People with mental illness have been victimized for much too long. Schizophrenia distorts reality and makes it hard for the afflicted to function in society. People who act strangely may alienate and frighten others.
Sadly, the treatments for this disorder have often been far worse than the condition itself. Even 20th century treatments were barbaric.
Patients were subjected to insulin shock therapy. High doses of insulin were injected to make blood sugar drop dramatically and trigger convulsions and coma.
During the 1940s and 1950s electroconvulsive therapy (ECT) used electric current to induce seizures. Broken bones, dislocated muscles and memory loss were common complications. The amnesia was perceived as a benefit, since patients could not remember the treatment.
Mid-20th century mental hospitals also used high-pressure sprays alternating between hot and cold water. Patients were sometimes wrapped in straitjackets or cold wet sheets.
Perhaps the most horrifying treatment of this era was lobotomy. Patients had holes drilled in their foreheads so that surgical tools could be inserted to sever connections between the area directly behind the forehead and the rest of the brain. Lobotomies had a high mortality rate and were of questionable value.
When this surgery was replaced in the 1960s by antipsychotic medication, the psychiatric institutions needed for the previous treatments were often shut down. Antipsychotic drugs were supposed to revolutionize the treatment of mental illness and make it possible for schizophrenics to live in the community.
Medicines such as Thorazine, Stelazine, Mellaril and Haldol were more humane than lobotomies, but they did have frightening side effects. Although patients on such medications were less troubled by hallucinations, they often developed uncontrollable and irreversible muscle twitches or tics and profound restlessness. Confusion, sedation, dizziness, dry mouth and constipation often made patients very uncomfortable.
In the 1990s the “atypical” antipsychotics were introduced with fanfare. Drugs such as Abilify, Seroquel and Zyprexa were expected to do more than control hallucinations. There was hope that people taking them would be restored to normal social relationships and that they would not be bothered by the troublesome side effects typical of older antipsychotic medicines.
Subsequent research has not shown that the new medications are substantially better than the old ones. In addition, side effects such as serious weight gain, diabetes, heart disease, seizures and uncontrollable muscle movements are disturbing. Many patients eventually stop taking these medications.
We are disappointed that truly effective treatments for schizophrenia seem no closer now than half a century ago. The mentally ill seem to have been abandoned by society, as legislators cut mental health services whenever budgets are tight.
When a mentally ill person creates headlines by committing a violent act, calls go out for better treatment. (It is not clear, by the way, that the mentally ill are any more likely to become violent than the rest of us.) Unfortunately, the talk is hardly ever followed with concrete action. Not only do we need effective therapies, we need to commit to genuine societal support for the mentally ill.