Technology has failed so far to find the solutions needed for far too many with serious mental illnesses, and we are still waiting.

“Make the voices stop, make them stop!” He stood there pleading with me at the top of his voice, and I wished I had the power, the key, and the something that would make them stop. But, like so many others, I could offer nothing.

Psychiatrists prescribed every drug, new and old, in their favored “bible” (the PDR), and nothing worked. The patient was desperate and had tried suicide several times already. There was an uneasy awareness that it would end with one eventual success in ending his life. No, he wasn’t resistant to treatment, and he attended groups and private sessions and stood in line for the small cup with the few pills that, unlike Alice’s “one pill,” did nothing but put him to sleep.

Now, sleep was his only refuge, but he had to force himself to get up and participate. There was no respite for patients in this hospital except for one man, a mental health professional in a constant state of delusional physical paralysis, who lay in bed day after day.

The lengthy bed stays had even forced his scraggly beard to turn to one side, like a society matron’s upswept hair. He asked for nothing, said nothing, and only stared at anyone who came to attempt to talk to him. As a mental health “invalid,” he required total care for bathing and eating. There had been no magic pill for him, either, as he lay locked in some other reality in his lonely room. Who would have guessed that, at one time, he had a practice, lived in his own apartment in a major city, and had graduated from a prestigious university?

Over the decades, explorations for effective treatments for all aspects of mental disorders have run the course from unconscious conflict to raging hormones, neurotransmitters, and lifetime adversity. Curiously, it was discovered that the receptors on which Prozac worked were not primarily located in the brain but in the gut. Now, as research continues, especially with treatment-resistant mental disorders, such as major depression and schizophrenia, a new emphasis is being placed on the gut and what it might contribute to the treatment and relief of symptoms.

The latest exploration of the gut microbiome is in seeking treatments for treatment–resistant schizophrenia. Remember the patient who pleaded to have the voices stopped? His diagnosis was schizophrenia, and since none of the medication helped him with his symptoms, we can assume it was treatment-resistant schizophrenia. Unfortunately, he also had a long history of street drug abuse, and that may have complicated any future treatment for him.

The researchers who explored the microbiome's involvement in schizophrenia are pointing the way. They indicate that future research should take medication and lifestyle variables into account when designing and interpreting previous findings of microbiome changes in people with persistent schizophrenia. They believed that a particular medication may have caused changes in the microbiome. That may be an area for medication in the future and a distinct change from previous thinking on treatments.

One review summarizes the current thinking on the link between the brain, the intestinal epithelium, and the microbiota in the gut, and it delves into the many pathways — such as those involved in immunology, neuroanatomy, and neuroendocrine function — that convey signals and information from the gut microbiota to the brain. All of this presents intriguing questions regarding how, when considering lifestyle, both diet and exercise might be important factors in treatment regimes for all aspects of mental health disorders. After all, isn't the gut influenced by the diet we practice?

Researchers thought to establish the efficacy of a form of bright light therapy as the latest treatment for major depression. Of course, this was based on the premise that light entering through the eye had a dramatic effect on neurotransmitters that would, in turn, affect any symptoms of major depression.

I can imagine how disappointed patients are when they are told they have treatment-resistant major depressive disorder. The very words "treatment resistant" are not exactly hopeful, and it's unfortunate that anyone would be told via a diagnosis that there might be little hope for help. Isn't hope something all mental health professionals strive to maintain in their patients?

Although the current state of mental health treatment has not reached the level we would hope to alleviate symptoms of persons diagnosed with these disorders, the future holds hope in new areas of exploration, such as the gut’s involvement. The brain may be keeping its secrets, but the gut has waited for our attention and is now receiving what it deserves.