Historical Fiction, History, Research, Wanderer Among Shadows

The Puritans and Mental Illness

*Cover image: Detail from T. H. Matteson’s “The Trial of George Jacobs, Austust 5th, 1692”

In my previous blog post, Interesting Things I Learned about the Salem Witch Trials and the Puritans, I briefly discussed how 17th century Puritans were more supportive and tolerant of the mentally ill than later generations. In this post, I will go into more detail about the topic. After my own struggle with depression and anxiety, I decided to incorporate mental illness into my novel, Wanderer Among Shadows. My main character, Sarah Parker, suffers from the same disorders after her various ordeals. I intended the inclusion of mental illness in the story to shed light on the topic. It is meant to help those suffering from it to realize they are not alone and to allow those who have not been through mental illness to understand it better. Because of this decision, I had to research how mental illness was treated in Puritan society.

By the 1600s, scholars began to realize that the brain controlled emotions, cognitive and motor function, and could receive information from the five senses, which they referred to as “common sense.” The theory of the four humors was still held by some as well in which bodily fluids- blood, black bile, yellow bile, and phlegm- affect a person’s heath and behavior (more on this in a bit). Spirituality did not leave the discussion of bodily functions though. In 1664, Thomas Willis explained that humans had a “Sensitive Soul,” which was found throughout the body and gave information from the senses to the brain, and a “Rational Soul,” which was in the brain and capable of reason, abstraction, and surviving death. The Puritans also distinguished neurological disorders, like stroke and epilepsy, and intellectual disabilities as separate from mental illness.5  They described mental illness with words and phrases such as “distracted,” “mad,” “out of their wits,” “crazed,” “distempered,” and “not in his right mind.” 2

However, unlike today, the Puritans did not categorize the various types of mental illness with the exception of melancholy. Melancholy would be most equivalent to what we would deem depression today, but the symptoms associated with melancholy were vaster than the typical symptoms associated with depression. Melancholy would be described with symptoms familiar to depression such as lethargy, loss of pleasure in things, a sense of hopelessness, and suicidal thoughts.1,2 Minister and writer Richard Baxter went further and included symptoms like  hallucinations and belief in prophecies, which would today be more associated with schizophrenia.1

 The Puritans ascribed the causes of mental illness to physical, psychological, and/or spiritual ailments. They recognized that mental illness could come about from injury, disease, a weakness in reason or temperament, or sometimes abuse and traumatic life events.2,5 For example, Reverend John Higginson, in a letter to his son, explains how his daughter and her children were abandoned by her husband who spent all their money and that she became “…by overbearing melancholy crazed in her understanding.” 6 In particular, under the four humors theory, melancholy was believed to be caused by an imbalance in the black bile.4 Reverend Baxter referred to melancholy as a black, distinct humor and described it as blood blackened by impurities and poor circulation. But when the cause of melancholy was not physical, he claimed that it was the result of people being too impatient with the burdens God subjected them to instead of patiently submitting to his will. 1 The Puritans also believed that mental illness could result from sinful behavior and that God could give it to someone as punishment or to test their spiritual conviction. They believed “madness” could also be caused by demonic possession or a lack of faith.5 They knew that not all symptoms of mental illness were permanent and could diminish over time.2

Because the causes of mental illness were believed to be both spiritual and physical, the cures therefore took on spiritual and physical natures. On the spiritual side, prayer and fasting and repentance for sins were typically prescribed remedies.1,2 Those suffering from melancholy were advised to be among cheerful people and to give thanks and praise to God while turning their minds away from blasphemous thoughts.1 Reverend Cotton Mather also urged people to be patient and kind to those suffering from melancholy because he recognized that if their caretakers found “melancholicks” to be burdensome, it was only because of their mental illness.4 Cures for mental illness that were physical in design included industrious labor to keep the mind busy, proper diets according to body type, purgatives, bloodletting, herbal mixtures, and other concoctions that are outright bizarre by today’s standards. These bizarre cures could involve animal blood or parts and metals like steel. 1,2  

As my story takes place during the Salem Witch Trials, I will note that mental illness and witchcraft accusations were not always correlated. Sometimes people with mental disturbances could be accused of being witches, but other times mental illness could be their saving grace. At least one woman in 1669 was saved from a witchcraft accusation after a Massachusetts court found her to be mentally ill.2 In 1692 during the Witch Trials, Rebecca Fox petitioned the court and the governor to have her daughter Rebecca Jacobs, who was accused of witchcraft, released from prison because she was mentally ill and incapable of surviving the harsh prison conditions on her own. She likewise asked that her daughter’s confession not be taken too seriously because of her mental health issues. Eventually Jacobs would be found not guilty by the reconvened court in 1693.6 In addition, it was recognized that people suffering from mental problems could falsely accuse someone of witchcraft because of delusions or hallucinations. As Reverend John Hale pointed out, “Melancholy and imagination hath fancied many things to proceed from witches, when there is no ground for it.” He explained that a bodily problem like disease or injury could cause a person to imagine a witch. He also warned that when a person was supposedly afflicted by witchcraft, that Satan may have caused them to imagine an innocent person hurting them.3

Overall, the mentally ill were generally tolerated in their towns if they did not cause trouble. In fact, laws were created to ensure that communities were providing for the mentally ill when they could neither care for themselves nor had family that could sufficiently care for them. In some desperate circumstances, they could be sent to a poor house or another family by the government.5 The violent or severely burdensome could be confined in separate housing or forced to leave their towns. Though not always, mental illness could likewise get someone out of trouble for crimes or allow them to be given less severe punishments because they were not fully understanding of their actions, just as today. People would also provide for their mentally ill relatives in their wills or take responsibility of their property if they were unable to manage their estates on their own.2 I included one instance of this in my story. Sarah Parker’s real life Aunt Mary suffered from some sort of mental instability. Her son Stephen petitioned the Salem Quarterly Court in 1685 “…that his mother ‘is in a distracted condition, and not capable of improving any of her estate for her own comfort & also having some money come from England … to request this Honored Court to empower myself or some other, to receive said money (being about ten pounds)…’” 6

By the latter half of the 18th century, mental illness was being seen as having more medical, physical causes, not religious ones. Eventually, the mentally ill began to be housed separately from their families and neighbors and were placed in asylums. Early mental wards were more often meant to protect society from the mentally ill rather than to provide them with proper medical treatment. People started to think of the mentally ill as beasts and criminals prone to violence.5 Of course from there, inhumane medical treatments ensued. The view of the mentally ill and the field of psychiatry have improved today, but there is still much that needs to be done. If there is one thing we could learn from the Puritans, it’s that the mentally ill need care, not stigmatization.


  1. Baxter, Richard. “The Cure of Melancholy and Overmuch Sorrow, by Faith and Physic.” The Practical Works of the Rev. Richard Baxter, Mills, Jowett, and Mills, 1830, pp. 236-285.
  2. Eldridge, Larry D. “‘Crazy Brained’: Mental Illness in Colonial America.” Bulletin of the History of Medicine, vol. 70, no. 3, 1996, pp. 361-386.
  3. Hale, John. A Modest Enquiry into the Nature of Witchcraft. Boston, 1702. Applewood Books, 1973.
  4. Mather, Cotton. “’De Tristibus, or The Cure of Melancholy’ from The Angel of Bethesda.” The Nature of Melancholy: From Aristotle to Kristeva, edited by Jennifer Radden, Oxford University Press, 2002, 161-166.
  5. Tannenbaum, Rebecca. Health and Wellness in Colonia America. Greenwood of ABC-CLIO, LLC., 2012.
  6. The University of Virginia’s Salem Witch Trials Documentary Archive

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