Mental Health Psychology / Psychiatry Women's Health / Gynecology

The history of a controversial ‘condition’: Female hysteria

Doctors have quickly diagnosed women with “hysteria,” an assumed mental health disorder for centuries, explaining any habits or signs that made men uncomfortable.

Historical status
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For the better part of two decades, all of these and more might easily come under the umbrella of “female hysteria,” a fondness for writing, signs of post-traumatic stress disorder or depression, and even infertility.

Female hysteria was one of the most commonly diagnosed “disorders” throughout the 18th and 19th centuries. But the mistaken notion that women are somehow predisposed to mental and behavioral conditions is much older than that.

In fact , the term hysteria originated in Ancient Greece. The womb, hystera, which they said appeared to wander about the female body, was spoken by Hippocrates and Plato, triggering a number of physical and mental disorders.

But what was female hysteria meant to be, what were its symptoms, how did physicians “treat ” it, and when did they cease to diagnose it as a medical condition?

These are some of the questions in this feature in Curiosities in Medical History that we answer.

Female hysteria in the 18th century

While the original notions of female hysteria stretch well into the history of medicine and philosophy, this diagnostic became popular in the 18th century.

French physician Joseph Raulin described hysteria in 1748 as a ‘vaporous ailment’-affection vaporeuse in French — a disease spread in large urban areas by air pollution.

While Raulin observed that both men and women could contract hysteria, because of their lazy and irritable disposition, women were, according to him, more predisposed to this ailment.

Another French doctor, François Boissier de Sauvages de Lacroix, described hysteria as something akin to emotional instability in a treatise published in 1770-1773, “subject to sudden changes with great sensitivity to the soul.”

Some of the signs of hysteria he alluded to included: “swollen belly, suffocating angina [chest pain] or dyspnea [shortness of breath], dysphagia [difficulty swallowing], cold limbs, tears and laughter, oscitation [yawning], pandiculation [stretching and yawning], delirium, tight and driving heart, and plentiful and clear urine.”

De Sauvages agreed with his predecessors that women were mainly affected by this disease, and that “men are seldom hysterical.”

According to him, sexual neglect was often the source of female hysteria. He introduced the case study of a nun impacted by hysteria to explain this, who was healed only when a well-wishing barber took it upon himself to please her.

Via mesmerism, an alleged psychosomatic procedure popularized by Franz Anton Hypnot, a German doctor who was active in Europe in the 18th century, was another way to “treat” instances of hysteria.

Mesmer claimed that magnetism, an intangible current that ran through animals and humans, and whose imbalances or fluctuations could lead to health disturbances, affected living beings.

Mesmer believed that he was able to operate on this magnetic undercurrent and cure numerous illnesses, including hysteria, in humans.

Hysteria in the 19th century

There was perhaps also more discussion of female hysteria and its possible causes in the 19th century and the beginning of the 20th century.

Silas Weir Mitchell, an American physician who had a particular interest in hysteria, began advocating the “rest cure” as a “treatment” for this disease around the 1850s.

Lots of bed rest and strict avoidance of all physical and mental activity were included in the rest cure. Mitchell preferentially recommended this medication to women who he found to be hysterical.

He would encourage men with hysteria, on the other hand, to participate in loads of outdoor exercise.

The remaining remedy was famously prescribed by Mitchell to the American author Charlotte Perkins Gilman, who found the experience so harrowing that she wrote “The Yellow Wallpaper,” a psychological horror story that maps the gradual psychological degradation of a woman who is compelled to pursue this “treatment” by her doctor, her husband, and her brother.

Neuropsychiatrist Pierre Janet, who was most active between the 1880s and the early 1900s, claimed in France that hysteria arose from the distorted understanding of physical disease by an individual himself.

Janet wrote that hysteria was “a nervous disease ” where “ a dissociation of consciousness ” took place, frequently characterized by symptoms such as somnambulism, the appearance of“ double personalities, ”and involuntary convulsions.

Sigmund Freud, the father of psychoanalysis, also took an interest in hysteria, although his views on its causes differ throughout his career.

He argued that hysteria, often with an element of erotic suppression, was the conversion of psychological problems into physical symptoms.

At first, he suggested that traumatic events caused symptoms of hysteria, although later, he said that previous trauma was not necessary for the development of hysteria.

Vibrators for hysteria?

The 2011 Rom-com Hysteria popularized the view that in female patients, vibrators are tools intended to treat hysteria.

This tale stems from Rachel Maines ‘s groundbreaking book on medical history: The Technology of Orgasm, which first appeared in 1999.

In the late 19th century, Maines argued, physicians would often treat the symptoms of hysteria in female patients by manually stimulating their genitalia. The vibrator finally appeared, according to her, as a gadget that would save doctors some effort when treating their patients.

More recently, however, researchers argue that the viewpoint of Maines was flawed and that no evidence existed to support her theory.

“None of her English-language sources even mention the production of ‘paroxysms’ [an euphemism for orgasm] through massage or something else that might remotely indicate an orgasm,” says its research paper that contradicts Maines’s theory.

Yet such stories and theories arose precisely because the relation between female sexuality and hysteria was stressed by 19th-century medical treatises.

Some doctors of the 19th century infamously suggested that genital problems could cause psychological problems, including hysteria, in women.

For example, Richard Maurice Bucke, a Canadian psychiatrist active in the late 19th century, preferred to conduct invasive surgery to “cure” female mental illness patients, such as hysterectomies, where doctors extract the uterus.

Hysteria, therefore, remained an umbrella term for a long time, which included numerous and widely different symptoms, reinforcing harmful sex and gender stereotypes.

Although this “condition” is no longer recognized and started in the 20th century to “fall out of fashion,” this was actually a long and unstable process.

The American Psychiatric Association ( APA)‘s first Diagnostic and Statistical Manual of Mental Disorders (DSM-I), published in 1952, did not list hysteria as a state of mental health.

Yet it reappeared in the 1968 DSM-II, until it was withdrawn again in the 1980 DSM-III by the APA.

Again and again, medical history scholars point to evidence that hysteria was nothing more than a way of explaining and pathologizing “everything about women that men considered mysterious or unmanageable.”

And while medical practices have progressed incomparably over the past few decades, studies still show that knowledge on women in medical studies is often scarce.

This, in fact, tends to influence whether they receive accurate diagnosis and therapies, indicating that there is a long way to go for society and medical science to ensure that all demographics have the greatest chance of proper healthcare.