Biomedical Therapy

Definition of Biomedical Therapy

One of the most significant discoveries in psychological treatment, especially in the treatment of severe disorders, is the use of biomedical therapy.

Biomedical therapies could include lifestyle changes, drugs (or psychopharmacology), neurostimulation (i.e. electroconvulsive therapy, magnetic stimulation, deep-brain stimulation), and psychosurgery

Biomedical Therapy in Psychology

It's easy to think that psychology and biology are two separate entities. However, the more appropriate perspective is that anything psychological is, in fact, biological. The neuroplasticity of our brains allows for it to be ever-changing. As psychotherapy changes the way we think or behave, it also changes our brain.

Research has revealed that successful psychological treatments do in fact show changes in the brain.

Types of Biomedical Therapy

Let's explore the different types of biomedical therapy including lifestyle changes, drug therapies, neurostimulation therapies, and psychosurgery.

Therapeutic Lifestyle Changes as a Type of Biomedical Therapy

The mind-body connection is one that should never be ignored or downplayed. Our lifestyle choices and our social environments affect our brain and our body which affect our mental health. Humans have always been designed for physical activity and social development. That's why our ancestors hunted and gathered in groups. Biomedical treatments that involve lifestyle changes alone can do wonders for our mental health.

Exercise is a type of biomedical treatment, Freepik.com

For example, getting enough sleep at night will boost energy, alertness, and immunity. Taking nutritional supplements such as fish oil can improve brain functioning. Aerobic exercise alone can pump our body full of endorphins that put antidepressants a run for their money. Even the time we spend outdoors or in nature can significantly reduce stress. A good place to start when considering how to use biomedical treatment to treat mental health disorders is to assess simple, everyday changes that could promote a healthy brain and body.

Drug Therapies as a Type of Biomedical Therapy

Drug therapies have been developed through discoveries in the field of psychopharmacology.

All drugs used in psychotherapy can come with their own side effects. Therefore, while developing drug therapies, psychopharmacologists must consider the drug's efficacy to ensure it is in fact helpful and not harmful or simply useless. They must look at how many people recover from their disorder without treatment (and how quickly).

They must also consider whether or not a person's recovery is because of the drug or because of a placebo effect. In other words, if someone receives a sugar pill (the placebo) thinking it's an antidepressant, do they show improvement simply because they believe they are being treated. Several studies would suggest yes. For example, one study found only a small difference between the effects of Zoloft, an antidepressant drug, and the placebo in reducing symptoms of depression (Wagner et al., 2003)

Antipsychotic Drugs

Antipsychotic drugs are known to have the most dramatic effects in treating people with severe psychological disorders such as schizophrenia. Researchers accidentally stumbled on the use of antipsychotic drugs (originally used only for medical purposes) and their ability to reduce hallucinations and delusions.

First-generation antipsychotic drugs such as Chlorpromazine (Thorazine) mimic the neurotransmitter, dopamine, and then block the activity of dopamine in the brain by occupying the receptor sites. This supports the theory that schizophrenia may be linked to an overactive dopamine system in the brain.

These drugs have been shown to reduce the positive symptoms (i.e. hallucinations or paranoia) of schizophrenia. However, they are not as effective in treating the negative symptoms (i.e. withdrawal or apathy). They also come with potentially severe side effects. A person may develop sluggishness, twitches, and tremors that resemble Parkinson's disease. Long-term use can even produce symptoms of tardive dyskinesia.

In some cases, this side effect may be more debilitating than the psychotic symptoms themselves and is often irreversible. However, antipsychotic drugs have allowed people who would otherwise need to be institutionalized to leave the hospital and return to their daily lives. New drugs have also come along with less severe symptoms such as risperidone (Risperdal) and olanzapine (Zyprexa). Or, clozapine (Clozaril) does not produce tardive dyskinesia and can also reduce both positive and negative symptoms of schizophrenia. It can, however, produce fatal blood disease in 1 to 2 percent of users which can be managed.

Drug therapy, Freepik.com

Antianxiety Drugs

Anti-anxiety drugs include Xanax, Valium, or Ativan. They are designed to reduce symptoms of anxiety without reducing concentration or alertness. They may resemble the effects of alcohol in that they depress the central nervous system activity. This is why these drugs should never be consumed with alcohol.

Antianxiety drugs as a biomedical treatment have helped reduce the symptoms of post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder by reducing a person's learned fears. However, these results were if antianxiety drugs are used in combination with psychotherapy.

Some psychologists criticize antianxiety drugs for only reducing the symptoms of anxiety without actually helping the person resolve their underlying problems. Additionally, while taking antianxiety medication you can experience immediate relief. As a result, most antianxiety drugs are known to be habit-forming which leads to addiction.

Antidepressant Drugs

Although antidepressant drugs were originally developed to treat depression, they may also be used to treat anxiety, OCD, and PTSD. Depression may be related to lower levels of serotonin and norepinephrine in the brain, neurotransmitters responsible for mood, arousal, positive emotion, and motivation. Selective serotonin reuptake inhibitors (SSRIs) are among the most commonly used antidepressant drugs. They include drugs such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil) and work by blocking the breakdown and reabsorption of serotonin and norepinephrine

While effective, they are not without side effects. They may include weight gain, dry mouth, hypertension, or dizzy spells. Also, SSRIs do not bring immediate relief and may take up to 4 weeks to start showing effects. Many psychologists feel that antidepressants should only be prescribed after psychotherapeutic attempts have been made. Even still, many treatment plans will combine antidepressants with psychotherapy or other more mild biomedical treatments such as aerobic exercise.

Mood-Stabilizing Medications

Another category of biomedical treatments that utilize drug therapy is mood-stabilizing medication. Mood-stabilizing medications may include Depakote which was originally used to treat epilepsy but is effective in treating manic episodes in Biopolar disorder. Another type of mood-stabilizing medication used to treat bipolar is Lithium. Lithium is a salt that can even be found in natural drinking waters. It is known to help level out emotional highs and lows and can reduce suicidal ideations. Lithium is a salt that can even be found in natural drinking waters.

Neurostimulation as a Type of Biomedical Therapy

Now we move into slightly more intense forms of biomedical treatments called neurostimulation or brain stimulation. For many of us, when we think of neurostimulation, we picture an evil scientist who tried to control someone's mind by shocking their brain with electricity. While it is not quite as dramatic and no longer involves convulsions, electroconvulsive therapy (ECT), does in fact use an electric shock to manipulate the brain. First introduced in 1938, ECT is conducted while the patient is awake and strapped to the table. With a jolt of electricity, a 30 to 60-second seizure is triggered. ECT has been used to treat severe psychological disorders such as severe depression that are "treatment-resistant," meaning no medication or psychotherapy has worked.

Other forms of neurostimulation include mid-cranial electrical stimulation, magnetic stimulation, and deep-brain stimulation.

Psychosurgery as a Type of Biomedical Therapy

Finally, the most drastic and intrusive of all biomedical treatments is psychosurgery.

A lobotomy, a common psychosurgery procedure, was originally developed by Egas Moniz in the 1930s. Monzi found that cutting the nerves connecting the frontal lobe to subcortical centers in the brain that controlled emotion calmed patients who were uncontrollably emotional or violent. While this is the least used biomedical treatment today, it was not always the case. According to Valenstein (1986), thousands of people with severe disturbances were lobotomized between 1936 and 1954 after Walter Freeman developed a 10-minute lobotomy operation. Enthusiasm for this procedure soon died down after realizing the severe side effects it caused including seizures, memory and reasoning impairments, lethargy, and lack of creativity.

Psychosurgery requires brain surgery, Pixabay.com

Other, less drastic procedures have since been developed such as a cingulotomy. This procedure involves cutting out a small fiber bundle that connects the frontal lobe to the limbic system. While this procedure has shown success in treating severe depression and OCD, severe side effects like seizures are still likely. All in all, cutting into someone's brain is the very, very last resort in treating mental illnesses.

Biomedical Therapy vs. Psychotherapy

Biomedical therapy and psychotherapy should not be at odds with one another. Many times, a person's best treatment path is a combination of both. It's important to note that biomedical therapies that use drugs are not an automatic cure for psychological disorders. They usually cannot stand on their own. Biomedical therapies only help to reduce symptoms but do not teach a person how to coping skills or problem-solving skills. This is where psychotherapy can fill in the missing pieces.

For example, aerobic exercise may be combined with cognitive-behavioral therapy to treat anxiety and depression. The aerobic exercises can help facilitate more calm for people with anxiety and more energy for people with depression. Cognitive-behavioral therapy will help reverse negative thinking and maladaptive behaviors. Antipsychotic drugs used to treat schizophrenia may be combined with psychotherapies such as social skills training, family therapy, and group therapy.

Examples for Biomedical Therapy

Biomedical therapies are not limited to the ones previously discussed. Other examples of effective biomedical therapies are in treating substance use disorders. This mental health condition has many physiological symptoms. Drugs wreak havoc on our brain's functioning and create pathways that facilitate addiction. Quitting a highly addictive drug like heroin cold turkey can cause severe withdrawal symptoms such as abdominal pain, nausea, shaking, and muscle spasms. A person in withdrawal will often say it feels like they will die if they do not get another fix. And in fact, death can occur from heroin withdrawal due to other health complications a person may have.

Biomedical treatments can be used to manage the symptoms of withdrawal so a person can safely discontinue use. Addiction to opioids and heroin can be treated by using biomedical treatments such as methadone. Methadone is a drug that targets similar areas in the brain as heroin and other opiate drugs to suppress withdrawal symptoms and relieve cravings. Methodone is still an addictive drug and can still be abused. Therefore, the treatment requires a person to go to a clinic or hospital to receive their dose rather than administering it themselves and risking misuse. Some people have to stay on methadone forever. however, others are able to successfully become drug-free.