The dominant definition for madness from ancient times until the 17th century was that of a social deviation, a type of behavior which was incomprehensible and incompatible with existing norms. The sole vague definition of madness that medicine of that time provided came from Galen (129-c.199), who attributed madness to disturbances in the four humors (bodily fluids). From the 17th century in Europe, the first mental hospitals began to admit patients. The role of the doctors was still consigned mainly to providing supervision and care, rather than actually treating a patient.
It was during that time that the idea of describing madness as a mental disorder emerged and the first works on mental illnesses, their classes and symptoms were published. This shift in the interpretation of madness was succeeded by the psychoanalytical approach developed by Sigmund Freud (1856-1939). He challenged the common perceptions of hysteria (an illness traditionally confined to women) as a problem due to physical factors and argued for a more fine, psychoanalytical approach.
In 1948, Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association was published. The physical interpretation of madness was challenged by feminists and anti-psychiatrists, like Thomas Szasz (b. 1920) and Ronald Laing (1927 -1989), who argued that madness was a social stigma and had no physical existence. The "existence," of different kinds, or trends of madness tends sto support this. For example, in the 19th century doctors reported multiple cases of glass delusions. The most famous patient suffering from such a delusion was Princess Alexandra Amelie of Bavaria (1826-1875) who at the age of 23 was seen awkwardly walking. When questioned by her parents, she announced that she had swallowed a grand glass piano.
There are no credible studies of gender differences in the rate of suffering from mental illnesses. Although most women experience emotional swings during the menopause, there is no empirical evidence that links menopause and depression or mental disorders.
One reason for why women are seen as more susceptible than men to mental problems is that they are often vulnerable or dependent. Women who comply with society's expected gender role might have that behavious used against them to define them as mad. Meanwhile, women who dare to challenge the fixedness of gender roles are considered as socially deviant and, therefore, are mad too.
Not until the late 20th century could the quality of treatment of mental illness be described as anything more than basic. Sometimes, it was no better than babaric. Janet Frame (1924 -2004) and Kate Millett (b 1934) both provided remarkable autobiographical accounts of their own treatment for mental illness in hospitals. Frame was diagnosed as a schizophrenic when she was 23 years old and spent five years in what was then called "a mental institution." After being discharged from London's Maudsley Hospital, Frame visited another hospital where the schizophrenia diagnosis was refuted. In her book, Frame admitted that there were grounds for her hospitalization, due to her uncontrolled mood swings and some physical problems. But Millett refused to accept the diagnosis of maniacal disorder.
Other narratives are much darker. The Bell Jar (1963), by the poet Sylvia Plath's (1932-1963), Lori Schiller's The Quiet Room (1994) and Elizabeth Wurtzel's (b. 1967) The Prozac Nation (1994) present the crushing effects of mental illnesses. The main heroines of these books are ugly, dirty and inclined to hurt themselves.
But while the feminist authors questioned the quality of help provided at mental hospitals, there were cases that showed how patients with heavy mental problems could benefit from therapy. Mad, Bad, and Sad: Women and the Mind Doctors (2008), by Lisa Appignanesi (b. 1946), opens with the story of Mary Lamb (1764-1847), a writer who had murdered her mother in a manic fit. After serious therapy and support from her brother, Lamb managed to bring her distress under control.
Contemporary therapies do not treat madness, but rather mental illnesses, including depression and work-related stress. Cognitive-behavioral therapy is seen as an effective treatment for men as well as women.