Evolution of the treatment of depression

“Depression has been known to be around since 400 B. C. when Hippocrates treated mental illness as diseases to be understood in terms of disturbed physiology, rather than reflections of the displeasure of the gods or evidence of demonic possession, as they were often treated in Egyptian, Indian, Greek, and Roman writings (PBS. org, 1999) “In the United States, the almshouse was the precursor of hospitals, but it was not a hospital in the true sense. Almshouses, also called poorhouses because they served primarily the poor, existed in almost all cities of moderate size and were run by the local governments.

These institutions served, primarily, general welfare functions by providing food and shelter to the destitute. Therefore, the main function of the almshouse was custodial” (Shi and Singh 2012). Around 1770 the first asylum in the United States was built in Williamsburg, Virginia. It was used for patients who were thought to have untreatable mental illnesses. “Attendants in these asylums employed physical and psychological techniques in an effort to return patients to some level of rational thinking. Techniques such as bleeding, forced vomiting, and hot and ice-cold baths were also used” (Shi and Singh 2012).

Around 1840 someone did something about mental illnesses in the United States. Reformer Dorothea Dix saw that people with mental illnesses in Massachusetts were “incarcerated with criminals and left unclothed and in darkness and without heat or bathrooms. Many were chained and beaten. Dix lobbied to establish 32 state hospitals for the mentally ill” (PBS. org, 1999). Sometime before World War I, the State Care Act was passed. This act made state governments financially responsible for mentally ill people.

Local governments then sent all those with a mental illness, including older citizens to the state asylums. “The quality of care in public asylums deteriorated rapidly, as overcrowding and underfunding ran rampant” (Shi and Singh 2012). Expectation in the United States was that hospitals and humane treatment for the mentally ill would make them better. That proved to be false. Nellie Bly a reporter for New York World pretended to be a mentally ill woman so as to become a patient at an institution. Her reports resulted in more funding to improve conditions in asylums (PBS. org, 1999).

“On July 3, 1946 President Harry Truman signed the National Mental Health Act, calling for a National Institute of Mental Health to conduct research into mind, brain, and behavior and reducing mental illness. As a result of this law, NIMH was formally established on April 15, 1949” (PBS. org, 1999). During the 1960’s many people with mental illnesses were discharged from institutions. In the United States they were directed to local mental health homes and facilities. The number of institutionalized mentally ill people in the United States dropped from about 560,000 to about 130,000 in 1980.

Some of these discharges were because of medications that allowed psychotic patients to live more successfully and independently. However, many of those people suffering from mental illness become homeless because of inadequate housing, being non-compliant with their medications and follow-up care (PBS. org, 1999). The website dbsalliance. org states that “depression is a treatable illness involving an imbalance of brain chemicals called neurotransmitters. People with mental illnesses should not be looked at as having character flaws or personal weakness.

A person cannot make them self well by trying to snap out of it” (dbsalliance.org, n. d. ). Sometimes mental illnesses run in families; however, it is not contagious and the direct causes of mental illness are not known Dbsalliance. org also states that “some episodes of depression are often because of stressful situations”. People who have recurrent episodes of major depression are sometimes said to have “unipolar depression” or “clinical depression” because they only feel periods of low, or depressed moods (unlike someone who is bipolar, that has both high and low moods). Depression can be hereditary; however many people with depression have no family history of it.

The exact causes of depression are still not known. What is known is that both genetics and a stressful environment, or life situation, contribute to its cause. Usually, it is not one or the other, but a combination of both (dbsalliance. org, n. d. ). The website Macalester. edu states that as we learn more about depression, science has focused more attention on the biological causes. This, as well as the countless studies done since the 1950s has changed the core focus of treatment from psychological to pharmacology (Auger, Gerber, Malecek, & Schaffer, 2005).

“Many research studies have documented the potential benefits that can derive from antidepressant medications. Tricyclic antidepressants, MAO Inhibitors, and Selective Serotonin Reuptake Inhibitor (SSRI) medications have been found effective in reducing depressive symptoms. The newer antidepressants produce similar outcomes as found with the older antidepressants but often create fewer side-effects. In fact, depressive symptoms can be temporarily suppressed by many different medications, including barbiturates, benzodiazepines, and antipsychotic medications.

The beneficial effects of antidepressant medications seem to last only as long as the patients continue to take the prescribed dose” (Overholser 2006). Seeking treatment is a choice that takes strength. Mental illnesses are not flaws or weaknesses. Looking for treatment means a person has the courage to find a way to feel better. Talk therapy has been tested clinically and found to be effective. In some cases it works as well as medication. Good talk therapy helps change behaviors that could otherwise make a person’s mood less stable.

In my opinion the treatment for depression has improved significantly. Some people do still choose to have electroconvulsive therapy or only do talk therapy. But many prefer medications. When people are compliant with their medication it does not change who they are. Their medication just helps their moods even out. There are side effects to mood stabilizers; however the benefits outweigh the risks. When correctly diagnosed and treated, a person with depression can live a long, healthy and stable life. Millions of people do it, including me.

References Auger, G., Gerber, A. , Malecek, N. , & Schaffer, G. (2005, Spring). http://www. macalester. edu. Retrieved from http://www. macalester. edu/academics/psychology/whathap/ubnrp/depression05/history. html dbsalliance. org. (n. d. ). http://www. dbsalliance. org. Retrieved from http://www. dbsalliance. org/site/PageServer? pagename=education_depression PBS. org. (1999-2002). PBS. org. Retrieved from http://www. pbs. org/wgbh/amex/nash/timeline/index. html Shi, L. , & Singh, D. (2012). Delivering Healthcare in America: A Systems Approach (5th ed. ). Boston, MA: Jones and Barlett.

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