The word “hysteria” comes from the ancient Greek word for uterus, hystera, reflecting a belief that lasted over two thousand years: that women’s unexplained physical symptoms were caused by a malfunctioning or displaced womb. But the concept is even older than the Greeks, and its evolution from ancient medical theory to modern psychiatric diagnosis reveals as much about cultural attitudes toward women as it does about medicine itself.
Ancient Roots: Egypt and Greece
The earliest descriptions of hysteria-like symptoms appear not in Greek texts but in ancient Egyptian medical papyri, which described physical ailments believed to originate from the uterus. Greek physicians of the fourth century B.C. expanded on these ideas, carefully documenting symptoms they attributed to a “wandering womb,” a restless uterus thought to migrate through the body and press on other organs. Symptoms ranged from choking sensations to paralysis to convulsions, all blamed on the uterus settling in the wrong place.
Interestingly, the noun “hysteria” itself never actually appears in any of the Hippocratic texts. The concept was there, but the specific label came later. Greek physicians also proposed that prolonged sexual abstinence caused the condition, an idea that shaped medical thinking for centuries and led to prescribed “treatments” including marriage, conception, and various suppositories and perfumes meant to coax the womb back into position.
The 19th Century Spectacle
Hysteria reached its most dramatic cultural moment in the 1800s, largely through the work of French neurologist Jean-Martin Charcot at the Salpêtrière hospital in Paris. Charcot believed he had discovered a new disease he called “hystero-epilepsy,” in which female patients exhibited convulsions, contortions, fainting, and impaired consciousness. He replaced traditional ward rounds with theatrical clinical demonstrations on a floodlit stage, open to the public, where he used hypnosis to trigger and suppress symptoms in patients. These performances made hysteria a sensation, but they also turned real suffering into entertainment.
Charcot’s work drew a young Sigmund Freud to Paris. Freud would go on to reshape the concept entirely. In his 1895 book Studies on Hysteria, co-authored with Josef Breuer, Freud proposed that hysteria wasn’t caused by a wandering uterus or a neurological defect. Instead, he argued that psychological distress could “convert” into physical symptoms: paralysis, blindness, seizures, and numbness that had no detectable physical cause. This was the birth of what he called conversion. Initially, Freud believed his patients had experienced real abuse that produced their symptoms. He later reversed course, proposing that fantasies and internal psychological conflicts, rather than actual events, drove the condition. That reversal remains one of the most controversial moments in psychiatric history.
Hysteria as a Tool for Control
For most of its history, hysteria was diagnosed almost exclusively in women. The diagnosis gave physicians and families a medical-sounding reason to dismiss, confine, or control women whose behavior didn’t conform to social expectations. A woman who was too emotional, too sexual, not sexual enough, or simply difficult could be labeled hysterical. Treatments reflected this: marriage and pregnancy were prescribed as cures well into the 19th century. Charcot used ovarian compression to stop seizure episodes. Other physicians prescribed electrical stimulation, opiates, or simply removing a woman from her home and social life.
The diagnosis functioned as a catch-all for any female symptoms that couldn’t be easily explained, which meant it absorbed an enormous range of genuine medical and psychological conditions. Women with epilepsy, trauma responses, autoimmune disorders, and anxiety were all lumped together under one label rooted in the assumption that their uterus was to blame.
How Hysteria Disappeared From Medicine
The formal diagnosis of hysteria was removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980, with the publication of the DSM-III. What had been called “hysterical neurosis” was reclassified under dissociative disorders and what is now known as functional neurological disorder, or FND. The change reflected a growing recognition that the old diagnosis was too vague, too gendered, and too tangled in centuries of bad science to be clinically useful.
The DSM-5, the current edition used in the United States, formally calls the condition functional neurological disorder (previously conversion disorder). The international diagnostic system, the ICD-11, uses the term dissociative neurological symptom disorder. Both describe the same core phenomenon: neurological symptoms like weakness, tremors, seizures, or sensory loss that are real and disabling but don’t match patterns seen in known neurological diseases.
What the Condition Looks Like Today
Functional neurological disorder is not rare, and it affects people of all genders. The most common form involves psychogenic nonepileptic seizures, episodes that look like epileptic seizures but don’t show the electrical brain activity associated with epilepsy. Other subtypes include functional weakness or paralysis, tremors, abnormal gait, and sensory loss. A hallmark of functional symptoms is that they often improve when the person is distracted. A functional tremor, for example, may change in frequency or amplitude when the person is asked to perform a counting task.
The DSM-5 no longer requires that a psychological stressor be identified for diagnosis, a significant shift from Freud’s model. It also dropped “la belle indifférence,” the idea that patients seem strangely unbothered by their symptoms, as a diagnostic criterion. These changes reflect a more nuanced understanding: the symptoms are real, they cause genuine disability, and pinpointing a single psychological trigger isn’t always possible or necessary for treatment.
How Treatment Has Changed
The contrast between historical and modern treatment is stark. Where ancient physicians prescribed perfumes, marriage, and prayer, and 19th-century neurologists used hypnosis and ovarian compression, current treatment centers on cognitive behavioral therapy (CBT), psychodynamic psychotherapy, and mindfulness-based approaches. CBT encourages patients to track their symptoms alongside daily stressors, helping them identify patterns and situations that make symptoms worse. Psychodynamic therapy focuses on building a personal narrative that may include recognizing the effects of childhood trauma and developing greater awareness of internal emotional conflicts.
Grounding and distraction techniques are also commonly used, based on the understanding that focused attention on symptoms can amplify them. For functional seizures specifically, treatment typically involves ongoing coordination between neurology and psychiatry, combined with one of these therapy approaches. The emphasis is on collaboration between disciplines rather than a single clinician declaring a verdict, a meaningful departure from the days of Charcot’s stage.
The symptoms that ancient physicians attributed to a wandering uterus were real. The suffering was real. What changed over 4,000 years was not the existence of the condition but the story medicine told about it, and who got blamed.