Transcript Treatment of Mental Illness

Treatment of Mental Illness
Prehistory to Colonial America
• For most of human history, very little was known about
the workings of the human mind, especially about why
a person would act abnormally
• Often, it was believed that the mentally ill were
afflicted and/or possessed by evil spirits/demons.
• Treatments included:
1. Trepanning
2. Spells/witchcraft
3. Exorcism
4. Execution (particularly burning at the stake)
Colonial America
• According to astrological beliefs, a child born under a
full moon would be more likely to exhibit mental
instability. From this, comes one of the terms used to
describe the mentally ill: lunatic
• Cures during colonial times focused on methods that
either would cause crisis or expel it (i.e. catharsis).
Methods used:
1. Submersion into ice water
2. Inducing of vomiting
3. Bleeding
Colonial America, cont.
• The most common method, however, was to
imprison them.
Early 19th Century
• “Moral Management”
Influenced by the Enlightenment. Generally, the
emphasis was humanizing the patient, not
animalizing him/her
Improvements included
1. home-like environment
2. Recreation
3. Work details
4. Outdoors
Early 19th Century, cont.
• Phrenology: Belief that behavior based on the
shape of skull (from this come the terms
“highbrow” and “lowbrow”).
Late 19th Century
• Following Civil War, thousands of veterans
have:
1. PTSD (known then as battle fatigue)
2. Morphine addiction
• Overcrowding leads to a retreat back to
Colonial standards of treatment
• Opium introduced as a treatment
Late 19th Century
• State asylums are built that are large,
aesthetically pleasing, but are able to withstand
large amounts of abuse
• Local example: Peoria State Hospital in Bartonville
(closed 1973)
• Asylum featured in “One Flew over the Cuckoo’s
Nest” also reflective of this time period.
• Major problem: Asylums considered so nice they
become dumping grounds for the homeless,
unwanted, elderly, and poor
The Dark Ages (mid 20th Century)
• With patient numbers rising, mental-health
professionals attempt what are now
considered barbaric methods to improve
patient outcomes.
1. Trepanning
2. Electroconvulsive Shock Therapy (ECT)
3. Insulin Shock Therapy: patient given insulin
to the point of rendering the person
comatose
And…
4. Lobotomy
a. Originally, the lobotomy would separate the
front portions of the brain from the rear.
Common result: patient forgot what caused the
disturbance/depression in their minds. The
problem: took too much time and skill.
The solution
b. trans-orbital lobotomy (aka “pre-frontal
lobotomy)
- watch video
- developed by Walter J. Freeman
- Outpatient brain surgery, took about ten
minutes to perform.
Modern Era
The Breakthrough (1954): Thorazine
(chlorpromazine)
- The first medication that is useful in the
treatment of mental illness. Promoted as
“lobotomy in a bottle.”
- Used to treat
1. Schizophrenia
2. Major Depression
3. Mania
Medication Uses
OCD: Prozac, Zoloft
Anti-anxiety: Xanax, Valium, Ativan
Depression: Prozac, Zoloft, Wellbutrin, Cymbalta
Schizophrenia: Risperal, Zyprexa, Haldol
• According to Sharfstein (2005), antidepressant medications accounted for $13.4
Billion in sales worldwide, with anti-psychotic
medications accounting for $6.5 Billion.
• In comparison, the weight-loss industry in the
United States(2007): $50 Billion
Other Methods
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Counseling
Behavior Modification
Cognitive-Behavioral Therapy
Systematic Desensitization (treatment of phobias)
12-Step Programs (AA, other addiction programs)
Group Therapy
ECT (in milder form)
Psychoanalysis
Note: Medication to treat mental-health issues is becoming
more prevalent, and reaching younger ages (including preschool)