wandering uterus, instead believing it was caused by a disease of the womb or a disruption in reproduction.

Between the 5th and 13th centuries, the influence of Christianity in the Latin West altered the understanding of hysteria. It became perceived as satanic possession and was treated through prayers, amulets, and exorcisms. During the Renaissance, many patients of hysteria were prosecuted as witches and underwent interrogations, torture, exorcisms, and execution.

In the 16th and 17th centuries, activists and scholars worked to change the perception of hysteria back to a medical condition. In 1697, English physician Thomas Sydenham theorised that hysteria was an emotional condition rather than a physical one. In the 18th century, hysteria started to be associated with the brain rather than the uterus, opening the possibility that it could affect both sexes.

During the Victorian era, hysteria was described as a cluster of signs and symptoms such as hallucinations, nervousness, and partial paralysis, thought to affect only women. It was considered a diagnosable physical illness in women in the 19th century and a mental illness in the 20th century. Influential figures such as Sigmund Freud and Jean-Martin Charcot dedicated research to hysteria patients. Freud believed that hysteria stemmed from childhood sexual abuse or repression.

In the 20th century, hysteria diagnoses began to decline in Western countries, replaced by anxiety and depression diagnoses. By the end of the century, hysteria was removed from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. Today, hysteria is not accepted as a medical diagnosis, and symptoms previously attributed to hysteria are now classified under various medical categories such as epilepsy, histrionic personality disorder, conversion disorders, and dissociative disorders.

Is hysteria gendered?

The term "hysteria" has been used as a synonym for over-emotional or deranged, and it is often gendered. The word itself comes from the Greek "hystera", meaning "uterus", and the earliest meaning of the term was "of, relating to, or characterised by hysteria", referring to a medical diagnosis. Hysteria was historically believed to be caused by a wandering uterus, which would place pressure on other organs and cause ill effects. This belief was supported by the works of Plato and the physician Aeataeus, and was called "hysterical suffocation".

The idea that hysteria was a female-only condition persisted for millennia, with Western medicine and culture reinforcing the connection between the understanding of women's behaviour and their reproductive capacity. In the 19th century, physicians widely attributed mental disturbance in women to a malfunction of their sex organs, a phenomenon that had no parallel in the diagnosis of male patients. Even when French neurologist Jean-Martin Charcot emphasised that hysteria could afflict both men and women, the wider medical community continued to associate female psychology with female physiology.

While the term "hysterical" can be used to describe men, it is most often applied to women. A study of the Corpus of Contemporary American English (COCA) found that the word "hysterical" is used with female-tagged nouns 49% of the time, compared to 14% for male-tagged nouns. The study also found that when used to describe men, "hysterical" is usually used to describe a mental or emotional point of no reasonable or safe return, such as a veteran with PTSD experiencing a psychotic break.

The gendered nature of the term "hysterical" is further evidenced by the fact that it is often used to shame women who challenge authority or express dissent and passion. Women who do not conform to traditional gender roles and expectations are often labelled as hysterical, with the implication that their behaviour is a result of their unstable and deviant bodies. This is particularly evident in political contexts, where conservative figures frequently use the language of mental illness to discredit their opponents, particularly women.

In summary, while the term "hysterical" can be applied to both men and women, it is most often used to describe women and is closely linked to gendered stereotypes and expectations. The continued use of the term contributes to the degradation and control of women, reinforcing the idea that women's behaviour is inherently tied to their biology.

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