Mental Illness​—Is There a Cure?

“They took me to the hospital,” recalls Irene. “I enjoyed talking matters out with the psychiatrists, but it didn’t help much. Then they gave me electroshock therapy. I was terribly frightened. But again, it didn’t help much.

“My husband then talked me into getting into a car with him. I thought I was going home. But we pulled up in front of this big complex of very old brick buildings. ‘What is this?’ I asked my husband. ‘I want you to go in there and talk to someone,’ he said. Then I realized it was a mental institution . . . ”

IRENE’S illness erupted in the year 1955​—right in the midst of a mental-health revolution. New medications were being developed to reduce surgical trauma. Doctors discovered that when mental patients were treated with these same drugs, “patients who formerly required treatment in isolation rooms or straitjackets now were capable of being left unattended. . . . The drugs totally eliminated certain kinds of psychoses.” (The Brain, by Dr. Richard M. Restak) The revolutionary effects of these medicines on the mental-health field can again be illustrated by schizophrenia.

Irene’s doctors tried a new antipsychotic drug. Where talk therapy and electroshock had failed, medication succeeded. Irene and thousands like her were able to leave mental hospitals and go home.

Chemical Control

Physicians did not know how the drugs worked. But it appeared that they blocked the brain’s receptors that normally take up a chemical called dopamine. When the activity of dopamine was thus inhibited, some patients improved. When drugs were given that enhanced the action of dopamine in the brain, patients often became worse. A window was thus opened into the chemistry of mental illness. (See box.)

Much is still unknown about schizophrenia. But antipsychotic medications have become well established as effective treatments. Unfortunately, doctors say that about a third of schizophrenic patients do not respond to the drugs​—or to any sort of treatment. And, at best, the medications help to control​—not cure—​schizophrenia, toning down or eliminating the wilder, acute symptoms of the illness. Still, they are a giant leap from surgery or straitjackets.

Why, then, look upon patients who use these medications as weak-minded or as drug addicts? Antipsychotic drugs are not addictive, do not make patients high, and are not taken for pleasure. Dr. E. Fuller Torrey compares antipsychotic medications to “insulin for diabetes.” And Dr. Jerrold S. Maxmen concludes: “People who take such drugs are not ‘running away from their problems,’ but facing them.”

Irene, though, soon found that there is also a dark side to these medications.

Problems due to Side Effects

“I felt like a zombie,” recalls Irene. “I couldn’t function. I remember sleeping sometimes as much as 16 hours a day.” Irene’s life deteriorated. She tried coming off the medication​—only to end up in the mental hospital again.a

Some patients indeed suffer adverse reactions ranging from restlessness, dizziness, and drowsiness to jaundice, shock, and weight gain. One of the undesirable reactions is tardive dyskinesia, which afflicts 10 to 20 percent of patients who undergo long-term treatment with antipsychotic drugs. It involves involuntary twitching of the face and the mouth.

Since doctors cannot predict how a patient will react to a drug, prescribing medication involves a measure of trial and error. One clinical psychologist told Awake!: “Doctors may wade through three or four different medications before they find an effective one with the fewest side effects.”

Fortunately, most side-effect problems can be controlled. In Irene’s case, simply changing medications did the trick. Her drowsiness disappeared and so did her delusions. She left the mental hospital and began leading a normal life again! For nearly 30 years she stayed on an even keel​—until she tried going off the drug. She says: “I thought I was well. But after a year my thinking went off again. My doctor said, ‘Go back on the medication.’” A small price to pay for getting her life back on track.

Not all respond to drugs so successfully, and the medications often work at a snail’s pace. Too, some patients intensely dislike their medication. But when their symptoms are so severe that they cannot function, it may be a choice between medication and the mental hospital.

Alternative Treatments

Interestingly, sugar, wheat, milk, and lead, as well as vitamin deficiencies, have all been implicated as perpetrators of emotional disturbances. This raises the possibility of a nutritional treatment for schizophrenia. Such an approach has already had a measure of success in the treatment of depression. And some researchers​—including Nobel prize laureate Linus Pauling—​claim that large doses of vitamins have dramatically reduced the symptoms of schizophrenia in some patients. This is called orthomolecular psychiatry.

The idea​—at least in principle—​seems sound to many. Orthomolecular psychiatrists point out that a disease named pellagra, caused by vitamin-B deficiency, produces psychotic symptoms. The cure? Large doses of the vitamin niacin. But does a similar treatment work for schizophrenia? Up till now, orthomolecular psychiatrists have been unable to convince their more orthodox peers.

A NIMH (National Institute of Mental Health) report cautioned: “Although it would appear that the theory of orthomolecular psychiatry has presented a potential area for research and investigation, the current claims of therapeutic efficacy can find little, if any, support from [scientific] studies.” Needless to say, a balanced, nutritious diet makes good sense. A doctor, though, can likely best determine if a severe vitamin deficiency exists.

Dr. David Shore of the Schizophrenia Research Branch of NIMH seemed to sum up the attitude of mainstream medicine when he told Awake!: “Everybody would like an easy answer to schizophrenia​—like vitamins or dialysis.b But it just isn’t that simple. We wish it were.”

A person should nevertheless approach all medical treatments with due caution, being wary of sensational claims. “Anyone inexperienced puts faith in every word, but the shrewd one considers his steps.” (Proverbs 14:15) Do not accept any treatment blindly. If medication is prescribed, take the time to familiarize yourself with the possible reactions and side effects.

Comfort for the Mentally Ill

Because we live in “critical times hard to deal with,” people today are subjected to considerable stress. (2 Timothy 3:1; Luke 21:26) And since all are subject to the debilitating effects of sin and imperfection, it is no surprise that even some God-fearing people have succumbed to mental illness.​—Romans 5:12.

But knowing that mental illness is a disease helps one to have a balanced view of it. Irene, for example, feared that her illness was caused by an attack by the demons. While it is possible that in some cases demonic forces are involved, the Bible does not teach that all illnesses are caused by the demons. (Ephesians 6:12; compare Matthew 4:24; Mark 1:32-34; Acts 5:16.) More often than not, when a person hears voices or manifests bizarre behavior, an illness such as schizophrenia may be involved.

Irene was greatly relieved to learn that her illness was not of demonic origin. She sought medical help and found some relief. Recall, though, that the Bible tells of an ill woman who “had been put to many pains by many physicians and had spent all her resources and had not been benefited but, rather, had got worse.” Only Jesus Christ was able to heal her. (Mark 5:25-29) Medical science today is likewise limited. True, one can take reasonable steps to attain a measure of relief. But rather than getting trapped on a treadmill of searching for an elusive cure, some may simply have to learn to live with and endure the problem.

Knowing that God deeply cares for us, however, can ease much anxiety. (1 Peter 5:6, 7) “Jehovah has sustained me through this and many other trials,” says Irene. She also has the hope of a coming new system under Jesus Christ in which “no resident will say: ‘I am sick.’” (Isaiah 33:24; 2 Peter 3:13) “Keeping my eyes fixed on the prize of living forever in Paradise, now so near, has helped me to remain steadfast.” Her faith helps more than any medication doctors have to offer.

[Footnotes]

[Box on page 7]

The Chemistry of Schizophrenia

Our brain is an incredibly complex communications network, connecting billions of neurons, or nerve cells. Yet the neurons are not physically connected to one another. A gap measuring a mere millionth of an inch (0.000003 cm) separates their tentaclelike extensions, or dendrites. For nerve impulses to flow smoothly, nerve signals must jump this gap. To do so, the cell releases a battalion of chemical “messengers” called neurotransmitters. These “swim” across the gap and latch onto special receptors, each designed to accept a specific chemical.

In a normal brain, all this activity goes on in a smooth and orderly manner. In schizophrenics, however, neurotransmission seems to get out of control. Some feel an excess of dopamine overstimulates the neurons and causes them to “misfire.” Disjointed thoughts may result. Curiously, though, not all schizophrenics have high levels of dopamine in their brains. Could it be that certain brains are just supersensitive to dopamine? Or are there different types of schizophrenia? Or could it be that some other chemical abnormality combines with dopamine?

No one really knows. Nor does anyone really know whether bad chemistry causes schizophrenia or vice versa. Chemistry is just one piece of the schizophrenia puzzle.

[Box on page 8]

Shock Therapy​—Controversial

Perhaps the most controversial therapy of all is shock therapy. Doctors, however, often refer to it by a more benign-sounding name: electroconvulsive therapy, or ECT. Scary portrayals of the procedure in films, such as One Flew Over the Cuckoo’s Nest, have made the public generally fearful of ECT. Yet, each year in the United States alone, an estimated one hundred thousand patients receive ECT. A survey of psychiatrists revealed that ECT is “overwhelmingly used only when medication, usually in large dosages and often in combination with psychotherapy, has been ineffective.”

ECT has been greatly modified, so it is not the gruesome procedure most imagine it to be. When properly administered, the patient does not feel a thing. He is anesthetized and given a muscle relaxant (to protect against skeletal injury). Electrodes are placed on his head and small amounts of electricity are passed through his brain, causing a brief seizure.

John Bonnage, information officer for the APA (American Psychiatric Association) refers to an APA task-force study that concluded that ECT was “one of the most effective ways of treating depression.” Bonnage informed Awake!: “ECT is rarely used anymore in treating schizophrenia, however, unless severe depression accompanies it.”

Doctors really do not know how or why ECT works. Opponents have thus called it “the psychiatric equivalent of kicking a TV set when the picture begins to fail.” There is some evidence, though, that ECT may affect neurotransmission in a way similar to psychiatric drugs. Critics call ECT dangerous and brain disabling, pointing to the risk of memory loss and even fatalities. Proponents, though, say that modified procedures have greatly reduced these risks. They further argue that the high danger of suicide that accompanies severe depression may make the benefits of ECT far outweigh any risks.

[Box on page 10]

Freudian “Insight” Therapies​—Help or Hindrance?

Dr. David Shore of the Schizophrenia Research Branch of NIMH told Awake!: “There’s a lot less psychoanalysis, and the like, going on these days in psychiatry.” The reason? For one thing, mounting evidence that Freudian analysis and related insight therapies simply do not cure schizophrenia. Freudian therapies hinge on the unproved premise that mental illnesses are a reaction to experiences in life, to childhood traumas buried in the unconscious mind. The analyst thus tries to probe the unconscious mind via questions and “free association” to help the patient gain insight into the source of his problems.

Schizophrenics, though, already have difficulty communicating. To expose such ones to the probings of insight therapy is, according to Dr. E. Fuller Torrey, like “directing a flood into a town already ravaged by a tornado.”

There are the dangers of “transference,” whereby a patient can develop overly strong feelings for the therapist. Some claim that patients have become “addicted” to their therapists, unable to curtail the treatment. Too, sharing intimacies with a member of the opposite sex may invite moral problems.

Mainstream psychiatrists thus lean toward biological treatments and view classical psychoanalysis as obsolete for treating schizophrenia. Some forms of talk therapy, though, may be used effectively in connection with drug therapy to provide a patient with support, help him understand his illness, and reinforce the need to take medicine. And at times a doctor uses probing questions to help him diagnose an illness. This, however, is not the same as psychoanalysis.

[Pictures on page 9]

The effect of medication is often dramatic