Bu çalışmada 1950'lerden bugüne depresyona karşı başvurulan birincil sağaltım biçimi olan antidepresif farmakoterapinin gelişiminden evvel tarihte depresyon tedavisinde ve etiyolojisinde ne gibi uygulama, tanımlama ve açıklamalara başvurulmuş olduğu, Osmanlı Anadolusu da dâhil olmak üzere her çağdan örnek mahiyetindeki başlıca yazılı eserler üzerinden ele alınmıştır. İncelenen metinlerden varılan sonuçlar özetlenecek olursa, geçen binlerce yılda depresif haletiruhiye; (i) terminolojik olarak "kalbin hiddeti," "melankoli," "nevrasteni," "hipokondri," "mâlihülyâ," "evham," "İngiliz illeti," "Amerikanit," "manik depresif psikoz" gibi çok çeşitli adlarla anılmıştır; (ii) "kanın kalpten taşması"ndan kötü yiyecek ve içeceklerin hazmedilememesine, "kara safra"nın baskınlık ve fazlalığından genel olarak vücuttaki "hıltlar" arasındaki dengesizliğe, çok çalışıp çok düşünmekten az çalışıp boş durmaya, kitle iletişim olanaklarının gelişmesinden kadınların entelektüel faaliyetlere katılmaya başlamasına, medeniyetin getirdiği suni ve müfrit yaşam tarzından dini liberalizme ve iklimlerin kasvetli yağmurlarına kadar, kimi absürt kimi görece makul çok çeşitli etiyolojik açıklamalarla izah edilmiştir; (iii) hılt dengelemek adına çeşitli maddelerle gastrointestinal boşaltıma yol açmak, elektrik akımına maruz bırakmak, kafatasını dağlamak, sıcak/soğuk suyla hidroterapi uygulamak gibi yararsız/zararlı olanlardan; bitkisel droglarla fitoterapi, ağır hayvani yiyeceklerden ve yüksek alkollü içkilerden kaçındırma, doğayla iç içe ve ölçülü bir hayata çağırma, elektrokonvülsif terapi, bilhassa psikanaliz olmak üzere psikoterapi, bedensel ve zihinsel meşguliyet ya da aksine istirahat gibi nispeten yararlı/zararsız sayılabilecek olanlara kadar, çok çeşitli terapötik yöntem ve modaliteler ile tedavi (edilmeye gayret) edilmiştir.
Anahtar Kelimeler: Amerikanit; depresyon; depresyon tarihi; hipokondri; malihulya; manik depresif psikoz; melankoli; nevrasteni
In reference to a set of main representative manuscripts from each era identified, including the Ottoman Anatolia, this study discusses the historical applications, definitions, and explanations elaborated in the treatment and etiology of depression prior to the development of antidepressive pharmacotherapy, the primary therapeutic modality in use against depression since the 1950s. The conclusions drawn from the texts examined can be abstracted as follows: During the past millennia depressive mood (i) was terminologically referred to by numerous names including "the anger of the heart," "melancholy," "neurasthenia," "hypochondria," "mâlihulyâ," "vapors," "the English malady," "Americanitis," and "manic depressive psychosis;" (ii) was etiologically explained sometimes absurdly and sometimes relatively plausibly by miscellaneous causes including "blood overflowing the heart," indigestion of bad foods and drinks, the particular predominance/ excess of the "black bile" or a general imbalance between the "humors" constituting the body, overworking and overthinking, underworking and idleness, development of the mass media, women's participation in intellectual activities, artificial and extravagant lifestyles brought about by civilization, religious liberalism, and rainy, gloomy climates; and (iii) was treated with multifarious therapeutic modalities ranging from futile/harmful practices such as gastrointestinal purgation with various substances for humoral counterbalancing, exposure to electric current, cauterization of the skull, and hydrotherapy with hot/cold water to relatively helpful/harmless methods including phytotherapy with herbal drugs, encouraging for abstaining from strong alcoholic drinks and heavy foods of animal origin and living a moderate life in touch with nature, electroconvulsive therapy, psychotherapy (particularly psychoanalysis), and physical and intellectual occupation or, contrarily, rest.
Keywords: Americanitis; depression; history of depression; hypochondria; mâlihulyâ; manic depressive psychosis; melancholy; neurasthenia
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