When did the medical world start to understand anxiety disorders? Learn about the diagnosis and treatment of anxiety from ancient to modern times.

Doctors and therapists know a lot about anxiety. Education campaigns have helped the general public understand more about it, too. Many of us know at least the basics of what anxiety is and how to treat it.

But have we always known about it? When did humanity discover the concept of having an “anxiety disorder”? How did people deal with these disorders in the past?

You might be surprised to learn that although anxiety disorders have always been with us in some form, we knew very little about them until the start of the 20th century.

Anxiety disorders have always been part of the human experience. Even as far back as 5,000 BC, descriptions of something that sounds like post-traumatic stress disorder (PTSD) appear in ancient Indian writings.

But the study of anxiety really got its start about 2,000 years ago in the Greco-Roman world.

Ancient writers like Hippocrates, Cicero, and Seneca described people who had symptoms that we today recognize as anxiety symptoms, like irrational fears of certain situations or continual worry. They thought these symptoms might be related to disease or problems within the body.

Even though the Greco-Roman philosophers noticed anxiety symptoms, it took centuries for humans to make much progress in understanding anxiety.

In the 1600s, physicians and scholars began writing about a condition they called “melancholia.” Melancholia was a broad term that covered many different anxiety and depression symptoms.

Nervous conditions were also sometimes called “vapors.” Doctors didn’t fully understand that anxiety and depression were distinct conditions, or that there could be different kinds of anxiety disorders.

Humanity’s understanding of anxiety didn’t advance much in the next 200 years. A French medical textbook from the 1700s moved the needle forward by identifying a term called “panophobia.”

Panophobia was described as an intense fear at night that comes over a person for no reason. Modern psychologists would probably call this night terrors.

This textbook described subtypes of panophobia that match up with modern diagnoses like hypochondria or generalized anxiety disorder. Physicians were beginning to realize that these anxiety symptoms could actually be grouped into different categories.

The medical field really got interested in defining and diagnosing anxiety in the late 1800s and early 1900s. It started with the term “neurasthenia” in 1869, which covered a broad range of anxious symptoms.

Psychiatrists like Sigmund Freud would expand on that term to refine the definitions of different types of anxiety even further. The first Diagnostic and Statistical Manual of Mental Disorders (DSM) was published in 1952.

It was the first time that the medical community clearly defined and wrote down guidance about the subtypes of anxious conditions.

It took about 30 more years to fully understand these subtypes. Many of the anxiety diagnoses we’re familiar with today weren’t named until the DSM-III in 1980, such as:

People have been trying to figure out how to ease anxiety symptoms since the dawn of time, but it took a long time before effective treatments were discovered.

Ancient scholars on anxiety treatment

Although the ancients didn’t have a sophisticated way to diagnose different anxiety disorders, their solution might sound surprisingly modern.

The Stoic philosophers of ancient Rome recognized that symptoms of anxiety were caused by thoughts and feelings that might be negative or untrue.

So, they reasoned, people should learn to deal with their inner thoughts differently in order to cope. They encouraged people to embrace the present moment rather than focus on the past or the future.

Outside circumstances can’t always be controlled, they reasoned, so we have to control our inside reactions instead.

20th-century treatment progress

It wasn’t until the early 20th century that physicians and psychologists began to take meaningful steps toward easing anxiety for the average patient.

In the 1930s, Orval Mowrer’s 2-factor theory built on Pavlovian conditioning, also known as fear conditioning, and began the initial drive toward modern exposure therapies.

Once anxiety became more widely understood, neurologists and psychologists like Sigmund Freud and John B. Watson proposed new ways of treating it.

Freud thought doctors should help patients talk about their inner thoughts and feelings, while Mowrer thought that behavior change and conditioning were the best ways to help.

Watson’s work focused more on how you shape people early in development, and how you actually can make people fearful or anxious about something.

This was the beginning of modern psychotherapy, and these two concepts would eventually form the basis of cognitive behavioral therapy (CBT).

Strides forward in the ‘50s

Initially called, cognitive therapy, classic cognitive therapy was originally tested in the 1960s. The more modern form of cognitive therapy, CBT, consists of classic cognitive therapy, exposure therapies, as well as, behavioral, problem-solving, and social skills training methods.

It remains one of the most popular anxiety treatment methods because there’s plenty of evidence that it gets good results.

In the 1960s, doctors also realized that certain types of drugs could control anxiety symptoms. Physicians began to move away from treating mental ailments at inpatient facilities. Mental health was increasingly treated at outpatient facilities.

The standard approach to anxiety was beginning to look much more modern in terms of therapy, medication, and outpatient treatment. Psychotherapy has continued to advance.

Researchers continue to discover new and better drugs that treat anxiety with fewer side effects and risks.

Drugs weren’t used to treat anxiety until the middle of the 20th century. At that time, doctors started prescribing things like:

Although these were effective for symptoms in many patients, some of the drugs carried the risk of addiction, and some could be very sedating. But benzodiazepines are still commonly used.

Three decades later, in the 1980s, doctors discovered the benefits of SSRIs and SNRIs. They carried less addiction risk and gave patients fewer side effects. These remain some of the most popular anxiety medications available today.

In recent decades, doctors and patients have recognized the value of adding all-natural techniques alongside psychotherapy and medication.

Natural treatments are often advised to patients to help control anxiety symptoms, such as:

Although anxiety disorders have always been a problem, humanity has only known how to diagnose and treat them in recent history.

Our ability to deal with anxiety disorders improved as diagnoses became more specific, psychotherapy was developed, and medications were tested. As research continues, the list of effective treatments will hopefully keep growing.

If you have been diagnosed with an anxiety disorder, ask your doctor about new developments in the field of anxiety treatment.

Your doctor can help you decide which treatments are right for you. They can also alert you to promising new therapies or big breakthroughs.