system
Given the following post, respond as if you're commenting on Reddit:
human
What kind of treatment would someone with schizophrenia have received in the early 70s?

How well was the condition even understood then?

Edit: Some really great answers here, guys, thank you. If anyone has any information on the second question "How well was the condition even understood then", that would be great also. Anything you can give me, however small, would be helpful. Thanks

Edit 2: For the two people who recommended me the books, the semi-autobiographical one and one that I think began with the word edan, I think the mods blocked your comments from going through. I'd be very grateful if you could pm me the titles. Thanks

Edit 3: whoever just left that "your smile makes" comment (that was all I saw of it), I think the mods blocked it from going through. Pm me it, it looked interesting.
gpt
Thorazine and later haldol were the main antipsychotic drugs at that time. They were probably used in much higher doses then we use them now, which caused a lot of people tardive dyskinesia—an often permanent disorder of abnormal involuntary movements.  When you see an old homeless guy on the street and he’s moving his tongue in and out constantly,  or grimacing repeatedly, good chance this is what he is suffering with.

People with schizophrenia probably also received a lot of benzodiazepines as well, things like Valium.

In some cases they would’ve received electroconvulsive therapy.

The 70s also marked the tail end of long term institutionalization for many. State hospitals were starting to be closed at that time due to a combination of factors— the overzealous belief in the efficacy of the newer antipsychotic drugs, empty coffers across the United States, and the effects of the civil rights movement.  Whereas prior to the 70s people with very chronic and severe mental illness could be institutionalized in what would hopefully be a therapeutic community, after the 70s, the “home“ for people with severe chronic mental illness increasingly became the prison system and the streets.

Edit:  to answer your second question, it was unfortunately understood then about as well as it is understood now, which is to say, not very well. We still don’t really have anything solid to point at in terms of genetic underpinnings, causation, pathophysiology, etc. Certainly nothing that has resulted in significantly better treatments. There are some newer antipsychotics with better side effect profiles than the old stuff, but they come with their own issues. Many of the newer antipsychotics unfortunately have a propensity to cause weight gain, dysregulated blood sugar, etc.  “pick your poison.” Of note, ECT is very rarely used in this day for psychosis, but that probably has more to do with protections most states have put in place regarding consent for treatment. Very hard to give involuntary ECT in the United States whereas in the past it would only take a single physician’s order in most cases.