Manic-depressive insanity in the sense here delimited is a very frequent disease. About 10 to 15 per cent, of the admissions in our hospital belong to it. The causes of the. malady we must seek, as it appears, essentially in morbid predisposition.
…and that was in 1921.
All quotes from: Manic-Depressive Insanity and Paranoia
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Emil Kraepelin is still quoted in academic papers and so forth, but obviously when reading him we must remember it was published first in 1921. Nonetheless, much holds true and much will resonate, even with the most postmodern, label fearing manic depressive. His clinical studies are fascinating no matter what we think of the results these days and whether or not you agree with Hagop Akiskal’s proposal to create more (and more precise) categories within bipolar disorder, Kraepelin is extremely interesting as a starting point. It’s also interesting to see how much of what we know about the disorder now, was already known then, almost a century ago.
I’ve only pulled out quotes about depression, but there’s a whole heap more and I found him particularly fascinating on the subject of psychosis.
Deploy quotation marks.
Manic-depressive insanity in the sense here delimited is a very frequent disease. About lo to 15 per cent, of the admissions in our hospital belong to it. The causes of the. malady we must seek, as it appears, essentially in morbid predisposition.
In contrast to that, the feelng of mental inhibition in states of depression is often greater than the actual lowering of efficiency, probably because the inhibition of thought can be overcome up to a certain degree by volitional effort, but just by that it becomes especially distinct to consciousness. The patients complain that they feel themselves “as if under a ban,” as if fettered, that their thoughts are paralysed, that they now need hours for the simplest mental activity, as for example writing a letter, which formerly they could accomplish in a few minutes.
The torment of the states of depression, which is nearly unbearable, according to the perpetually recurring statements by the patients, engenders almost in all, at least from time to time, weariness of life, only too frequently also a great desire to put an end to life at any price. “There’s nothing to be done with me but powder or in water,” said a female patient, and another expressed herself thus, “Millstone round my neck, and then to the bottom of the sea.”
Insight. —Sense and orientation are in spite of the great difficulty in perception and thinking completely retained. Generally a very vivid morbid feehng also exists, not infrequently even a certain morbid insight, in as far as the patients express their regret for former improprieties, and their fear lest they might again let themselves be carried away by excitement.
The duration of the attack is usually longer than in mania ; but it may likewise fluctuate between a few days and more than a decade.
“I was on a small scale always melancholic,” declared a patient, and a female patient said, “I brought melancholy with me into the world.”
At this point the experience which I had of the form of manic-depressive insanity among the natives of Java, is perhaps not without significance. There was a whole series of cases there which I thought I should include in this form; these were relatively not fewer than among the European patients examined at the same time.
Specific comforting encouragement at the height of the moodiness is for the most part fairly ineffectual; later when the mood is clearing up, the benefit without doubt often appears greater than it is in reality
Recall quotation marks.
Zomg, I am such a fucking nerd.