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Mental illness is a widespread issue that millions of people have to manage every day. According to the National Alliance on Mental Illness, one in five adults in the U.S. experience some form of mental illness every year, with the most common being a major depressive episode or anxiety disorder.
While these numbers are sobering, it’s also important to look at the whole picture. Recent world events have certainly contributed to higher rates of mental illness, but the numbers also indicate that more people are recognizing and seeking help for these issues than ever before. Widely available modern treatments allow many people to tackle the symptoms of mental disorders safely and effectively.
There’s still a lot to improve on, but we’ve come a long way since the days of asylums, prisons, and lobotomies. By diving into the history of mental health treatment, we can see just how much the medical field and society have progressed in how we recognize, view, and treat these widespread conditions.
Obsolete Mental Health Treatments
So many of the “treatments” from back in the day are now seen as strange and barbaric, but a key few stand out as the most disturbing.
Bloodletting and Purging
Bloodletting and purging are some of the most infamous treatments in a short history of mental health. They stemmed from the ancient Greek idea of the “four humors.” Ancient physicians believed that the body contained four fluids that determined a person’s health, energy, and even personality. For over 2,000 years, doctors attempted to adjust the balance of the four humors to treat serious illnesses, usually by bloodletting, purging, or vomiting. Some doctors would use razors to release blood, although the use of leeches was very popular. Ancient physicians also thought that fainting from blood loss was helpful and would often bleed a person until they began to swoon.
Asylums and Isolation
Toward the end of the medieval period, isolation became the preferred treatment for mental illnesses. Because of a growing population of people needing mental healthcare, asylums rose in popularity and were truly widespread by the mid-1700s. Originally, the idea was that asylums would provide a refuge from harmful environments that doctors felt were responsible for mental illness. In reality, their real function was to remove people with mental disorders from the view of their families and communities. In fact, they were so prison-like, that the two institutions were interchangeable in many areas.
Many cultures associated mental disorders with poor morals, so people felt as if those with mental conditions needed punishing. As a result, asylums would typically include strict regimens of exercise, work, and politeness. Medical practitioners would use brutal methods like chain restraints and ice baths to control the residents and enforce their rules.
Overcrowding and poor sanitation rapidly became major issues and asylums functioned as little more than prisons or warehouses for people with mental illnesses. All of these issues led to important and widespread movements for prisoner and asylum reform that resulted in massive, institutional changes that continue to protect people today.
Shock Therapies
In the early 1900s, shock therapies became the new “fad” in the mental health field. One of the earliest, insulin shock therapy, involved injecting high levels of insulin into patients to trigger convulsions and comas. After a few hours, physicians would revive the patients. They would repeat this daily for many months to treat schizophrenia and many other conditions they simply referred to as “madness.”
A short time later, doctors would perform a similar procedure with the drug metrazol. This medication triggered seizures that were so violent that patients would fracture their spines. Of course, this was terrifying and traumatic for the patients and even triggered bouts of amnesia.
Electroconvulsive shock therapy would eventually replace both of these procedures. By combining electricity with anesthetics and muscle relaxers, the fracture rate dropped and doctors claimed to see notable improvements in patients with depression. However, amnesia and increased suicidal tendencies remained among the most notable side effects.
Lobotomies
The most notorious of treatments, the lobotomy, actually won the Nobel Prize in Physiology and Medicine in 1949. In a lobotomy, surgeons remove the connections between the prefrontal cortex and the brain’s frontal lobes. Despite the Nobel Prize, the lobotomy was extremely controversial, especially in the medical community. Some patients did experience improvement of their symptoms, but lobotomies often introduced a range of other issues. As psychiatric medications became available in the ‘50s, most practitioners stopped performing lobotomies.
Early Medications
While effective mental illness medications are a relatively recent invention, physicians have used various drugs to address mental disorders for centuries. During the rise of the asylums, medications largely focused on sedating and restraining patients in the overcrowded buildings. Drugs like morphine and opium were widespread and resulted in addiction for many people. Barbiturates would place patients into a deep sleep, as well. In some cases, doctors would use toxic mercury to control mania.
The 1950s saw the rise of many mental health medications. Chloral hydrate was somewhat popular but carried many side effects, including psychotic episodes. Chlorpromazine was the first antipsychotic drug. Though not ideal, it was much safer than the previous drugs and it largely replaced electroconvulsive therapy and other shock therapies.
What Treatments We Still Use
While most of these practices and drugs are obsolete—for good reason—there are some that we continue to use today for treating mental health issues:
- Bloodletting is still in use today, though in a radically different manner and not for mental health issues.
- Similarly, morphine and opioids are widespread painkillers but aren’t typically a part of the treatment path for those with mental health disorders.
- Chlorpromazine is widely available for treating issues like schizophrenia and bipolar disorder, though there are usually better choices.
- Electroconvulsive therapy (ECT) is still around for people who need a more powerful treatment for conditions like severe depression, mania, and dementia. Qualifying for ECT often requires multiple physician meetings and a psychiatric recommendation, as well as a history of other unsuccessful treatments. ECT still carries some risks of memory loss and confusion, but it is far safer than it once was.
The Modern Approach
The way we approach mental illnesses now is a far cry from the obsolete mental health treatments that were once in use. Today, the goal is safety and long-term effectiveness with a patient-first approach. Talk therapies like cognitive-behavioral therapy allow individuals to manage symptoms without the need for extreme surgeries or procedures. Additionally, medications for mental disorders have improved dramatically in just the last few decades and have far fewer side effects than the original antipsychotic drugs.
If you have questions about how to manage a mental health condition or how we might help you or someone close to you, reach out any time. At FHE Health, our experts have decades of experience creating individualized plans of care that make life manageable. Our doors are always open or you can call us today.
