Mental Health Conditions: A Dysregulation Disorder; Not a ‘Random Mystery Illness’
Mental health conditions have affected people since the dawn of time. Have they always been labelled a ‘mental health condition’? Of course not, but people experiencing difficulties with their mental health would go seek help from a ‘More Knowing Other’ (MKO), whoever that may be.
Trephination was one of the earliest forms of treatment, which dated back about 7000 years or so. Trephination removed a small part of the skull using an auger, bore or saw, the practice was likely used to relieve headaches, mental illness and even the belief of demonic possession. We don’t know much more about the practice due to lack of evidence, but I think it’s safe to say it wasn’t effective.
Bloodletting and purging was used in the 1600’s, and it has its roots in ancient Greek medicine. Claudius Galen believed that disease and illness stemmed from imbalanced ‘humors’ in the body. English physician Thomas Willis used Galen’s writings as a basis for this approach to treating mentally ill patients. Bleeding, purging, and even vomiting were thought to help correct those imbalances and help heal physical and mental illness” (Hussung 2016).
Isolation was the preferred treatment for mental illness beginning in medieval times, which led to Insane Asylum’s popping over all over the place by the 1700’s. It was in these times where Asylum’s were used partially as a form of treatment, but also to ensure the person struggling was removed from the community. Due to mental health conditions being treated like a physical illness, some horrendous ‘treatments’ were used, ranging from ice baths to full restraint.
Insulin coma therapy was the treatment of choice for approximately 40 years between the 1920’s and 1960’s. Patients were given an insulin injection that caused their blood sugar to fall and the brain to lose consciousness, as it was thought these changes in insulin levels could improve the function of the brain. However, with a mortality rate of up to 10%, things soon moved on to a different form of treatment. (Hussung 2016)
Then came the infamous ‘lobotomies’. This consisted of surgically cutting or removing the connections between the prefrontal cortex and frontal lobes of the brain. The procedure could be completed in five minutes, and actually won the Nobel Prize in Physiology and Medicine in 1949! It was always controversial and discontinued soon after the arrival of psychiatric medications.
Starting in the early 1950’s, Electroconvulsive Therapy, or ECT was used far more than it is now. It was done without anaesthetic and often without consent, and far more treatments were given than is common now. Many people experienced it as more of a punishment than a treatment.
It is now used in a more controlled and (hesitantly using the same description) safer way, ECT (Electroconvulsive Therapy) is a treatment that involves sending an electric current through the brain to trigger an epileptic seizure to relieve the symptoms of a mental health problem. The treatment is given under general anaesthetic and using muscle relaxants, so that your muscles only twitch slightly, and your body does not convulse during the seizure. Is that a win? I’m not so sure!
Medication has long been used in the treatment and management of mental health conditions, including anti-psychotic and antidepressant medications (Killaspy 2007). It is fair to say the overall result of medication for mental health conditions is mixed. Some have reported significant benefits from taking medication, whereas others have reported no improvement or a worsening of symptoms.
Since the introduction of evidence based practice (EBP) many studies have shown that the ‘Placebo effect’ is still more effective than many of Big Pharma’s latest attempts (Weimer et al 2015), although their profits still seem to be doing okay.
Medication is often used as an adjunct to other interventions, such as Psychotherapy. There are a wide range of treatments available, far beyond the scope of this post, and yet some of the most common approaches are psychodynamic, cognitive behavioural therapy, interpersonal psychotherapy, and family therapy. There is also counselling available with a vast array of qualified counsellors spread across the country, and many more online. The options are numerous, the success is less clear.
And while psychotherapy and other talking therapies have helped many, with the rise of mental health conditions climbing ever more sharply, and the apparent struggle of people to overcome their issues, this means millions of people across the country and many more millions across the world have to live with their condition being supported, not sorted.
So what now? Could it be that mental health conditions arise due to a ‘Dysregulation Disorder’? Whereby a mechanism is at play that creates the necessary internal environment that leads to the expression of a mental health condition?
Interesting? I think so….Stay tuned for part 2…
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