Changing Views of Mental Illness - IB Psychology Mr Poll



Changing Views of Mental Illness

Ideas of Mental Illness and how to deal with it have changed over centuries.

Middle Ages

➢ Thought abnormal behaviour caused by evil spirits in the body

➢ Exorcism was used as a religious ceremony to cast out suspected evil spirits

➢ Praying, Fasting and Drinking foul substances were used to vomit and force out evil spirits from the body

➢ Chipped holes in human skulls to allow evil spirits to escape (trepanation)

➢ Abnormal behaviour was thought to be associated as being witches or warlocks who represented Satan, as a result thousands of people were burned at the stake in Europe and North America

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Eighteenth Century

➢ People who were thought "abnormal" were placed in asylums (chained, isolated, no aid)

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➢ End of the 18th century Dr. Philippe Pinel changed thought and placed these people in hospitals and were not physically abused

Nineteenth and Twentieth Centuries

➢ Classifications of mental illness: No more one-size-fits-all In the late 1800s, Emil Kraepelin distinguished differences between types of mental illness: manic-depressive psychosis, schizophrenia, etc.. Patients were no longer seen as simply “insane.”

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➢ Freud and psychoanalysis: Psychoanalytic therapies ("talking cures") were developed by Sigmund Freud, Carl Jung and others around the turn of the century.

➢ They focused on identity, memory, childhood, sexuality, and meaning.

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➢ Lobotomies: Various methods of lobotomies were used for decades beginning in the late 1930’s, sometimes involving drilling into the brain to sever nerves thought to be capable of regenerating into healthy connections. (cutting or prefrontal cortex connestions)

➢ The most renowned was Doctor Walter Freeman’s technique, in which an ice pick-like object was inserted through the eye socket and tapped into the brain with a rubber mallet

➢ At least fifty thousand people, including  “the mentally ill,” “delinquent” young adolescents and unhappy housewives were lobotomized by various techniques through the early 1960s. Some were severely disabled by the procedures.

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➢ Electroconvulsive therapy (ECT): Shocking!

ECT, introduced in the 1930s, used a brief electrical stimulus to induce a cerebral seizure. In the early years, according to the Mayo Clinic, “electroconvulsive therapy could be painful and downright dangerous.

➢ It was administered with neither anesthetics nor muscle relaxants, and the electrical current was much higher than today. Powerful seizures racked the body with a force that could break bones.”

➢ The procedure is still used, in more humane ways, but can have complications, such as memory loss and confusion.





➢ The drug revolution: Several successful anti-psychotic drugs were introduced in the 1950s, including the powerful chlorpromazine (Thorazine).

➢ Studies show that 70 percent of patients with schizophrenia clearly improve on anti-psychotic drugs. Later in this decade came the discovery of the monoamine oxidase inhibitors (MAOIs) and the tricyclic antidepressants.

➢ Behavior therapy: Developed in the mid-1950s, behavior therapy has become a widely used method to help people replace distorted thoughts and beliefs with those that help them feel and function better.

➢ Working with a therapist, they can use it to learn to deal with emotions, relate to others in different ways and solve problems. It has been shown to be highly effective and in over a relatively short time.

➢ De-institutionalization: In the 1960s, thousands of patients formerly housed in mental institutions were released to be directed toward decentralized clinics for new medications and social services.

➢ However, many have had problems accessing services and some are now living on the streets without medications or assistance.

➢ Approximately one-third of homeless people are estimated to be untreated mentally ill.

➢ National advocacy: In the 1980s, national organizations, such as the National Alliance for the Mentally Ill, the National Mental Health Association (now Mental Health America) and others, were formed to protect, support, educate, and advocate for the mentally ill.

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Late Twentieth Century to the Present

➢ Prozac and its descendants:

The late 1980s and 1990s introduced new and more effective antidepressants, starting with the very popular fluoxetine (Prozac).

➢ These selective serotonin reuptake inhibitors (SSRIs) did not have the side effects of the MAOIs or the tricyclics.

➢ Drugs such as SNRIs and NRIs: venlafaxine (Effexor), duloxetine (Cymbalta), nefazodone and mirtazapine (Remeron) followed.

➢ New drugs that do not fit into any of these categories, such as Wellbutrin are now popular. Numerous antidepressants, mood stabilizers and anti-anxiety drugs are used today, along with medications designed to treat the side effects they cause. 

➢ As a result treatments have improved significantly and people have been released from institutions

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