Electroconvulsive Therapy (ECT)

Electroconvulsive therapy (ECT) is more commonly known as electroshock therapy, and most commonly associated with its use in “treating” patients in mental hospitals. When properly performed, electric currents are passed through the brain to intentionally trigger a brief seizure. This seems to cause a change in brain chemistry that can quickly reverse symptoms of certain mental illnesses. This is most often used when other treatments are unsuccessful.

When people hear the words electroshock therapy, they picture an image similar to Jack Nicholson in “One Flew over the Cuckoo’s Nest” where he is forced on a gurney without anesthesia, with two electrodes connected to his temples, with him thrashing about having violent seizures. It was common in early mental hospitals to perform this therapy without anesthesia. They would detain the patient onto a gurney, place two electrodes on the temples, place a bite block in the mouth so they would not bite off their own tongue, then produce high doses of electricity causing violent seizures. These seizures were so violent it wasn’t uncommon for the patient to have memory loss, fractured bones, and other serious side effects.

Today electroconvulsive therapy is safer and only performed on people while they are under general anesthesia. ECT is used to treat severe depression, especially when accompanied by psychosis like a desire to commit suicide, severe mania that occurs as part of bipolar disorder, catatonia, and agitation and aggression in people with dementia. This therapy is a good treatment option when medications aren’t tolerated or other therapies haven’t worked. In certain cases, ECT is used during pregnancy when medications can’t be taken to avoid harming the fetus, elderly adults who can’t tolerate drug side effects, and when ECT has been successful in the past.

Risks and side effects of therapy may include confusion, memory loss, physical side effects, and medical complications. One type of memory loss associated with electroshock therapy is retrograde amnesia. Retrograde amnesia is having trouble remembering events that occurred before treatment began. Physical side effects include nausea, vomiting, headache, jaw pain, muscle ache and/or muscle spasms.

There are two types of electroconvulsive therapy today. Unilateral, where electrical currents focus on only one side of the brain, and bilateral, where both sides of the brain receive electrical currents. Generally in the United States, treatments are given two to three times weekly, for three to four weeks – for a total of six to 12 treatments.

Despite the bad reputation this specific therapy receives, with modern inventions and new regulations on the treatment, it can be a beneficial treatment for some of the most serious psychiatric health problems.

Resource: http://www.mayoclinic.com/health/electroconvulsive-therapy/MY00129/DSECTION=what-you-can-expect

 

 

History of a Lobotomy

Lobotomy- surgical interruption of one or more nerve tracts in the frontal lobe of the brain: used in the treatment of intractable mental disorders.  (thefreedictionary.com)

Today, when people hear the term lobotomy, they picture someone lying on a medical table with an ice pick being shoved into their brain above the eye. But what would happen if you were asked to picture a leucotomy? Would you even know what that word meant? The leucotomy is the predecessor of the lobotomy. Developed in 1935 by Antonio Egas Moniz, the leucotomy was thought to help with mental illness’ like schizophrenia, anxiety, depression, and bipolar disorder. Moniz had a theory that mental illnesses like the ones listed above, were due to a sickness in nerve cells. This led Moniz to performing the first leucotomy in 1935, where he would drill holes into his patients head, then inject ethyl alcohol into the frontal lobe to damage nerves. After seven patients, Moniz reframed from using the alcohol injections, and starting using a wire to just sever the nerve connections. In 1936, Moniz published his findings, with a very strong bias that patients had improved. However, his published findings were only on the first few days after the surgery.

Moniz’s published findings, had become well known, especially amongst other neurologist. One important person, was a U.S. neurology professor named Walter Freeman. This was the man who took the name leucotomy and renamed it lobotomy. Within a year after reading Moniz’s findings, Freeman had already performed 20 lobotomies. He decided he wanted to find a more efficient way of performing the surgery. He wanted the efficient way to eliminate the need of drilling into the patients head. This was where the “ice pick” method was developed. The whole procedure only took about 10 minutes. A patient would go through electroshock therapy to make them unconscious for a short period of time, Freeman would take an ice pick like instrument and insert it above the eye, it was then tapped with a hammer into the frontal lobe, he would wiggle it around severing nerve connections, and lastly, he would pull the instrument out and give the patients dark glasses to hide their bruised eyes. Freeman himself was known for performing about 2,500 lobotomies. But that all ended in 1967, when he performed his last lobotomy, before being banned from performing surgery. Lobotomies later on became a practice less used, when antipsychotics and other medications were developed, to help treat the distress of the mentally ill.

(Howard Dully, 12 years old, mid way through his lobotomy)

 

 

 

(Howard Dully, after lobotomy, exhibiting classic bruised eyes)

 

 

 

 Here are a couple of links, one to the top 10 most notable and fascinating lobotomies, and the other to a video on youtube about Walter Freeman.

Top 10 Most Notable Lobotomies   http://listverse.com/2009/06/24/top-10-fascinating-and-notable-lobotomies/

PBS documentary of Walter Freeman   http://www.youtube.com/watch?v=_0aNILW6ILk

 

 

Plunge Bath

A Brief History of Early Mental Hospitals

Mental illness has always been a part of this world but it has been handled in many different ways depending on the time period. Before the mid to late 1700’s, mental illness was thought to be a lack of morals or spirituality, which resulted in punishment to the ill person and often their family as well. Mostly all mentally ill people were cared for by their families, but in severe cases, they were sent to stay in jails or almshouses (a house endowed by private charity for the reception and support of the aged or infirm poor; a poorhouse). When jails became overcrowded with the ill patients they had to find other resources to take in the abundance of people, leading to the building of mental hospitals.

According to the U.S. National Library of Medicine, the first real organized attempt to care for the mentally ill was in 1752 by the Quakers in Philadelphia. In this attempt they opened the Pennsylvania Hospital which had rooms in the basement, with shackles attached to the walls for the new admits. After a couple years there were so many people trying to get admitted, they decided to build an extra building on the side of the hospital known as, Pennsylvania Hospital for the Insane. This new hospital stayed in operation until 1998 under numerous different names.

In 1817 a hospital opened in Philadelphia with possibly one of the longest names; The Asylum for the Relief of Persons Deprived of the Use of their Reason. This facility was also opened by the Quakers and was a private mental hospital. It is still opened to this day for the same reason of helping the mentally ill, but under the name Friends Hospital.

By 1890 all 50 states had at least one publicly supported mental hospital if not more. At this point in time, the hospitals housed over 500,000 patients. Around this time new treatments were being discovered and readily available.

Before humane treatments started becoming available, patients were having to suffer through “treatments” that were really torture. Some of the most common treatments used in the early days were restraints, lobotomies, strong drugs, plunge baths, “shock” water treatments, bleeding, purging, gyrating chairs, and a machine used to swing patients around in the air. All these treatments were supposed to help “cure” the patients. Restraints are pretty common even to these days but widely vary in comfort compared to the old restraints. Cold, grimy, heavy metal shackles were used in the early days around wrists and ankles almost 24/7 only allowing enough movement to feed oneself. Today there are severe regulations on restraints including, they must be taken off every two hours for at least a half hour to check for skin break down; and they are no longer heavy metal chains. Plunge baths were frequently used to “shock” the patients into being cured. They were basically immersed in a large bathtub of ice cold water for long periods of time. Purging was the use of laxatives. One of the most common methods used was electroshock therapy. This therapy method was used to induce patients into seizures to put their symptoms into remission.

Mental hospitals have been around since the late 1700s and happen to have an eerie past that intrigues me. That is the reason I chose mental hospitals and everything associated with them as my topic. Ever since I was a little girl I have always been around and associated with people who have mental illnesses. My mother worked at a home for the mentally and physically disabled where I was first introduced to a man with schizophrenia. Being so young I didn’t quite understand what was wrong with all these people, specifically the schizophrenic. This was probably the point in my life when I became interested in these type of people and their living situations. This was the time when my mom told me the story about a movie called Sybil. Sybil made in 1976 tells the story of a lady who has multiple personalities due to sexual abuse by her mother as a child.

My intent for this blog is to learn more information about these institutions and all things associated with them good or bad, and share it with the readers. Seeing as I am planning on majoring in nursing and possibly specializing in the mental health field I thought my interest in it would help me learn more and get prepared for the type of people I may work with. I am specifically interested in the dark history of mental hospitals like the mistreatment of patients, unethical surgeries and treatments, dirty living conditions, and overcrowding. In my opinion, mental hospitals in the early years sound like they should have been built for disease bearing animals not humans.

Hospitals for the mentally insane are just one other thing in the history of America that shows how cruel we can be to our own people; which is exactly what the mentally ill are, people.

 

What to look forward to next: A History of Mental Hospitals

Before psychiatric hospitals started being developed, people with mental illness were kept in prisons and basements away from other people. There were no proper treatments to help these people, and in most cases, the illness became worse after the people were locked away by themselves with nothing. The revolution of developing facilities specifically for these people started when prisons became overcrowded with the mentally ill. However the issue of overcrowding only became worse in the established hospitals. A hospital for 500 was housing as many patients as 2,000.

Danvers State Hospital- Danvers, Massachusetts

 

 

 

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