There is much written evidence of the inhumane treatment methods of the mentally ill throughout history. Many books and movies have portrayed the horrors of the “lunatic asylum,” where patients were chained to beds, denied normal human care and treated abominably.
John H. Krystal, M.D., chairman of psychiatry and professor of neurobiology at the Yale University School of Medicine in New Haven, said that although it’s easy to judge inhumane treatment in the past harshly, looking back also provides perspective, prompting new views of psychiatric illness that lead to the testing of new treatments.
The earliest form of treatment for mental illness symptoms began 7,000 years ago and was called trephination, which involved using a bore, auger or saw to open the skull, part of which was removed to cure headaches, mental illness or demonic possession. One cringes remembering anesthesia had yet to be discovered.
During the 18th century, physicians had still not fully separated mental and physical illness, resulting in physical treatments for mental disorders such as ice water baths, physical restraints and isolation. Asylums were supposedly for treatment but more often were places of isolation where patients could be hidden from society.
Surgical intervention for mental illness began in the 1880s when Swiss physician Gottlieb Burkhardt removed parts of the brain cortex in patients with auditory hallucinations and schizophrenia symptoms. The surgery was not to cure but to calm. Frontal lobotomy was the next “advancement” in which holes were drilled in the skull and ethyl alcohol was injected into the prefrontal cortex to disrupt the neuronal tracts believed to cause the illness.
In the 1930s, insulin coma therapy gained attention when it was believed that a dramatic change in insulin levels would “rewire” the brain. That treatment was discontinued as recently as the 1960s. Some physicians believed that mental illness could be reduced by inducing seizures and patients were given the stimulant metrazol. The resultant seizures were ineffective, but the field of seizure-related therapies led to the study of electric shock and electroconvulsive treatment.
Advances in treatment methods for mental illness take place more slowly than those for physical illness, but progress is being made. Mental illness results from a combination of biological, psychological and environmental factors, and the challenge is discovering the interaction of each. Genetic research and brain imaging are preparing the way for improvements in the treatment of mental illness.
Clinicians know that some mental health disorders overlap each other with patients exhibiting symptoms of two or three disorders at a time so they do not fit into predetermined categories. Researchers are developing approaches that take into consideration not only the category of a disease but also the number of ways in which a person can be affected.
Researchers at Cardiff University’s National Centre for Mental Health in Wales are using this new way of thinking to make studies of psychology, brain function and biology more powerful and relevant to patients. A study of 60,000 people combined research from across the world and discovered common genetic risk factors between patients with autism, attention deficit hyperactivity disorder bipolar disorder, major depression and schizophrenia. Other studies using brain scanning technology have found similarities in the brain activity of people with anxiety and mood disorders.
Perhaps lab tests for mental illness may be the future norm, allowing for early diagnosis and treatment.
Sovereign Health is stays on the forefront of modern behavioral treatment. If you would like further information on our programs, please call our 24/7 helpline.
Written by Veronica McNamara, Sovereign Health Group writer