The Development of Treatments
The Development of Treatments for Mental Health Problems
Schizophrenia and clinical depression are both treated using a combination of biological and psychological approaches. Biological treatments target the brain directly, changing the actions of neurons and synapses. Psychotherapy works differently — it changes how a person thinks, feels or behaves. Many patients are offered a combination of both types of treatment.
The two main types of drug treatment are anti-psychotics (mainly for schizophrenia) and anti-depressants (mainly for clinical depression). Both work by changing the actions of neurons and synapses in the brain.
Anti-psychotic Medication
Anti-psychotic drugs are the main biological treatment for schizophrenia. The biological explanation of schizophrenia states that an overactive dopamine system — too much dopamine activity at the synapse — causes symptoms such as hallucinations and delusions. Anti-psychotics work by blocking dopamine receptors on the post-synaptic neuron, reducing the amount of dopamine able to bind and stimulate further activity.
By reducing this excess dopamine activity, anti-psychotics can lower the severity of symptoms and help a person function more normally in daily life. They do not cure schizophrenia, and many patients need to keep taking medication over the long term to keep symptoms controlled.
Anti-depressant Medication
Anti-depressant drugs are the main biological treatment for clinical depression. The most commonly prescribed type increases the amount of serotonin available at the synapse between two neurons, often by blocking its reuptake into the neuron that released it. This leaves more serotonin free to keep stimulating the next neuron, which is linked to improved mood over several weeks of use.
Anti-psychotics reduce dopamine activity at the synapse to treat schizophrenia. Anti-depressants increase serotonin activity at the synapse to treat clinical depression. Both change how neurons communicate rather than changing a person’s thoughts directly.
Psychotherapy
For schizophrenia, psychotherapy can help a patient understand and manage their symptoms, challenge unhelpful beliefs linked to their condition, and reduce the distress caused by hallucinations or delusions. For clinical depression, psychotherapy often focuses on identifying and challenging negative or irrational patterns of thinking, and on gradually rebuilding activities and relationships that depression has caused a person to withdraw from.
Psychotherapy for schizophrenia usually works alongside anti-psychotic medication rather than instead of it, because symptoms often need to be biologically stabilised before a patient can engage fully with talking therapy. Sessions may focus on coping strategies, reducing stress that can trigger episodes, and improving family communication and support.
Psychotherapy for clinical depression can be used alone for milder cases, or alongside anti-depressants for more severe or treatment-resistant depression. It aims to change the beliefs and behaviours that maintain low mood, giving the person skills they can continue to use after therapy ends.
The Development of Neuropsychology
Neuropsychology has developed as a way of studying schizophrenia and clinical depression more precisely. Instead of relying only on a patient’s reported symptoms, neuropsychology uses tests and scanning techniques to measure how the brain is actually working, and how well a treatment is changing that activity over time.
Neuropsychological tests, such as the Wechsler Memory Scale, measure specific functions like memory, attention and problem-solving. These tests can show which cognitive functions are affected in a patient with schizophrenia or clinical depression, helping clinicians track how a treatment is working.
Brain imaging techniques allow researchers and clinicians to see the structure or activity of a living brain. This has provided direct evidence of differences in brain volume and activity — for example in the frontal lobes, hippocampus and temporal lobes in schizophrenia — supporting biological explanations of these conditions and helping monitor whether treatment is changing brain activity over time.
The development of neuropsychology — through neuropsychological tests and brain imaging — has allowed schizophrenia and clinical depression to be studied and monitored more scientifically, rather than through reported symptoms alone.
Evaluating the Development of Treatments
Biological treatments (anti-psychotics, anti-depressants) are widely accessible and can produce relatively fast improvements in symptoms, but they treat the chemistry of the brain rather than the underlying thoughts or life circumstances, and stopping medication can allow symptoms to return. Psychotherapy addresses the whole person and can produce longer-lasting change, but it requires more time, patient engagement and access to a trained therapist.
Combining biological and psychological treatments, and using neuropsychological evidence to guide and monitor them, is increasingly seen as the most effective overall approach to improving the mental health of people with schizophrenia and clinical depression.