Biological Treatments
Aside from talk therapy, there are also other, more
direct ways of dealing with mental illnesses. These fall under the category of
biological treatment, and include methods such as medication,
electro-convulsive shock therapy, and even psychotherapy, all of which come
with their own degree of controversy. But we’ll delve into that later. Let’s
start simple with medication.
When
we medicate a mental patient, what we are doing is manipulating their
neurotransmitters. Now let’s think for a second about just what a
neurotransmitter is. A lot of people like to think of the brain as having
“wiring” of some sort, transmitting electrical signals continuously throughout
the brain. Not so; along the axons, (the proverbial wiring) there are synaptic
clefts; gaps in the wiring that the signal has to transverse. And so, one side
of the axon, (the transmitter) will release neurotransmitters to relay the
information across the gap. The other side, (the receptor) picks this
information up, and it continues on its merry way. When using medication, we
want to manipulate one or a combination of these neurotransmitters;
norepinephrine, serotonin, and dopamine. These are chemicals that the brain
produces naturally, but can be manipulated to produce desired effects.
Norepinephrine, for example, is associated with energy and alertness. Dopamine
corresponds to the pleasure-reward centers in the brain, and serotonin, along with
pleasure and happiness, is also thought to induce obsessive/compulsive
behavior. There are, however, problems; first of all there are many, many areas
of the brain through which these neurotransmitters pass, and only a couple
areas we actually want to be affected. This spells two words; side effects.
Second, because the brain is an amazing piece of equipment, it know how to
self-regulate; meaning if there’s suddenly too much of a certain
neurotransmitter introduced artificially, the brain will slow its natural
production. This means that a patient will need more and more medication over
time, and is likely to get addicted. Despite the downsides there are many, many
different drugs in use right now with the purpose of somehow manipulating these
neurotransmitters. Here are four of the most common;
Tricyclics:
Tricyclics slow the re-uptake of norepinephrine and serotonin. What that means
is that when the neurotransmitters are released, they take longer to be
absorbed into the receptor, meaning they hang around longer than usual. This is
said to increase their effects. There are, however, side effects, which include
weight gain and poor concentration.
Monamine
Oxidase Inhibitors (MOI): There are certain enzymes in the brain made to
destroy norepinephrine and serotonin if they hang around in the brain too long.
This drug inhibits those enzymes, meaning said neurotransmitters can hang
around a little longer. There are also many side effects, including high BP,
and blurred vision.
Selective
Serotonin Reuptake Inhibitors (SSRI): These do exactly what they sound like;
they slow serotonin uptake like the tricyclics, but they’re very selective
about it; leaving norepinephrine alone and going straight to the serotonin.
These produce fewer side effects, and allow for higher doses than other
medications. One very famous type of SSRI is actually Prozac.
Lithium
Carbonate: This is most effective with bipolar disorder. It serves to end manic
episodes, and what psychiatrists have found is that when the manic episodes
end, the depressive ones do as well.
Once
again, the thing to remember is that these drugs have downsides, which can
sometimes be huge. So more and more people nowadays are saying that they should
serve only as a transitional; to get people into a stable enough frame of mind
where they would be willing to actually go to therapy, and slowly stop the
medication as their mental state improves. But there are certain cases in which
this is not an option.
Schizophrenia,
for example. Talk-therapy to a schizophrenic is basically useless; the illness
has an almost entirely biological cause. That’s why many schizophrenics take
anti-psychotics, such as chlorpromazine, which works by blocking dopamine
receptors, and reduces positive symptoms. (Delusions, hallucinations, paranoia,
etc.)
But
there are problems with this, too. A schizophrenic on medication will often
feel like before they had this amazing ability. They may feel like they were
somehow more perceptive than anyone else, more intelligent, and the meds are
just dumbing them down. Not to mention, a nasty side effect of large doses of
chlorpromazine, (which will happen eventually, to the brain’s self-adjusting
system) is something called tardive dyskinesia, the symptoms of which include
excessive lip smacking, and drooling. People who have been taking
chlorpromazine long enough sometimes even have to hold a towel at all times,
constantly wiping the drool from their face, which is not very effective. This
is why one of the biggest challenges with schizophrenics is actually keeping
them on their meds.
Before
the end of the essay, there are two other treatments I’d like to talk about,
which can be considered more physical treatments. The first is electro-convulsive
shock therapy, and this is a great example of how discoveries in science can
come about completely by accident. (Remember penicillin?) A while ago, it was
discovered that when people with severe epilepsy experienced a seizure, they
reported feeling calm and happy. Obviously not happy about the seizure, but
there were definitely positive effects. Not long after it was discovered that
when a seizure was induced in a depression patient by way of administering
electric shocks through specialized equipment, their symptoms were alleviated;
they felt better. This treatment is
still in use today, though it is by no means a cure-all; it is a transitional,
used in cases where the patient is suicidal, and needs to get into a good
enough place that talk-therapy will be effective. The effects are by no means
long-term.
And
finally, frontal lobotomy; one of the most gruesome and controversial
treatments of the modern world. (No longer in practice today, thank goodness!)
One of the most famous figures in frontal lobotomy was a man named Walter
Freeman. Just under a hundred years ago, Freeman began giving these such
lobotomies to his patients. He would anesthetize the patient, and then slip a
small, kitchen ice pick up into the skull around the eye, moving it back and
forth and severing the connections to the prefrontal cortex in the frontal
lobes of the brain. The good news; when you performed this procedure on a
violent patient, suddenly they would stop attacking people and become
completely docile. Often they would simply sit around playing cards all day.
The bad news? Severing that connection basically takes away everything that
makes you you, and turns you into
what is basically an obedient, sentient vegetable. Think of the Ood from Doctor
Who, and you’ll know what I’m talking about. Eventually people realized that
what Freeman was doing was wrong, and his infamy drove him to other areas, with
other patients. If a housewife was too unhappy with her situation to live
anymore, he would give them a frontal lobotomy. If a child was too unruly for
their parents to handle, he would give them a frontal lobotomy. He ended up
lobotomizing nineteen children, including one four-year-old. And that’s why mad
science isn’t always fun, folks.
The
treatments we’ve been talking about are not the only treatments out there.
There are many others, farther out of the periphery of the mainstream, from art
therapy to comic therapy. (Yes, Marvelites, it exists.) But these are the most
well-known, and most reputable types.
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