Biomedical Therapies

Humans have a long, and sometimes disturbing history of biomedical treatment of disorders. In ancient and medieval times, the process of trepanation – a drilling or cracking of a hole in the skull to expose the brain – was sometimes used to free evil spirits or demons from within a person’s head.

Trepanation ultimately fell out of favor as a treatment for psychological disorders. However, in the 20th century another biomedical procedure, lobotomy, gained in use. Lobotomy is a form of psychosurgery in which parts of the frontal lobe of the brain are destroyed or their connections to other parts of the brain severed. The goal of lobotomy was usually to calm symptoms in people with serious psychological disorders, such as schizophrenia. Lobotomy was widely used during the twentieth century – indeed, it was so mainstream that Antonio Moniz won a Nobel Prize in physiology for his work on one lobotomy procedure. However, lobotomy was always highly controversial, and widely criticized as a tool of behavioral control of people who were engaged in behaviors that were not clinical in nature. By the 1960s and 1970s lobotomy fell out of favor in the United States.

One of the reasons lobotomy fell out of favor was the development in the 1950s and 1960s of new medications for the treatment of psychological disorders; these are now the most widely used forms of biological treatment. While these are often used in combination with psychotherapy, they also are taken by individuals not in therapy. This is known as biomedical therapy. Medications used to treat psychological disorders are called psychotropic medications and are prescribed by medical doctors, including psychiatrists. In Louisiana and New Mexico, psychologists are able to prescribe some types of these medications (American Psychological Association, 2014).

Different types and classes of medications are prescribed for different disorders. A depressed person might be given an antidepressant, a bipolar individual might be given a mood stabilizer, and a schizophrenic individual might be given an antipsychotic. These medications treat the symptoms of a psychological disorder. They can help people feel better so that they can function on a daily basis, but they do not cure the disorder. Some people may only need to take a psychotropic medication for a short period of time. Others with severe disorders like bipolar disorder or schizophrenia may need to take psychotropic medication for a long time. Table 1 shows the types of medication and how they are used.

Another biologically based treatment that continues to be used, although infrequently, is electroconvulsive therapy (ECT) (formerly known by its unscientific name as electroshock therapy). It involves using an electrical current to induce seizures to help alleviate the effects of severe depression. The exact mechanism is unknown, although it does help alleviate symptoms for people with severe depression who have not responded to traditional drug therapy (Pagnin, de Queiroz, Pini, & Cassano, 2004). About 85% of people treated with ECT improve (Reti, n.d.). However, the memory loss associated with repeated administrations has led to it being implemented as a last resort (Donahue, 2000; Prudic, Peyser, & Sackeim, 2000). A more recent alternative is transcranial magnetic stimulation (TMS), a procedure approved by the FDA in 2008 that uses magnetic fields to stimulate nerve cells in the brain to improve depression symptoms; it is used when other treatments have not worked (Mayo Clinic, 2012).