Hysteria << hihs TEHR ee uh or hihs TIHR ee uh >> is a medical diagnosis that is no longer in use. The word hysteria comes from the Greek word hystera, meaning uterus (womb). Ancient Greeks explained certain pains or sensations felt by women by saying that the pains were caused by the uterus “wandering” in the body and bumping up against certain organs. Stomach pain might be explained as the uterus bumping up against the liver. The uterus was supposedly wandering because it was empty. It was thought the pains might cease if the woman became pregnant.
History of hysteria.
For many centuries, people who complained of heart palpitations, difficulty moving their limbs, stomach pains, difficulty swallowing, nausea, or vomiting were often diagnosed with hysteria. Doctors treating these and other symptoms could have difficulty, at first, distinguishing mild complaints from serious or even life-threatening illness. But if enough time safely passed without mishap, the complaints were diagnosed as “hysteria.”
Over time, a wide assortment of physical and mental states came to be considered hysteria. This was especially so in the late 1800’s. By the late 1900’s, however, psychiatrists had stopped diagnosing hysteria. One reason for this change was that attributing so many symptoms to hysteria dismissed women’s medical concerns. Physicians had also recognized that “hysterical” symptoms were found in men as well as in women, even though some occurred more often in women. Overall, there was also a greater appreciation of the wide variety of conditions with psychological causes.
People still use the word hysterical in a nonmedical sense to describe extreme emotions, such as great excitability, outbursts of weeping, or extreme anger. These emotions usually have little to do with official diagnoses, though some of them can be symptoms found in certain mental disorders.
Related diagnoses.
Psychiatrists today generally consider the separation of mental and physical symptoms to be less important than they did in the past. They also recognize that childhood trauma is an underlying cause of many psychiatric conditions, including some that may previously have been diagnosed as hysteria.
An important shift in diagnosis and terminology related to the idea of hysteria came with the 1980 edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), a classification system published by the American Psychiatric Association. Readers who looked up the word hysteria in the book’s index were redirected to other diagnoses.
The 2013 edition of the DSM includes several categories of disorders that might have been labeled hysteria in the late 1800’s and early 1900’s. These categories are (1) trauma and stressor-related disorders, (2) dissociative disorders, and (3) somatic symptom and related disorders. Some individuals may experience overlap of these disorders, or certain symptoms in addition to them.
Trauma and stressor-related disorders
are based on “exposure to a traumatic or stressful event” in childhood or adulthood. Such disorders include post-traumatic stress disorder (PTSD), attachment (relationship) disorders, and social neglect. Social neglect results from the absence of adequate caregiving during childhood.
Dissociative disorders
involve a loss or change of memory or identity. These disorders include depersonalization (out-of-body experiences), amnesias, dissociative identity disorder (formerly called multiple personality disorder), and trances.
Somatic symptom and related disorders
include conversion disorder. Conversion disorder was once described as the translation of emotional feeling into bodily states. For example, someone might experience the paralysis of a limb instead of feeling great rage. However, individuals with the disorder felt the term conversion disorder implied their physical symptoms were not real. For that reason, doctors today usually call this disorder functional neurological symptom disorder. Another disorder in the same category, somatic symptom disorder, is a diagnosis for an individual’s excessive focus on somatic (bodily) concerns. The diagnosis of this disorder has replaced the older diagnosis of hypochondriasis (see Hypochondria).
Treatment.
Some of the disorders above—particularly those that involve pain—are treated by primary care doctors. However, psychiatrists and psychologists are better trained to treat many of them. These specialized doctors generally treat patients with various kinds of psychotherapy. Occasionally, hypnosis may be used. Various medicines can also provide effective treatment. These medicines include antidepressants and anxiolytics (antianxiety drugs). Certain symptoms may be treated with antipsychotic medications. See Mental illness (Treatment of mental illness).
