treatment of mental disorders treatment of mental disorders mental disorders are classified as a psychological condition marked primarily by sufficient disorganization of personality, mind, and emotions to seriously impair the normal psychological and often social functioning of the individual. individuals diagnosed with certain mental disorders can be unable to function normally in society. mental disorders may consist of several affective, behavioral, cognitive and perceptual components. the acknowledgement and understanding of mental health conditions has changed over time and across cultures. there are still variations in the definition, classification, and treatment of mental disorders. treatment of mental disordersspecialtypsychiatry and clinical psychology history treatments, as well as societies attitudes towards mental illnesses have substantially changed throughout the years. many earlier treatments for mental illness were later deemed as ineffective as well dangerous. some of these earlier treatments included trephination and bloodletting. trephination was when a small hole was drilled into a persons skull to let out demons, as that was an earlier belief for mental disorders. bloodletting is when a certain amount of blood was drained out of a person, due to the belief that chemical imbalances resulted in mental disorders. a more scientific reason behind mental disorders but both treatments were dangerous and ineffective nevertheless. during the 17th century however, many people with mental disorders were just locked away in institutions due to lack of knowledgable treatment. mental institutions became the main treatment for a long period of time. but though years of research, studies, and medical developments, many current treatments are now effective and safe for patients. early glimpses of treatment of mental illness included dunking in cold water by samuel willard (physician), who reportedly established the first american hospital for mental illness. the history of treatment of mental disorders consists in a development through years mainly in both psychotherapy (cognitive therapy, behavior therapy, group therapy, and ect) and psychopharmacology (drugs used in mental disorders). different perspectives on the causes of psychological disorders arose. some believed that stated that psychological disorders are caused by specific abnormalities of the brain and nervous system and that is, in principle, they should be approached for treatments in the same way as physical illness (arose from hippocrates's ideas). psychotherapy is a relatively new method used in treatment of mental disorders. the practice of individual psychotherapy as a treatment of mental disorders is about 100 years old. sigmund freud (1856–1939) was the first one to introduce this concept in psychoanalysis. cognitive behavioral therapy is a more recent therapy that was founded in the 1960s by aaron t. beck, an american psychiatrist. it is a more systematic and structured part of psychotherapy. it consist in helping the patient learn effective ways to overcome their problems and difficulties that causes them distress. behavior therapy has its roots in experimental psychology. e.l. thorndike and b.f. skinner were among the first to work on behavior therapy. convulsive therapy was introduced by ladislas meduna in 1934. he induced seizures through a series of injections, as a means to attempt to treat schizophrenia. meanwhile, in italy, ugo cerletti substituted injections with electricity. because of this substitution the new theory was called electroconvulsive therapy (ect). beside psychotherapy, a wide range of medication is used in the treatment of mental disorders. the first drugs used for this purpose were extracted from plants with psychoactive properties. louis lewin, in 1924, was the first one to introduce a classification of drugs and plants that had properties of this kind. the history of the medications used in mental disorders has developed a lot through years. the discovery of modern drugs prevailed during the 20th century. lithium, a mood stabilizer, was discovered as a treatment of mania, by john f. cade in 1949, "and hammond (1871) used lithium bromide for 'acute mania with depression'". in 1937, daniel bovet and anne-marie staub discovered the first antihistamine. in 1951 paul charpentier synthesized chlorpromazine an antipsychotic. influences there are numbers of practitioners who have influenced the treatment of modern mental disorders. during the 18th century in philippe pinel a french physician helped/advocated for better treatment of patients with mental disorders. similar to pinel benjamin rush, a philadelphian physician believed patients just needed time away from the stresses of modern life. which he believed was the cause of mental disorders to develop. benjamin rush(1746–1813) was considered the father of american psychiatry for his many works and studies in the mental health field. he tried to classify different types of mental disorders, he theorized about their causes, and tried to find possible cures for them. rush believed that mental disorders were caused by poor blood circulation, though he was wrong. he also described savant syndrome and had an approach to addictions. other important early psychiatrists include george parkman, oliver wendell holmes sr., george zeller, carl jung, leo kanner, and peter breggin. george parkman (1790–1849) got his medical degree at the university of aberdeen in scotland. he was influenced by benjamin rush, who inspired him to take interest in the state asylums. he trained at the parisian asylum. parkman wrote several papers on treatment for the mentally ill. oliver wendell holmes sr.(1809–1894) was an american physician who wrote many famous writings on medical treatments. george zeller (1858–1938) was famous for his way of treating the mentally ill. he believed they should be treated like people and did so in a caring manner. he banned narcotics, mechanical restraints, and imprisonment while he was in charge at peoria state asylum. peter breggin (1939–present) disagrees with the practices of harsh psychiatry such as electroconvulsive therapy. classification german physician emil kraepelin was more interested in the causes of mental disorders and potential classifications rather than focusing on and attempting to treating symptoms of mental disorders. this led to the classification of manic depression and schizophrenia, as well as the start of a framework for classifying other disorders. however this method of research/work was ignored until the need for a universal classification system. this need would later lead to the creation of the dsm. which not only provided classification of mental disorders but helped to understand where to start in terms of treatment. psychotherapy a form of treatment for many mental disorders is psychotherapy. psychotherapy is an interpersonal intervention, usually provided by a mental health professional such as a clinical psychologist, that employs any of a range of specific psychological techniques. there are several main types. cognitive behavioral therapy (cbt) is used for a wide variety of disorders, based on modifying the patterns of thought and behavior associated with a particular disorder. there are various kinds of cbt therapy, and offshoots such as dialectical behavior therapy. psychoanalysis, addressing underlying psychic conflicts and defenses, has been a dominant school of psychotherapy and is still in use. systemic therapy or family therapy is sometimes used, addressing a network of relationships as well as individuals themselves. some psychotherapies are based on a humanistic approach. some therapies are for a specific disorder only, for example interpersonal and social rhythm therapy. mental health professionals often pick and choose techniques, employing an eclectic or integrative approach tailored to a particular disorder and individual. much may depend on the therapeutic relationship, and there may be issues of trust, confidentiality and engagement. to regulate the potentially powerful influences of therapies, psychologists hold themselves to a set of ethical standers for the treatment of people with mental disorders, written by the american psychological association. these ethical standards include: striving to benefit clients and taking care to do no harm; establishing relationships of trust with clients; promoting accuracy, honesty, and truthfulness; seeking fairness in treatment and taking precautions to avoid biases; respecting the dignity and worth of all people. medication psychiatric medication is also widely used to treat mental disorders. these are licensed psychoactive drugs usually prescribed by a psychiatrist or family doctor. there are several main groups. antidepressants are used for the treatment of clinical depression as well as often for anxiety and other disorders. anxiolytics are used, generally short-term, for anxiety disorders and related problems such as physical symptoms and insomnia. mood stabilizers are used primarily in bipolar disorder, mainly targeting mania rather than depression. antipsychotics are used for psychotic disorders, notably in schizophrenia. however, they are also often used to treat bipolar disorder in smaller doses to treat anxiety. stimulants are commonly used, notably for adhd. despite the different conventional names of the drug groups, there can be considerable overlap in the kinds of disorders for which they are actually indicated. there may also be off-label use. there can be problems with adverse effects and adherence. antipsychotics in addition of atypical antipsychotics in cases of inadequate response to antidepressant therapy is an increasingly popular strategy that is well supported in the literature, though these medications may result in greater discontinuation due to adverse events. aripiprazole was the first drug approved by the us food and drug administration for adjunctive treatment of mdd in adults with inadequate response to antidepressant therapy in the current episode. recommended doses of aripiprazole range from 2 mg/d to 15 mg/d based on 2 large, multicenter randomized, double-blind, placebo-controlled studies, which were later supported by a third large trial. most conventional antipsychotics, such as the phenothiazines, work by blocking the d2 dopamine receptors. atypical antipsychotics, such as clozapine block both the d2 dopamine receptors as well as 5ht2a serotonin receptors. atypical antipsychotics are favored over conventional antipsychotics because they reduce the prevalence of pseudoparkinsonism which causes tremors and muscular rigidity similar to parkinson’s disease. the most severe side effect of antipsychotics is agranulocytosis, a depression of white blood cell count with unknown cause, and some patients may also experience photosensitivity. atypical and conventional antipsychotics also differ in the fact that atypical medications help with both positive and negative symptoms while conventional medications only help with the positive symptoms; negative symptoms being things that are taken away from the person such as a reduction in motivation, while positive symptoms are things being added such as seeing illusions. antidepressant early antidepressants were discovered through research on treating tuberculosis and yielded the class of antidepressants known as monoamine oxidase inhibitors (mao). only two mao inhibitors remain on the market in the united states because they alter the metabolism of the dietary amino acid tyramine which can lead to a hypertensive crisis. research on improving phenothiazine antipsychotics led to the development of tricyclic antidepressants which inhibit synaptic uptake of the neurotransmitters norepinephrine and serotonin. ssris or selective serotonin reuptake inhibitors are the most frequently used antidepressant. these drugs share many similarities with the tricyclic antidepressants but are more selective in their action. the greatest risk of the ssris is an increase in violent and suicidal behavior, particularly in children and adolescents. in 2006 antidepressant sales worldwide totaled $15 billion usd and over 226 million prescriptions were given. research on the effects of physical activity on mental illness research completed as increasing evidence of the benefits of physical activity has become apparent, research on the mental benefits of physical activity has been examined. while it was originally believed that physical activity only slightly benefits mood and mental state, overtime positive mental effects from physical activity became more pronounced. scientists began completing studies, which were often highly problematic due to problems such as getting patients to complete their trials, controlling for all possible variables, and finding adequate ways to test progress. data were often collected through case and population studies, allowing for less control, but still gathering observations. more recently studies have begun to have more established methods in an attempt to start to comprehend the benefits of different levels and amounts of fitness across multiple age groups, genders, and mental illnesses. some psychologists are recommending fitness to patients, however the majority of doctors are not prescribing patients with a full program. results many early studies show that physical activity has positive effects on subjects with mental illness. most studies have shown that higher levels of exercise correlate to improvement in mental state, especially for depression. on the other hand, some studies have found that exercise can have a beneficial short-term effect at lower intensities. demonstrating that lower intensity sessions with longer rest periods produced significantly higher positive affect and reduced anxiety when measured shortly after. physical activity was found to be beneficial regardless of age and gender. some studies found exercise to be more