Sheer lunacy or something else?

I'm not a psychologist but...

This is what the notes in the medical casebook of David Ritchie Sr say about his mental condition shortly after arriving at the London County Asylum in Hanwell:

"When about 18 years old, patient had religious mania, length of time unknown. Six years ago patient again became peculiar for 3 days, he then went to church army. He has been quite all right till last Thursday fortnight, when he was told by his master that he would not suit him and was told that he could go as soon as he got another place, he had only been in this situation a week. This seemed to worry him greatly and that evening he wandered out and gave his money away and had a drink or two and did not get back till five in the morning, he gave his watch away and also his overcoat and also about 2 or 3 pounds in money, and next day wandered about all over Hampstead Heath, and on the Saturday he began to get above [delusions, etcetera] and was taken to the infirmary. Has always been quiet and somewhat strange in his manner. Irritable over trifles. No history of syphilis or drink."

According to the Collins English Dictionary, the word "lunacy" is no longer in technical use and is generally regarded as offensive. It was formerly used to describe any severe mental illness characterised by strange or foolish behaviour. People once thought that insanity was related to the phases of the moon, hence the similarity between "lunacy" and "lunar". Today, much more is known about the causes and symptoms of mental illness, leading to breakthroughs in treatment and a dramatic change in attitudes towards the mentally ill.

It would be very interesting, I think, to get a professional opinion on David Ritchie's presenting symptoms. As someone who has an amateur interest in psychology, I would hazard a guess that what is described in the above notes is standard psychosis, a psychotic break with reality. A psychotic episode can be easily treated with anti-psychotic medication, bringing the patient off his "high" so he can enter therapy. However, David Ritchie Sr wasn't given tablets, nor did he want them. No doubt, he had seen how drugs put some inmates of the asylum into a catatonic state, and was determined to maintain self-control so he could work towards recovery.

I'm not suggesting that the treatment he received was bad. Families who benefitted from the pauper asylums probably felt grateful to the government for what it provided for their sick fathers, mothers, daughters and sons. Yet I still feel desperately sorry for this man whose life could have been so different had he had access to modern medicine. If nothing else, he could have derived so much pleasure out of watching his granddaughters grow up, get married, and give birth to us, his great-grandchildren.

Photo credit: "On Hampstead Heath" by Adrian Clark.