Many may have viewed nutritional psychiatry as a new interest in the field of medicine, but it was actually an age-old remedy along with exercise, dating back to as early as the 18th century.
Studies have shown that certain nutrients may provide nerve-calming effects and help to boost our attention, or even lift our mood. For example, omega-3 polyunsaturated fatty acids, or fish oils, have been shown to improve attention in children with attention deficit hyperactivity disorder and to improve depressive mood.
In addition, recent studies have also shown that exercise not only increases the nutrients for our brain cells and bodies, but also helps to fight against memory-declining disorders, such as dementia.
One beautiful Saturday afternoon in March, I decided to pay a visit to the Bethlem Museum of the Mind, located in Bethlem Royal Hospital (BRH) in Beckenham. It was my first visit to the Museum.
he BRH was founded in 1247 and was the first institution in the UK to specialise in the care of the mentally ill. It continues to provide in-patient care as part of the South Landon and Maudsley (SLaM) NHS Foundation Trust, and has been based in South London since 1930.
The Museum was opened in March 2015, and prior to this, there was the Bethlem Gallery — an art gallery established in 1997 to support and exhibit artists who were current or former patients of SLaM. The Gallery is currently housed in the same building, shared with the Museum.
The Bethlem Museum of The Mind currently holds a vast collection of archives and historical objects that tell the history of mental health care in the UK and how it has changed over the years. The museum also periodically holds exhibitions of art works and talks on mental health.
The talk that I attended was given by Dr. Jane Darcy from King’s College London, and was part of the ‘The Anatomy of Melancholy’ exhibition. Dr. Darcy studies 18th- and 19th-century literature, with a special interest in the history of medicine. Her talk was on the diet and exercise strategies recommended by society doctors, including Dr. George Cheyne (1672–1743), to combat melancholy in the 18th century.
Melancholy is not a new term in the modern society. Even Jane Austen’s Mrs. Bennet from Pride and Prejudice knew ‘it was all about your nerves’.
In fact, possibly the most famous publication on melancholy, ‘The Anatomy of Melancholy’ by Robert Burton (1577–1640), was first published in 1621.
Burton’s book uses melancholy, now termed clinical depression, as a lens to scrutinize the emotions and thoughts of individuals. He writes: ‘the subject of our present discourse, is either in disposition or in habit. In disposition, is the transitory Melancholy which goes and comes upon every small occasion of sorrow, need, sickness, trouble, fear, grief…, which causes anguish, dullness, heaviness and vexation of spirit, any ways opposition to pleasure, mirth, joy, delight, causing forwardness in us, or a dislike. In which equivocal and improper sense, we call him melancholy, that is dull, sad, sour…And from these melancholy dispositions no man living is free…none so happy, none so patient, so generous, so godly, so divine, that can vindicate himself; so well-composed, but more or less, sometime or other, he feels the smart of it. Melancholy in this sense is the character of Mortality…This Melancholy of which we are to treat is a habit, a serious ailment, a settled humour…and as it was long increasing, so, now being (pleasant or painful) grown to a habit, it will hardly be removed.’ So, how did the people of the 18th-century deal with melancholy? Dr. Darcy spoked about how Dr. George Cheyne, who was a strong advocate for diet and exercise for such condition, based his advice on personal experience. Cheyne was a popular figure of local social life and carried out his clinical practices with frequent visits to the local taverns, which was a common practice back then. But the frequent visits to the taverns with the large quantity of food and drinks led him to become obese and unhealthy. However, he was able to regain his health by carrying out a meatless diet with only milk and vegetables, and recommended this diet to anyone who suffers from obesity (today, he’s known for his contribution to vegetarianism).
Cheyne also stressed the importance of exercise to his patients. In winter and in bad weather he would advise riding the chamber-horse. A chamber-horse or the exercise chair is usually made of mahogany and leather; it is a chair the simulates the motion made as you rode on a trotting horse. He also suggested walking, riding, fencing, dancing, billiards, tennis, football and digging in good weather. He also encouraged pregnant women not to be confined to their couches and beds, but to pursue air and gentle exercise to promote good health. He also gave advice regarding the time and duration of exercise, where exercise should never be performed on a full stomach and should be constant and orderly, but not violent nor long, until “not to Sweating, but to Warmth.” Another remedy for melancholy that became popularly prescribed by the physicians of the 18th century was cold sea water, whether the method was to bathe in it or drink it. Seaside resorts became where the place of serious healing.
One of the therapies developed was sea bathing, which involved dunking people in the freezing sea repeatedly, until the double effects of cold and suffocation caused “revitalisation.”
The patients would then be lifted from the water in their soaking flannel smocks (for women; men usually received the therapy naked), and were revived with intense back rubs and feet warmers before being carried to dry land for a warm cup of tea. The treatment plans could last from weeks to months.
It was thought that the rise in adrenaline triggered by the sea bath therapy would help reset the balance in the patient’s body and calm their nerves.
It is strange that three centuries later we actually believe that hot temperatures and sauna’s are good for depression. Although, there has recently been a case report re-examining the effect of swimming in open cold water in depression.
Later on, the medical practice of drinking sea water (classically with honey, or sometimes with milk) was revived after the 18th-century physicians and scientists looked back at the texts of Hippocrates and Celsus.
In sum, melancholy or clinical depression is not something new, it has appeared in writing as early as the 17th century. Diet, exercise, visiting nature and life style modifications are also not new ways to combat this illness in the 21st century — the methods have been around for more than 400 years and still prove to be effective. So, maybe today is the day to start a healthy diet, or an exercise regime, or to walk in the park to help us boost the nutrients for our brain cells and keep the mind-body balance.
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