But second and more importantly, your conception that before people used to talk about mental health issues seems very romantic and unrealistic. People from older generations, at least in the two cultures in my family, tend not to talk about emotions at all. The most striking example is that of my father's grandfather, who fought in the first world war and could not enter a forest for the rest of his life and get very pale and shaky in the vicinity of one (what we would today call PTSD). So what did his wife do when she wanted to collect mushrooms? "Just drive me there and stay in the car, if you do not want to man up. It's just trees, you idiot". You cannot talk about your weaknesses when you are expected to be strong and unbreakable. What a therapist can offer is a space where those expectations of society do not hold, and where the fear of looking weak or dumb can decrease a bit.