When, in the 1990s, my family doctor put it to me that I was depressed, the biochemical model of brain chemistry was ascendant in the understanding and treatment of depression. This science emphasised an imbalance of neurotransmitters — chemical messengers — whereby depression is linked to a lack of serotonin receptors in the brain, serotonin being responsible for many key body functions, such as mood modulation, feelings of reward, sleep, digestion and healing, among many others. The implication was that my depression was due to a biochemical imbalance instead of, or perhaps in combination with, my grief over my mother’s recent death.
At times during my life I have been prescribed medications and encountered therapists who have pushed different approaches to coping with depression that seemed to relate to major loss. In 1979, after my former husband’s sudden disappearance to live with another woman, an expensive therapy session involved facing a large circle of coloured cushions that I was meant to beat or embrace. I couldn’t inflict such actions on those bits of fluff. This was a version of the Gestalt therapy that I had learned about in a first-year university psychology paper, but even so my imagination fell short. Fortunately — thanks to the excellent public health system of the time — I was treated by an empathetic psychiatrist at Auckland Hospital. We explored my family history and dynamics, my economically poor background, politics and, yes, my relationship with my mother. The sessions were structured loosely within psychoanalysis.
That psychiatrist saved my life and encouraged me to complete my PhD and pursue a career. I still recall walking along the Devonport waterfront in 1980, and seeing the sun setting, smelling the sea, hearing the waves and the seagulls and feeling the warmth of the day. For at least the previous year I had felt absolutely nothing except pain.
Depression still lurked in my background and could become unbearable when I experienced intimate or professional stress, or profound loneliness. But like so many people living with depression, I pressed on with hard work, a demanding but rewarding career, and immersed myself in social activism through concern for the suffering of others. My sense of loneliness did not preclude a vibrant social life and wonderful friendships.
My closest bond was with my wonderful mum, Violet, who was born in 1922. She was prone to deep sadness; probably today this would bring a diagnosis of depression. She was also very ill throughout her life with cardiovascular and kidney illness. Her own mother had died when she was only nine years old. Her family was poor, and there could have been abuse.
One of Mum’s sisters, who was also my godmother, shot herself in the head in 1961. She had been a patient at Seacliff Psychiatric Hospital, at Karitane, north of Dunedin, and her mental turmoil included suffering from depression. Mum was devastated by her sister’s death, and Mum’s unhappy marriage and financial hardship also contributed to her own despondency. Her mood disturbance may have been accelerated by the side effects of the drugs she was taking for her heart condition, such as Serpasil (reserpine). Nevertheless, Mum was full of fun and spontaneity, and taught me the exuberance and power of trying and enduring, despite living under a ‘black cloud’.
My depression returned after Mum’s sudden death on 4 September 1994. The grief was prolonged and numbing, so my doctor prescribed the new wonder drug Prozac, which worked for me, and I began to feel better. After I gave birth to my daughter, Tara, in 1998, I felt very low but I never reached the depths of postnatal depression that many women in Aotearoa have experienced.
My mental descent resumed when redundancy faced several staff in the Division of Humanities at Otago University in 2016. When I lost my academic position of 26 years, my decline into depression was rapid, and I knew how serious this could be if not dealt with. So, even amid the chaos of Christmas, I managed to see my fantastic family doctor. Meanwhile the wonderful support of family, friends and colleagues kept me going. As did the memory of my late mother’s love and words of advice to keep trying.
Mine is just one perspective of how the black cloud can cast its shadow over people’s lives, but also how they may reflect upon this experience. The book explores the much greater variation of how depression is expressed and experienced over time and place, and across cultures in Aotearoa, with individuals having a range of outcomes. It also traces how the language and treatments for depression have changed.
During the twenty-first century there has been a backlash, both globally and in Aotearoa, against the medicalisation of depression, and a view has emerged that depression is just part of life’s woes. After all, our ancestors went through economic depression and wars, raised families and endured difficult marriages, and yet took such adversity in their stride. Given my personal experience with mental health, and interactions with health professionals, alongside academic research in the history of mental health, including within different cultures, I am aware of the way attitudes, diagnoses and treatments change over time. I would suggest that many people in the past, as today, did not cope with life’s upheavals, often with disastrous consequences.
Depression, far from being new, hangs over humanity. And although those who are prone to depression may endure several years of relief, the dark cloud is always on the horizon. The New Zealand writer Alistair Te Ariki Campbell wrote to his wife, Meg Campbell, in 1963:
As you know, when you start improving, you don’t as a rule
climb steadily to the surface. You still have ups and downs,
but the troughs get steadily shallower. So keep your pecker
up, my sweet.
In 2019 Wendy Parkins, an academic at the University of Otago and later a professor of English in the United Kingdom, wrote an insightful memoir about living with depression, anxiety and obsessive-compulsive disorder in which she described the slow, but hardly dramatic, path to some kind of acceptance and recovery.
Think of what makes you feel alive, what gives you vitality,
and then think of the absence of all those qualities. You’re not
dead — you get up each day and drag yourself around the daily
routines, or as many of them as you can still manage — but it’s
not much of a life. You’re un-alive . . . When I did not have the
energy to work I somehow always had the energy for plenty of
self-reviling . . .
It’s like living underwater or inside a tunnel — life is going on
elsewhere, where people are managing to have fun and also pay
their bills on time. You can catch a glimpse of them and their
world, you may even vaguely recall living there yourself, but
you can’t get to it. A numbing inertia robs you of the capacity to
be either convivial or responsible. And the desire for recovery
becomes simply a wish to live a quiet life without desperation.
This book is a history of depression and its forebear, melancholia, in Aotearoa New Zealand. It is not a memoir, even less a therapy book. Rather it aims to show how diverse cultures and ethnicities have experienced and lived with mental depression in our past.
Today there is rightful concern, globally and in Aotearoa, about a contemporary and unprecedented epidemic of depression, but this book reveals that depression has long plagued people within all cultures, across wide-ranging environments and circumstances. What we now recognise as depression may have once been called melancholia, nervous disease or simply part of life’s woes. Over the years people who live with depression have endured and tried to overcome it in a range of ways, from confinement in mental asylums and hospitals and care within the community to spirituality, drugs and technologies, or talking and other therapies.
The language and stories in this book can be confronting and disturbing. Depression can lead some people into extreme black holes, but most people who have encountered depression — whether their own or that of loved ones — press on; like mine, their lives are not constantly consumed by it. The dark outcomes for some that are described in this book are neither inevitable nor unavoidable.
Mental health hospital records, mostly of asylums and hospitals, are key to researching the early history of depression in Aotearoa. These archives may contain patient registers, case notes and admission papers. Under the 1846 Lunatics Ordinance a mentally ill person who threatened public safety or themselves, or who was unable to care for themselves or had no one else to do so, could be certified by two doctors and a magistrate and compulsorily held in either in a gaol, a hospital or an asylum.
The ordinance was replaced by the Lunatics Act in 1868, with revisions in 1882 and 1908. Its successor, the 1911 Mental Defectives Act, enabled people to admit themselves voluntarily. The current Mental Health Act was passed in 1969 and remains in force, with subsequent revisions and the lengthening of its title to the Mental Health (Compulsory Assessment and Treatment) Act in 1992.
Asylum and hospital records can provide only a partial history of depression, however, because most sufferers of the condition were never certified as insane or of unsound mind, and so did not fall within the medical system’s ambit. Although there are records for those who were admitted, access to these mental health records remains hugely restricted, usually for 100 years following admission. Even then, their notes may appear in case books that extend beyond that date and so are out of bounds, meaning that only part of the story is available.
For example, I tried to research the early mental health records of Jane Dick from Scotland — whose story is told in chapter 3, and who was admitted to Seacliff Mental Hospital in 1923 — but her case notes are likely to be in volumes that extend beyond that date given that she lived for many years after her first admission. Because of the privacy restrictions on New Zealand’s mental health records, I could not consult most public mental hospital records after about 1916.
Within those parameters I have sampled accessible records at the mental asylums and hospitals in Auckland, Dunedin, Hokitika and Christchurch. In 1911 the official term ‘asylum’ was nationally replaced by that of ‘mental hospital’. Auckland’s first asylum was the Whau Lunatic Asylum, later named the Auckland Provincial Lunatic Asylum and then the Auckland Mental Hospital. I consulted its records dating from 1853 to 1916. Otago was served between 1863 and 1878 by the Dunedin Lunatic Asylum, which from 1879 shifted further up the coast to the Seacliff Lunatic Asylum, later renamed the Seacliff Mental Hospital. Its records were available from 1879 to 1916.
Mentally ill patients on the West Coast were initially admitted to the lunatic ward at South Spit Hospital in Hokitika, then to the Seaview Lunatic Asylum, later renamed the Seaview Psychiatric Hospital. I researched its records dating from 1869 to 1916. For Canterbury patients I was able to access the records of Sunnyside Lunatic Asylum and Sunnyside Psychiatric Hospital dating from 1863 to 1917.
For public hospitals I selected records within the date ranges of the earliest available, 1900, and latest available (usually in the years before 1916). With Ashburn Hall, a private psychiatric hospital in Dunedin, I sampled records at five-yearly intervals to identify cases of melancholia and depression from 1885 until October 1945 (51 cases: 18 males and 33 females). I also examined the first 100 cases for melancholia, and checked admissions for 1948 at Ashburn. But because of access restrictions to the individuals’ actual mental health records, we often do not know what happened to these patients after they were admitted to a psychiatric institution.
Record-keeping procedures also varied between asylums and hospitals, meaning that a quantitative analysis of melancholia and depression across asylums is not possible. During the early colonial years, diagnoses were not always recorded, making it difficult to identify patients who were possibly admitted with depression. For example, early records at Sunnyside Lunatic Asylum in Christchurch often only recorded terms such as ‘mentally insane’. Mental health diagnoses have been and remain subjective, being heavily dependent on experts’ training, knowledge and experience. Doctors’ assessment of patients relied on testimony provided by family, whānau, friends, police, employers and others. Patient records for Ashburn Hall often contained elaborate family trees (genealogical charts) to show how insanity could be hereditary. This early medical ‘science’ provides only limited insight into the history of depression in Aotearoa.
Although I draw heavily on mental hospital records before 1920 for primary data, as I emphasise throughout the book, and elaborate on in chapter 7, in Aotearoa most people with depression either soldiered on — often denying their pain, perhaps diverting it through hard work, care for others, their faith or substance abuse — or had the support of whānau, family and friends. Family doctors might be turned to but, until antidepressants became available from the late 1950s, the medication that general practitioners could offer was limited. It is not surprising, therefore, that many people self-medicated through over-the-counter medicines or turned to alternative practitioners, known as quacks.
The asylum records I had access to provided only sparse, if any, details of the treatments patients received within the asylum or mental hospital. Before the 1950s, there was certainly very little drug therapy available for the treatment of melancholia or depression apart from the sedatives described in chapter 7. Generally, hospital regimens stressed the importance of routines such as regular meals, maintaining personal cleanliness, sleep, and working within the hospital or its grounds. At some asylums, such as Seaview in Hokitika, capable patients could work outside the asylum during the day, and some asylums had farms. In most asylums wholesome recreational and social activities — such as exercise, sports, games, needlework (for the ladies), dances and Christian worship — were encouraged for those patients able to participate. Melancholic patients were not usually restrained unless they became unruly.
Clearly, then, patient records can form only part of this history of depression in Aotearoa. In any event, as American historian Jonathan Sadowsky has pointed out, archives are not always the best source for unearthing histories of depression: ‘The strength of asylums and hospitals for historical research is also their weakness: they are document factories, and historians need documents . . . Depression is often a “quiet” condition, with a lot of pain directed inward, and less “acting out”.’
Few public records speak to a mental state such as depression because most sufferers did not ever encounter a psychiatric professional. So how did those who were not institutionalised experience depression? And how did communities deal with melancholia and depression, and what is unique within Aotearoa?
Sadowsky has also found the use of oral history in histories of mental illness challenging because of privacy concerns. I, too, faced this ethical issue, but in reverse: it was access to the archival evidence the historian craves that was made difficult due to privacy issues. Jane Dick’s story is one example of the complexity and frustration of unearthing oral and archival histories of depression. Her grandchildren supported her narrative being retold in this book, and much of her story has been verified through non-medical public records and family memories, but persistent requests to the Southern District Health Board to access Jane’s records as a patient at Seacliff Mental Hospital, Orokonui Hospital and Cherry Farm Psychiatric Hospital from 1923 to 1975 were denied. I was informed that Jane Dick was not identifiable in any of the Otago records, yet when I consulted the national index of patients at the archives in Wellington, her admission as a patient was recorded.
To enrich this history, I have used sources from the media, coronial inquiries, military records, and genealogy sites and collections, many available online. These sources often enable investigation of individuals well after access to asylum records is closed. Other sources for non-asylum records were memoirs, creative outputs, student dissertations, and manuscripts and oral histories deposited in the Alexander Turnbull Library and in the Hocken Collections.
There are now many governmental and non-governmental online documents and websites on mental health and depression in Aotearoa, some of which contain case studies and provide insight into diverse cultures. The epilogue makes considerable use of material available through the internet.
Citing historical data related to mental health is also contentious and complicated. Privacy guidelines and legislation must be followed. Some historians, survivors and descendants of those with mental illness consider that keeping names hidden perpetuates an unhealthy silence and stigma. Where feasible, I have followed the convention of referring to a mental health patient by their first name, followed by the initial of their surname. This style does not always apply to people with different cultural and naming practices. It is difficult to keep private earlier patients’ names that are now accessible through archives. Sometimes, when a name has been published, I disclose this. In a few sensitive cases I have used pseudonyms.
Coronial inquests up until around 1970 are openly available through New Zealand’s national archives. Again, I have used first names when referring to these records. Although I was given access to some later coronial inquests, I am not allowed to publish this material — a situation very different to that faced by historian John Weaver, whose 2014 book Sorrows of the Century analysed data from twentieth-century coronial records that could be published.
Citation from theses or secondary sources usually follows the styles those authors have used. Dissertations written by medical school students within the fifth-year programme of preventative medicine at the University of Otago from the 1920s until the 1970s provide a good insight into mental and public health in Aotearoa. However, strict conditions are imposed by the Hocken Collections on reading these dissertations to ensure the privacy of both the participants and the students. The coursework of the latter was never intended to be in the public domain, and it is also a matter of sensitivity to the authors’ ages and career stages at the time of their writing.
Old Black Cloud traces a history of mental depression in Aotearoa through various themes that span the nineteenth century through to the late twentieth century, and with an epilogue that reaches into the twenty-first century. The title is a twist on Aotearoa as the ‘land of the long white cloud’, derived from the title of a book written in 1898 by the politician, writer and poet William Pember Reeves.
This book digs into our past, long before depression was regarded as an epidemic in Aotearoa. Between 2011 and 2021 the recorded rates of depression in New Zealand increased from 14 per cent to 17 per cent; rates among Māori rose from 15 per cent to 21 per cent. The 2017/18 New Zealand Mental Health Survey found that Māori and Pasifika, along with women and the poor, were most at risk of being diagnosed with depression.
Here, Sadowsky’s questioning of whether there is a global and contemporary epidemic of depression seems pertinent. Certainly, depression is being diagnosed more than ever, but why is this so? Is it a genuine increase in incidence, or might the burgeoning statistics indicate that feelings of depression have become more medicalised, and therefore more prone to diagnosis, perhaps partly because of the global reach and power of the pharmaceutical industry? And as more people become unafraid to seek support for the symptoms of depression, the medical statistics will likely increase accordingly. Again, we must ask whether the actual incidence of depression has increased, or whether it is rather a matter of depression having become more visible, as more of us who experience depression ‘come out’ and share our experience of living with it.
This book also considers depression within New Zealand’s Indigenous and immigrant societies, cultures and environments. Historical and global literature have overlooked depression in Aotearoa and the South Pacific. Can depression be considered cross-culturally? And how do we avoid cultural stereotyping while acknowledging the different ways depression is recognised and treated within cultures and is clinically diagnosed?
The exploration of historical and cultural evidence again raises the question of whether depression is a modern ‘disease’. What are the links with melancholia? How have depressive conditions and moods been medicalised? Interwoven throughout the chapters are the stories of how many people have lived with melancholia and depression. Only a small percentage were ever sent to mental institutions, and far fewer committed suicide. Many New Zealanders have silently lived with depression, or indeed have regarded their ‘black cloud’ as part of the human experience of sadness and life’s woes rather than a medical illness. New Zealanders living with depression will often laugh at themselves; humour can mask depression, but it can also bring relief.
Mental depression is a serious issue within contemporary Aotearoa, and especially affects Māori, Pasifika, women and the poor, a radically different pattern compared to the colonial era, when depression was considered predominately the curse of ‘civilised’ men. To date there has been no history of mental depression in Aotearoa, in part because New Zealand has been somewhat peripheral in international medical history, and also because depression has been hidden under the long black cloud of Kiwi denial that we have not always lived up to the New Zealand ideal of being pragmatic and getting on with things. Mental depression may be universal, but how it has been experienced, understood, treated and lived with varies hugely. It is timely to offer this story from Aotearoa New Zealand.
