Mental illness in women vs men | Andrew Scull and Lex Fridman
Andrew Scull discusses how psychiatric treatments like ECT, lobotomy, and forced treatments were disproportionately applied to women rather than men throughout the 20th century, while men received different diagnoses like personality disorders. He notes that cultural representations, particularly films, significantly influenced public perception and clinical adoption of these treatments.
Summary
Andrew Scull examines the gendered history of psychiatric treatment, revealing that women bore the brunt of experimental and disciplinary psychiatric interventions despite men being more frequently diagnosed with certain conditions. He provides specific examples: Henry Cotton treated approximately 70% female patients, lobotomy procedures were performed on 60-70% female patients across multiple hospital records, and ECT remains heavily female-focused. However, Scull notes this reflects broader diagnostic patterns—depression is more commonly diagnosed in women, while men receive alternative diagnoses such as personality disorders and ADHD more frequently. He emphasizes that ECT, while used as a disciplinary tool in the 1950s-60s, is now primarily employed for serious and treatment-resistant depression cases. Scull also discusses the significant cultural impact of films depicting ECT, which created lasting public hesitation about the treatment and substantially reduced its clinical enthusiasm for decades, with effects that persist to the present day.
About this episode
Lex Fridman Podcast full episode: https://www.youtube.com/watch?v=s7d2d8FhevU Thank you for listening ❤ Check out our sponsors: https://lexfridman.com/sponsors/cv10056-sb See below for guest bio, transcript, links, and to give feedback, submit questions, contact Lex, etc. *GUEST BIO:* Andrew Scull is a historian of psychiatry. *Transcript:* https://lexfridman.com/andrew-scull-transcript *CONTACT LEX:* *Feedback* - give feedback to Lex: https://lexfridman.com/survey *AMA* - submit questions, videos or call-in: https://lexfridman.com/ama *Hiring* - join our team: https://lexfridman.com/hiring *Other* - other ways to get in touch: https://lexfridman.com/contact *EPISODE LINKS:* Andrew's Website (UCSD faculty page): https://sociology.ucsd.edu/people/faculty/emeritus/andrew-scull.html Desperate Remedies (book): https://amzn.to/4vmBquI Madness in Civilization (book): https://amzn.to/3SZhd0I *SPONSORS:* To support this podcast, check out our sponsors & get discounts: *Wispr Flow:* AI-powered voice dictation app. Go to https://lexfridman.com/s/wispr_flow-cv10056-sb *Fin:* AI agent for customer service. Go to https://lexfridman.com/s/fin-cv10056-sb *LMNT:* Zero-sugar electrolyte drink mix. Go to https://lexfridman.com/s/lmnt-cv10056-sb *Shopify:* Sell stuff online. Go to https://lexfridman.com/s/shopify-cv10056-sb *BetterHelp:* Online therapy and counseling. Go to https://lexfridman.com/s/betterhelp-cv10056-sb *Perplexity:* AI-powered answer engine. Go to https://lexfridman.com/s/perplexity-cv10056-sb *PODCAST LINKS:* - Podcast Website: https://lexfridman.com/podcast - Apple Podcasts: https://apple.co/2lwqZIr - Spotify: https://spoti.fi/2nEwCF8 - RSS: https://lexfridman.com/feed/podcast/ - Podcast Playlist: https://www.youtube.com/playlist?list=PLrAXtmErZgOdP_8GztsuKi9nrraNbKKp4 - Clips Channel: https://www.youtube.com/lexclips *SOCIAL LINKS:* - X: https://x.com/lexfridman - Instagram: https://instagram.com/lexfridman - TikTok: https://tiktok.com/@lexfridman - LinkedIn: https://linkedin.com/in/lexfridman - Facebook: https://facebook.com/lexfridman - Patreon: https://patreon.com/lexfridman - Telegram: https://t.me/lexfridman - Reddit: https://reddit.com/r/lexfridman
Key Insights
- Henry Cotton, lobotomy practitioners, and ECT clinicians disproportionately treated female patients—approximately 60-70% across these interventions—despite men being more troubled by certain conditions, indicating women received the brunt of experimental psychiatric treatments
- Men and women receive different psychiatric diagnoses for similar presentations; women are more commonly diagnosed with depression while men receive personality disorder diagnoses more frequently, explaining why certain treatments appear more female-focused
- A single film depicting ECT had such a powerful cultural impact that it substantially reduced clinical enthusiasm for the treatment for decades and continues to create public hesitation about ECT use today
Topics
Transcript
[0:03] ECT was used in the 50s and 60s as a tool of discipline in the hospitals. It was also used therapeutically, but overwhelmingly it was used as a a tool of a discipline and control. And that's true to life. Um lobotomy One of the interesting things we haven't talked about with all these treatments we've been discussing is that almost invariably except for the case of the syphilitic patients, for obvious reasons men were [0:35] more troubled by that condition than than women. It was women that got the brunt of these experiments. So, Henry Cotton about 70% of his patients who were treated were female. Lobotomy patients, it's hard to get overall numbers, but those of us…
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