New therapeutic compounds

New therapeutic compounds often changed the wild, reckless, abusive, or confused behavior of patients to such an extent that they could be given considerable liberty. Some psychotics, especially the more recently admitted, improved so rapidly that they could leave the hospital in a few weeks. It is now apparent that a brief course of treatment with tranquilizers is seldom enough for permanent cure, but the medicines are of tremendous value in making many psychotic patients, previously unreachable, amenable to psychotherapy. And continued maintenance doses of them allow thousands of patients to function in the community.

 Similarly, severely depressed patients may be treated with another type of compound-a central nervous system stimulating or mood- elevating agent. There is a whole family of such agents which have helped to cut short what could otherwise be long-drawn-out and even permanent depressive states. As yet, exactly how the "mind medicines" accomplish their work is not understood. It may be, as some physicians suggest, that in effect they help much as do antibiotics. As we have seen earlier, when the body is injured, it tends to heal itself, unless a wound or infection is overwhelming.

An antibiotic helps not by curing the disease but by changing the odds, helping to control the infectious organisms, giving the body a chance to muster its defenses and then to heal. In mental illness, the mind medicines probably produce no cures on their own, but by reducing the intensity of fears, wild ideas, and hallucinations, they may give the mind an opportunity to heal itself. That same type of effect may explain the value of other methods of treatment. Shock treatment, for example, can be considered to produce a temporary respite which may allow self-healing to take place. Electric shock and insulin coma are the most frequently employed forms of shock therapy. The patient is .rendered unconscious by a carefully controlled electric shock or dose of insulin. Shock therapy, especially when followed by psychotherapy, has been successful in severe depression, particularly involutionmelancholia, and in schizophrenia. 

Despite the ability of mind medicines to make psychoses recede, they are of only limited value in the treatment of neuroses. With the medicines, the neurotic patient remains what he is but doesn't feel as bad -until the medicines wear off. Psychosurgery may be employed, usually only in otherwise unyielding cases of mental illness. Psychosurgery stems from observations that soldiers and others who had suffered head injuries of a kind that severed the connection between the two parts of the brain, without injuring either part, sometimes underwent marked improvement in personality and experienced significant lessening of tension.

This is what the surgeon does-carefully sever the connections between the two parts of the brain -when he performs an operation called lobotomy. Social Treatment For social treatment, the patient is placed in a sheltered environment, such as a mental hospital, where there is a deliberate effort to provide him with many reassuring, and friendly, useful experiences. He is drawn into games, work, and other daily activities. The idea is that through many encouraging human contacts he can be rescued from his private night- mare and brought back, bit by bit, to a real world, one that, in the sheltered environment at least, is friendly, interesting, not as alarming as the one from which he fled. Like medicines, social treatment gives him some relief from the noxious thoughts that have ruled his life, helps him to rebuild himself, and helps him to visualize himself again as a person relating to other people.