Timeline of Mental Illness Treatments in the U.S.
By Gillian Hilscher
Keyes and Lopez’s understanding of mental health and illness—as well as the treatments that might prove most effective—was a long time coming. Take a look at the following timeline for a brief history of mental illness treatments in the United States, and keep reading for a deeper dive into some of the country’s most controversial treatments in the history of mental illness.
Brief Overview of Treatments for Mental Illness in the U.S.
Electroconvulsive therapy (ECT) rose to prominence in the 1930s as a means of treating schizophrenia, depression, and other major mental disorders. It involved inducing generalized seizures in patients and, when the patients failed to lose consciousness, administering painful electroshocks without anesthesia. This method gained popularity due to evidence at the time that suggested that generalized seizures (whether induced by chemicals or electric current) could cure mentally ill people that were previously considered untreatable. The new possibilities opened up by ECT created what Dr. Richard M. Glass calls a “wave of enthusiasm,” in which ECT was used in a broad, borderline-carefree manner—it became the go-to treatment for people with severe mental disorders. Its reputation became (understandably) tarnished when the ECT mania led to bitten tongues and fractured bones and teeth in its patients, who were unable to control their severe muscle spasms during the induced seizures.
ECT is still used today, but its methods are now much more humane and carefully researched. Patients receive general anesthesia and muscle relaxants to reduce intense spasms, and are given proper airway management throughout the procedure. Studies have shown success of ECT in treating severe (and often medication-resistant) depressive disorders, with no evidence of long-term cognitive impairments or structural brain damage. In order for its effectiveness to last, however, drug therapies must be used in addition to ECT; exactly how and when to incorporate medication into the course of one’s ECT treatment remains to be discovered.
The lobotomy is one of the most devastating failures in the history of medicine. It was originally developed in 1935, and claimed to alleviate mental illness symptoms by surgically separating the frontal lobe from the rest of the brain. Doctors would deliver electroconvulsive shocks to patients in order to render them unconscious, and would then access the brain by inserting a small instrument through the patient’s eye socket. Lobotomies were advertised as safe, simple, and quick, and became incredibly favored by hospitals short on doctors, beds, and money. Some patients actually reported improved conditions post-lobotomy, but it quickly became clear that the procedure took an indescribable something from each of its patients. This is no longer surprising, as later neuroscience research revealed that the frontal lobe has an important role in an individual’s reasoning, behavior, and other high-level executive functions.
Psychosurgery appears to have evolved from the inhumane lobotomy to the more refined (and better researched) method of deep brain stimulation (DBS), which uses implanted electrodes to selectively stimulate brain regions in order to treat mental illnesses and neurodegenerative disorders. DBS, however, seems somewhat unable to shake some of the lasting stigma associated with the era of the lobotomy.