The drama of Shakespeare and his colleagues reflects a common misunderstanding at that time as to the causes of mental health problems. They tended to describe anyone with such difficulties as suffering from ‘madness’ a term we would not now use in those cases; but the dramatists recognized that it was a condition that could arise from great stress and they explored how someone’s mental health could be affected when tested by extreme circumstances. In Thomas Kyd’s popular play, The Spanish Tragedy (?1587) the lead character Hieronimo’s son is murdered and, in failing to obtain legal redress against the perpetrator Lorenzo, Hieronimo’s mental health deteriorates and he resorts to revenge. The title page of an edition printed in 1615 advertises that ‘Hieronimo is mad again’ showing what it was about the play that people recalled and that his behaviour was classed as ‘madness.’
Shakespeare was adept at depicting various mental health problems on the stage. The most well-known is Hamlet, although, of course that character admits that he is feigning his ‘antic disposition.’ It means that he can behave erratically while he tries to work out what he should do about his father’s murder. Sometimes, Shakespeare uses the accepted idea that ‘madness’ can cause strange behaviour as a basis for comedy. In As You like It, Rosalind dismisses love as ‘merely a madness’ and the object of her affections, Orlando, does indeed enter at one point, according to the stage direction, ‘attired like a madman’ and has a tendency to write verses proclaiming his love, pinning them on trees.
Shakespeare also recognised that extreme stress could cause problems with mental health. Lady Macbeth, haunted by her role in the murder of King Duncan relives in her sleeplessness the moment she washed her hands to rid herself of the murdered man’s blood. Shakespeare has Macbeth recognize his wife’s condition – he asks the doctor ‘Can’st thou minister to a mind diseased?’ But the doctor’s reply ‘Therein the patient must minister to himself’ is not an absolutely truthful reflection of contemporary beliefs. In fact, Shakespeare’s own son-in-law, John Hall seems to have believed that some mental health issues were treatable since, in his casebook is a record of his treating a 17-year old girl. He treated it with enemas, laxatives and purgatives as if it were a physical illness that could be expelled from the body.
John Hall’s treatment of this patient is an indication that there was a more enlightened approach to mental health issues at this time than we might suppose. Despite the popular conception that in the past people with mental health problems were believed to be possessed by demons or devils that had to be cast out, or removed from society as a threat to its well-being, some modern mental health historians have theorized that many were viewed sympathetically. It was not seen as their fault that they were ill, merely that they were frail and served as an illustration of the constant battle for people to resist the temptations of evil and to do good (Fink, p. 41). That they were affected thus was deemed to be their unfortunate lot in life and because of this, they should be treated with kindness not cruelty (Fink, p. 44).