Early History

Mental health care has come out of the dark ages only recently. Social workers specializing in mental health in the early 20th century facilitated patient care by putting clients together with the most appropriate caregiver or finding a state-run institution that might house them.

• "Mental hospitals" were full of patients suffering from violent criminal impulses, psychotic delusions and various emotional disorders all the way down to stress induced nervous breakdowns. Little else could be done to treat serious mental illness.
• At the dawn of the 20th century, Sigmund Freud informed the well-to-do upper middle class that their behavior was influenced by unconscious memories, thoughts, and urges. Only a lifetime of analysis could enable sufferers to cope with the deep traumas they had suffered. Psychoanalysis became the mental health treatment of choice for almost 60 years until the invention of Valium in 1963.
• Diazepam, better known by the trade name Valium, belongs to a group of chemically similar sedative and anxiolytic (anti-anxiety) drugs called benzodiazepines.
• Valium, ("Mother's Little Helper") quickly became the best-selling medication in the United States between 1963 and 1982 and sales peaked in 1978 with more than 2.3 billion pills sold that year.
• Goodbye - Psychoanalysis / Hello - Psychotropics.

Mental Health Medications

The success of Valium (and its predecessor, Librium) opened the floodgates for an array of effective anti-psychotics to treat schizophrenia and a multitude of anti-depressants revolutionized how the mentally ill were cared for. The ability to control the florid symptoms of psychotic episode in schizophrenia or bring someone out of a deep depression was a major step forward. For the first time many patients were able to live more ‘normal’ lives inside and, on occasion, outside of the confines of asylums and mental hospitals.

Neurotransmitters

The most recent and effective developments in the pharmacology of mental and emotional health care is the development of the neurotransmitters. Neurotransmitters communicate signals from one neuron (nerve cell) to another target cell, such as another neuron, muscle, or gland. Neurotransmitter signaling helps our brains function and is involved in almost all bodily functions.

• A neurotransmitter can influence neurons in one of three ways: it can excite, inhibit, or modulate them.
• Excitatory neurotransmitters such as epinephrine and norepinephrine excite the neuron, causing it to “fire” the message onto the target neuron.
• Inhibitory neurotransmitters such as GABA and endorphins block or inhibit the message from being carried on further.
• Modulatory neurotransmitters or “neuromodulators” such as dopamine and serotonin influence other neurotransmitters’ excitatory or inhibitory effects.

Neurotransmitters influence emotions, including mood, such as fear, pleasure, and joy. These neurotransmitters include the following:

• Epinephrine: Responsible for the fight or flight response produced in stressful situations.
• Norepinephrine: Affects energy level and increases concentration.
• Dopamine: Responsible for pleasure and addiction, with people repeating actions to induce dopamine release.
• Serotonin: Involved in mood and contributes to well-being and happiness.
• GABA: Produces a calming effect by reducing the excitatory effect of neurons. High levels cause focus, while low levels increase anxiety.
• Acetylcholine: Involved in thought, learning, and memory.
• Glutamate: Involved in learning and memory.
• Endorphins: Produce euphoria—a sense of well-being—and reduce pain.

Caution

Social workers are concerned about the widespread use of Neurotransmitters. Not unlike the pain killer Oxycontin, various neurotransmitters have been quite effective in treating not only mental health but also mood disorders that are not as debilitating as serious mental illness. Anything that makes us "feel better" has the potential for abuse. In their eagerness to alleviate even the minor discomforts their patients may be experiencing; practitioners might be inclined to overprescribe these medications. Too much of a good thing is always a bad thing.