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Esther experienced lack of energy levels, when she was at her mother’s house. She would barely get up.

I hadn’t washed my hair for three weeks, either” (Plath 127).

Esther hadn’t got up to even wash her hair. Esther lastly experienced thoughts of suicide multiple times throughout the book.  She tried to drown herself multiple times or thought about how she would go about committing suicide.

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“Researchers once thought that people with seizure disorders had fewer mental health problems than people who didn’t experience seizures” (Kramlinger 63).

So researches thought that by inducing a seizure, this could help treat patients with mental health disorders.
#shocked

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#Messed-up

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“I hadn’t slept for seven nights” (Plath 127).

“I told doctor Gordon about not sleeping and not eating and not reading” (Plath 130).

“My hand made big, jerky letters like those of a child” (Plath 130)

Her depression is affecting her life substantially, this is because she is a writer and if she can not read or write, that is going to affect her job.

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https://www.dailymail.co.uk/health/article-6648945/Controversial-electric-shock-therapy-approved-treat-depression-not-safe.html

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In The Bell Jar, the main character, Esther would experience treatment after treatment, to help with her depression.

"Well, it will always be like that," she said firmly. "You will be having shock treatments three times a week -- Tuesday, Thursday and Saturday” (Plath 215-216).

Esther has to have 3 shock treatments a week and that is not it, there is more.

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“The yellow and orange shaded indicates areas of the brain with more brain activity. During depression, brain activity is reduced” (Kramlinger C3).

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Doctors would inject individuals with chemical substances that caused them to have a seizure. Then in 1938, 2 Italian physicians used electrical current instead of chemicals to trigger the seizure. This was better,

“because it offered greater control of when the seizure would occur. It also less risk of medical complications, including death” (Kramlinger 63).

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Electroconvulsive Therapy became the first affective treatment for severe depression. By the 1950’s ECT was used quite frequently.

#Unreal

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It is legal in the U.S. it is only used for the most severe cases, in which other treatment options have been unsuccessful. It is safer than it used to be, but it comes with some side effects such as confusion and memory loss.

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“Deep insulin coma therapy was regarded as the only specific treatment for schizophrenia from the late 1930s until it was discredited in the late 1950s” (Jones 147).

Esther, in The Bell Jar, used this as one of her treatment plans, which is interesting because this therapy was used mainly on Schizophrenia patients and Esther struggled with depression.

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https://www.priory.com/homol/insulin.htm

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Manfred Sakel developed this therapy at the University Neuropsychiatric Clinic in Vienna. Sakel first worked for a two year fellowship in internal medicine in Berlin.

“He next worked in a private psychiatric hospital in that city where he treated morphine addicts and found that small doses of insulin helped withdrawal” (Jones 147).

This gave him the idea to try insulin with psychotic patients. This created the idea of insulin injections, but then it evolved quickly.

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His theory was that insulin antagonized the neuronal effects of products of the adrenal system, these being the physiological cause of the patient's state.  It evolved from just giving injections, to putting patients in insulin comas.

#Bizarre

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Esther also experienced insulin injection.

“Three times each day the nurses injected me, and about an hour after each injection they gave me a cup of sugary fruit juice and stood by, watching me drink it” (Plath 191).

#Rough-life

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Depression causes the amygdala to enlarge, which is where the depressed brain in the photo above, has all of its activity. When the amygdala enlarges and is more active, it causes sleep disturbances, changes in activity levels, and changes in other hormones.

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Anti-depressants come in pill form and work by affecting neurotransmitters that are responsible for serotonin, norepinephrine and dopamine.
#pills’n’potions

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SSRIs increase levels of serotonin by blocking the absorption of serotonin into neurons making serotonin more available to improve transmission of messages between neurons.
#happypills

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His work attracted international attention and doctors from many countries came to study the treatment. In March 1936 the Board of Control for England and Wales sent a medical commissioner, Dr Wilson.

“In July 1936 His Majesty's Stationery Office published a 61-page booklet by Dr Wilson, Hypoglycaemic Shock Treatment in Schizophrenia, which received laudatory reviews in major medical journals and rapidly ran out of print” (Jones 147).

All of the information from the booklet came from the years of hard work by Sakel and it was really popular.

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SNRIs affect chemical messengers that are responsible for the communication between brain cells, ultimately it chemically alters your neurotransmitters to regulate mood.
#mychemicalromance

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Norepinephrine and Dopamine Reuptake Inhibitors

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Norepinephrine and Dopamine Reuptake Inhibitors

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NDRIs block the action of specific transporter proteins, increasing dopamine and norepinephrine neurotransmitters in the brain.
#sodope

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Coma therapy had largely fallen out of use in the US by the 1970s, it is still researched in some hospitals today, but not used.

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Patients are wrapped in a layer of cold wet sheets and then in a layer of dry blankets. It is used as a false sedative for patients who suffer from sleeplessness, restlessness, various anxiety states, all phases of manic depression psychosis and schizophrenia.

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“We watched Polly shiver after being wrapped in ice cold sheets” (Kaysen 20).

In the book Girl, Interrupted by Susanna Kaysen, Polly is a character that experiences the cold pack treatments during her time in the asylum and the main character shares her observations of the effects of this treatment.

“[Polly] walked with her red-and-white hands dropping from her wrists and her feet shuffling along the floor. The cold packs hadn’t worked; she still screamed all night until they put her on something. “It took awhile,” I said. “You walked okay when they started.” “Now I don’t,” said Polly” (Kaysen 23).

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The treatment of using cold wet sheet packs is not banned or illegal, but it is not commonly used nowadays. Only 46 psychiatric patients in the US, from ages 12-27, are undergoing the treatment of cold wet sheet packs currently.
#staycool

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Currently, CBT or Cognitive Behavioral Therapy is the most commonly used way to treat mental health issues, but also can be effective on a various scale of life problems. According to https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral research has shown that CBT has proven to cause significant improvement in people’s function of life.

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CBT is based on several core principles, including:

1. Psychological problems are based, in part, on faulty or unhelpful ways of thinking.

2. Psychological problems are based, in part, on learned patterns of unhelpful behavior.

3. People suffering from psychological problems can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives.

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CBT helps individuals work through their problems by developing coping skills, which is significantly better for individuals than medication or any kind of chemically altering treatment. Although, in some cases treatments and therapy are required if no results are coming forth.

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Jones, Kingsley. “Insulin Coma Therapy in Schizophrenia.” Journal of the

Royal Society of Medicine, vol. 93, no. 3, 2000, pp. 147–149., doi:10.1177/014107680009300313.

Kramlinger, Keith. Mayo Clinic on Depression, by Keith Kramlinger, Mayo

Clinic, 2001, pp. C1–63.

Plath, Sylvia. The Bell Jar: a Novel. Harper, 2013.

“Electroconvulsive Therapy (ECT).” Mayo Clinic, Mayo Foundation for Medical

Education and Research, 12 Oct. 2018, www.mayoclinic.org/tests-procedures/electroconvulsive-therapy/about/pac-20393894.

The Mayo Clinic Staff. “The Most Commonly Prescribed Type of Antidepressant.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 17 Sept. 2019, www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825.

Spilsbury, Richard. Depression, by Richard Spilsbury, Rosen Publishing Group, 2019, pp. 26–29.

American Psychiatric Association. “The Psychiatric Uses of Cold Wet Sheet Packs.” American Journal of Psychiatry, 1 Apr. 2006, ajp.psychiatryonline.org/doi/abs/10.1176/ajp.145.2.242?journalCode=ajp.

Girl, Interrupted, by Susanna Kaysen, Vintage Books, 1999, pp. 20–23.

Kennedy, Marguerite, et al. “The Sedative Wet Sheet Pack.” The American Journal of Nursing, vol. 36, no. 1, 1936, pp. 53–60. JSTOR, www.jstor.org/stable/3411733. Accessed 22 Apr. 2021.