Answering this question is the holy grail of psychiatry. Even before there were psychiatrists, such troubles were blamed on things like evil spirits, or an imbalance of “humors.” The latter was treated by bloodletting, which is perhaps the longest running tradition in medicine, originating in the ancient civilizations of Egypt and Greece, persisting for some 2,500 years through the Industrial Revolution. It was the “aspirin” of the day, used for just about every conceivable condition from pneumonia to depression. Yet, there was never any evidence that it did any good, and many times the patients died. Of course, it was always assumed it was the disease that killed them, rather than the treatment.

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