Does Psychosurgery Work, And Is It Safe?

One of the most controversial and widely debated topics in psychiatric science today may be psychosurgery and whether it is a viable treatment for mental illness. Although psychosurgery is used much less frequently today, it may be appropriate for some individuals who have not experienced relief from symptoms of mental illness through other treatment options. Often, medication and therapy (either in person or online) are used before psychosurgery may be considered.

History of psychosurgery

Psychosurgery is thought to have its roots in some of the earliest medical practices, perhaps dating back to ancient civilizations. However, it was not until the advent of new surgical techniques in the early 20th century that this type of medical procedure was generally able to be used more widely.

Psychosurgery has sometimes been used as an extreme measure to treat varying mental disorders, usually when other treatments have failed. To address the issue, skilled surgeons may remove or destroy parts of the brain thought to be responsible for causing distressing symptoms. 

Despite its invasive nature and associated risks, psychosurgery is often a last recourse in treating severe psychiatric conditions that may otherwise be untreatable.

Types of psychosurgery (lobotomy, cingulotomy, capsulotomy)

Several different types of psychosurgeries have been used in the past. These include the following:

• lobotomy

• anterior cingulotomy

• anterior capsulotomy

Each of these procedures usually involves cutting or burning specific areas of the brain in an attempt to alleviate certain mental illnesses. However, these procedures have largely been phased out due to their invasive nature and the risk of severe side effects. The lobotomy, first performed by Portuguese neuroscientist Antonio Egas Moniz, is especially well known.

Modern psychosurgery

Today, psychosurgery has generally evolved to become more targeted and less invasive. For example, instead of cutting or burning parts of the brain, modern psychosurgery typically uses focused procedures (such as deep brain stimulation) that utilize ultrasound waves or magnetic resonance imaging (MRI) instead of scalpels to target specific brain areas. This can allow for more targeted treatment with fewer side effects. 

Modern psychosurgery is becoming increasingly popular as a treatment for certain mental disorders, as it may provide a safer and more effective treatment compared to methods used in the past.

Safety reports of psychosurgery

Studies conducted on psychosurgery patients

Several studies have been conducted on patients who have undergone psychosurgery. The results of these studies have been mixed, with some showing positive outcomes and others showing no improvement in mental health symptoms. 

However, many experts believe that psychosurgery can be effective in some instances and that it can provide relief for people with specific mental health disorders.

Overall, it can be essential to consider all aspects of psychosurgery before deciding whether to undergo the procedure. It can be crucial that any patient considering psychosurgery carefully weighs the risks and benefits before making a final decision.

Negatives of psychosurgery

Psychosurgery can be a highly controversial practice due to its risks and potential adverse outcomes. Nevertheless, it’s sometimes been used to treat severe mental illnesses like anxiety, depression, bipolar disorder, schizophrenia, obsessive compulsive disorder, and more.

While psychosurgery can relieve some psychological symptoms in a small number of cases, it largely remains a risky option with drawbacks that could harm an individual's well-being. 

Risk for complications

One of the most significant risks associated with psychosurgery may be the potential for complications. Such complications can include excessive bleeding, infection, or permanent nerve damage.

Lack of research on the techniques psychosurgeons utilize 

Relatively few scientific studies have been conducted regarding the safety and efficacy of psychosurgery. This means that much may remain unknown about how this form of therapy works on a physiological level and its long-term effects.

Controversial nature of psychosurgeries

Because it is such an extreme treatment option, psychosurgery has become increasingly controversial in the medical community and among patients. Many believe this therapy should only be utilized as an absolute last resort due to its radical nature and the potential risks.

Benefits of psychosurgery 

Although psychosurgery carries with it some strong connotations because of its historical use as a “last resort” treatment for severe psychological conditions, modern science and therapeutic techniques may have changed how these procedures are performed.

For those living with severe mental disorders such as schizophrenia or major depression, psychosurgery may be a viable treatment option if other forms of therapy have failed to provide relief from symptoms.

The rise and fall of psychosurgery 

Throughout its history, psychosurgery often caused more harm than good. Patients often experienced long-term side effects, such as memory loss and cognitive decline.

Over time, public opinion generally shifted away from psychosurgery due to these risks and ethical concerns. By the late 1950s, it had largely been abandoned in favor of less invasive treatments. 

The rise of pharmacology for the treatment of mental disorders

In the late 1950s and early 1960s, pharmaceutical companies began developing psychoactive drugs, or medications that usually act on the central nervous system and can produce changes in mood or behavior. These medications were often used as treatments for various psychiatric conditions, such as depression, anxiety disorders, and schizophrenia.

Unlike psychosurgery, these drugs were generally considered safer and had fewer side effects. They could also be prescribed without invasive procedures. As a result, pharmacology quickly became popular among doctors and patients and gradually replaced psychosurgery as the primary method of treating mental illness. 

The impact of the switch from surgery to pharmacology

This switch from psychosurgery to pharmacology has significantly impacted modern mental health treatment. On the one hand, pharmacology has allowed psychiatrists to treat a wide variety of psychological disorders with relative safety and efficacy. On the other hand, there can still be a lack of research surrounding some medications.

However, studies show that “[t]he development and approval for other antipsychotic and antidepressant agents soon followed, with evidence that medical therapy was more effective, safer, and cheaper than psychosurgery.”

Pharmacology is likely here to stay and will probably remain one of the primary methods psychiatrists use when treating mental illness. 

Who is a candidate for psychosurgery?

Psychosurgery can be a serious medical procedure and should generally only be considered as a last option for mental illness that has not responded to other forms of treatment. Psychotherapy, medications, and other alternative therapies should normally be tried before undergoing psychosurgery.

The risks associated with this type of surgery can include seizures, infections, brain damage, or adverse emotional changes. Therefore, discussing psychosurgery thoroughly with one's physician can be crucial to make a fully informed decision about this potentially risky procedure.

Benefits of psychotherapy vs. psychosurgery

Cognitive-behavioral therapy (CBT) is a largely effective form of therapy that usually focuses on helping patients identify and modify unhealthy thinking patterns that may contribute to their distress or behavior problems.

CBT can help people become aware of how they think and feel in certain situations, learn how to respond differently, and develop more adaptive ways of thinking and behaving to achieve better outcomes. For psychosurgery candidates, CBT may help them manage their symptoms more effectively while exploring other options, such as medication management or lifestyle changes. 

The advantages of online therapy

Online therapy can help individuals develop healthier coping skills to manage stressors more effectively without invasive surgery.

This type of therapy usually also offers skills training in areas such as mindfulness, distress tolerance, emotion control, interpersonal effectiveness, and problem-solving techniques, which can help people who may have traditionally been a candidate for psychosurgery.

Through therapy sessions, individuals often gain insight into themselves to make positive life changes. Additionally, therapy is normally non-invasive and can be customized based on an individual’s needs and preferences. Online therapy can add more availability and convenience to the experience by empowering individuals to get professional help from the comfort of their homes.

Effectiveness of online therapy 

Online therapy can be an effective treatment for various mental health issues for those historically considered candidates for psychosurgery. By utilizing technological advances, a person can embrace the opportunity to receive professional assistance from home or anywhere they have an internet connection.

Studies have demonstrated positive results regarding a patient's feelings of well-being, reduction in depressive symptoms, and improved self-efficacy and social functioning, among other reported benefits.

This research further supports the notion that there is generally no difference between face-to-face therapy and computer-mediated therapy in terms of effectiveness. With the growing acceptance of this modality, online therapy may prove to be an invaluable resource for individuals who are not able to get traditional care as easily or with factors such as transportation and scheduling being potential obstacles.