Psychiatry

Psychiatry is the branch of medicine that deals with mental, emotional, and behavioral disorders. Psychiatrists are medical doctors with a specialty in mental health, including substance abuse. Psychiatrists are qualified to assess both the mental and physical aspects of psychological disorders.

Why Get Psychiatric Help?

Psychiatric help is sought for a variety of reasons. 

Problems can appear suddenly, such as a panic attack, frightening hallucinations, thoughts of suicide, or hearing “voices”. 

There are also long-term effects such as feelings of sadness, hopelessness, or anxiety that never seem to go away or difficulties functioning, making everyday life seem disorganized or out of control.

Psychiatrists, as physicians, are capable of ordering or performing a wide range of medical laboratory and psychological tests which, in conjunction with discussions with patients, give an impression of a patient’s physical and mental condition. 

A psychologist’s education and clinical training enable them to understand the complex relationship between emotional illness and other medical problems and the relationship between genetics and family history, to evaluate medical and psychological data, to make a diagnosis, and to develop treatment plans with patients.

Psychiatry Tests

Psychiatrists offer a variety of treatments to patients (including psychotherapy, medication, psychosocial interventions, and electroconvulsive therapy, among others), depending on each patient’s needs.

Psychotherapy

Often called talk therapy, psychotherapy involves a talking relationship between patient and therapist. 

Psychotherapy can be used to treat a wide variety of mental disorders and emotional problems. 

During psychotherapy, the goal is to rid a patient of disabling or troubling symptoms so that they may function more effectively. 

Therapy may take a few sessions over a week or two or may take many sessions over several years, depending on the severity of the problem. 

Individual, couple, family, and group psychotherapy options are available.

Medication

Medication is generally used by psychiatrists in much the same way that it is used to treat high blood pressure or diabetes. 

Psychiatrists can prescribe medications to treat mental disorders after conducting thorough evaluations. 

Although the exact mechanism of action of psychiatric medications is not fully understood, some provide benefits to the brain by modulating chemical signaling and communication and reducing symptoms of mental illnesses. 

To monitor side effects and effectiveness of long-term medication treatment, patients will need to meet with their psychiatrist periodically.

Other Treatments

Other treatments may also be used. 

ECT, a medical treatment that involves applying electrical currents to the brain, is most commonly used to treat severe depression that has failed to respond to other treatments. 

A few of the newer therapies being used to treat some mental disorders include deep brain stimulation (DBS), vagus nerve stimulation (VNS), and transcranial magnetic stimulation (TMS). 

Seasonal depression is treated with light therapy.

Psychiatric Disorders

Depression

Depression, also called major depression or clinical depression, is a mental health disorder that is characterized by a significant loss of interest in daily activities, and an unrelenting sad mood.

There are a variety of things that can cause depression, ranging from social anxiety to genetic factors.

Major depression can have a variety of symptoms, including changes in your sleep pattern or loss of sleep and appetite, and low energy and concentration levels.

Depression may also lead to thoughts of suicide and self-harm.

Generally, depression is treated through a combination of medication and therapy.

Some medications used to treat depression include SSRIs, Antidepressants, Anxiolytic medication and Antipsychotic medication.

Bipolar Disorder

Bipolar disorder is a mental health condition characterized by periods (or episodes) of extreme mood swings that affect mood, thoughts, and behavior. 

Bipolar disorder is classified into two categories. 

Bipolar I disorder is marked by episodes of mania and depression. 

Bipolar II disorder involves a milder form of mania called hypomania. 

There is also a third type of bipolar disorder known as cyclothymic disorder.

The symptoms of bipolar disorder vary greatly and are unique to each individual. 

There is no single treatment for bipolar disorder, and it usually involves a combination of treatment methods. 

The use of complementary medicine, talk therapy, and lifestyle changes can all be beneficial, but psychiatric medications are the mainstay of treatment.

Post-Traumatic Stress Disorder (PTSD)

PTSD is a psychiatric disorder characterized by extreme distress and disruption of daily life following exposure to a traumatic experience. 

Approximately 6% of the U.S. population will experience PTSD at some point in their lives.

PTSD symptoms are divided into four categories:

  • Intrusion symptoms
  • Avoidance of thoughts and behaviors
  • Negative changes in thoughts and mood
  • Changes in arousal and reactivity


Traumatic events can cause these symptoms. 
There are symptoms associated with each of the four categories.

Intrusion

These symptoms are related to intrusive thoughts and memories of the traumatic event.

  • Recurrent, involuntary, and upsetting memories of the incident
  • Having repeated nightmares about the event
  • Dissociation (e.g., flashbacks, feeling as though the event is happening again)
  • Strong and persistent distress after exposure to cues related to the event, whether inside or outside the body
  • A strong bodily reaction (such as an elevated heart rate) when reminded of the event

Avoidance

A person suffering from PTSD may avoid people, places, conversations, activities, objects, or situations that bring up memories of the traumatic event. 

The person may also avoid thoughts, feelings, or physical sensations that relate to the event.

Negative Changes in Thoughts and Mood

PTSD patients may experience a pervasive negative emotional state (such as shame, anger, or fear). 

The following symptoms may also be present:

  • Not being able to recall an important aspect of the event
  • A persistent and elevated negative opinion about oneself, others, or the world.
  • Increased self-blame or blame placed on others for the cause or consequence of the event
  • Having lost interest in previously enjoyed activities
  • Distancing yourself from others
  • The inability to experience positive emotions (such as happiness, love, and joy)

Changes in Arousal and Reactivity

People with PTSD often feel as though danger lurks around every corner (also known as hypervigilance). 

They might also experience:

  • Irritability or aggressive behavior
  • Problems sleeping
  • Heightened startle response
  • Difficulty concentrating
  • Impulsive or self-destructive behavior

Schizophrenia

Schizophrenia is a serious mental disorder in which people appear to interpret reality abnormally. 

Schizophrenia is usually accompanied by hallucinations, delusions, and disordered thinking and behavior that can make daily life difficult and even impossible. 

Schizophrenia requires life-long treatment.

Dissociative Identity Disorder

The condition dissociative identity disorder (DID) is characterized by the presence of two or more distinct personalities within an individual. 

Previously, the mental health condition was known as multiple personality disorder.

Those with DID will experience the presence of two or more distinct personalities or identities, otherwise known as alters. 

Persons with these personalities frequently experience loss of memory when it comes to what happened while they were controlled by another personality or alter.

Every alter has its own characteristics, personal history, and way of relating to the world. 

Alternative personalities can have different names, mannerisms, genders, and preferences than their core personalities.

People with DID may also experience the following symptoms:

  • Inability to recall childhood memories and personal history
  • Feelings of detachment or disconnection
  • Flashbacks or the sudden recall of previously forgotten memories
  • Losing chunks of time
  • Thoughts of self-harm or suicide
  • Hallucinations
  • Lack of awareness about recent events

Obsessive-Compulsive Disorder (OCD)

OCD is a mental health condition characterized by obsessions and compulsions that interfere with daily life. 

Because of obsessive thoughts caused by this mental illness, OCD was previously classified as an anxiety disorder. 

Extensive rituals may also be performed to reduce the anxiety caused by obsessions.

Symptoms of OCD often appear gradually and can persist if untreated. 

OCD may manifest as obsessions, compulsions, or both. 

Many aspects of life are affected by these symptoms, including school, work, relationships, and normal functioning.

Obsessions

Obsessions are thoughts, images, and ideas that won’t leave your head and are highly distressing or worrying.

Obsessions are commonly characterized by the following symptoms:

  • An aggressive attitude toward others or towards oneself
  • A need for everything to be in a certain order
  • Phobia against germs
  • Thoughts about forbidden or taboo topics, such as sex, religion, or harming others

Compulsions

Compulsions are behaviors taken up repeatedly in order to relieve anxiety. 

They are often related to obsessions. 

If, for example, you are obsessive about being contaminated, you may feel compelled to repeatedly wash your hands. 

This is not always the case.

Among the most common compulsions are:

  • Excessive washing or cleaning
  • Repeated checking (e.g., checking the door is locked, checking that the oven is off)
  • Ordering things in a particular or symmetrical way
  • Counting things over and over again

Attention-Deficit/Hyperactivity Disorder (ADHD)

ADHD is a neurobehavioral condition characterized by inattention, hyperactivity, and impulsivity. 

ADHD is most often diagnosed in children, but it can also affect adults.

ADHD has no known cause. 

However, researchers suspect there may be several factors that determine whether someone is likely to develop ADHD. 

Genetics, toxins, prenatal exposure to substances, and medical conditions can all have an effect.

Anorexia Nervosa

Anorexia nervosa is an eating disorder in which people restrict their food intake. 

A person might avoid eating altogether, eat very small portions, and/or cut out certain foods and eat only selected ones. 

Anorexia is characterized by the fear of being overweight (even if you are underweight).

Typically, anorexia begins in adolescence for children 15 or younger. 

Women and girls are affected the most. 

Anorexia can, however, affect people from all ages, genders, and races/ethnicities.

It is important to recognize all of the warning signs and symptoms of anorexia. 

The symptoms may vary from person to person, however.

Anorexia is not necessarily associated with all of these symptoms. 

Individuals with anorexia may not display all, or even any, of these signs.

There may be symptoms such as:

  • Being underweight (sometimes severely)
  • Distorted body image
  • Extremely restrictive eating
  • Taking diet pills or aids
  • Talking about weight or food all the time
  • Intense fear of gaining weight
  • Loss of periods (in women) or failure to begin a menstrual cycle (in girls) 
  • Loss or fluctuation of body fat and muscle
  • Binging and purging (by vomiting or taking laxatives)
  • Constipation, bloating, and stomach pains
  • Dehydration
  • Poor circulation (constantly feeling cold)
  • Skin that is yellowed, dry, or covered in soft hair (lanugo)
  • Dizzy spells and faintness
  • Extreme tiredness (fatigue)
  • Suicidal thoughts or actions


People with anorexia may exhibit specific behavioral symptoms, such as refusing to consume food in front of others, over-exercising to burn calories, or hiding their bodies in loose clothing. 

It’s common for some people to develop food rituals, such as cutting food into tiny pieces or rearranging food on a plate (to make it appear as if they’ve eaten more than they actually have).

Anorexia is associated with serious medical complications. 

Malnutrition, low blood pressure, slowed breathing and pulse, and damage to the heart and heart function are among the effects of anorexia. 

Dehydration and electrolyte imbalance are also possible. 

These symptoms can be life-threatening in some cases.

The most harmful misconception about anorexia is that all those who suffer from it are severely underweight. 

This may be true for some, but many people with anorexia appear to be in good health when in reality they are malnourished. 

The term atypical anorexia refers to people with anorexia who are not underweight.

Bulimia Nervosa

Bulimia is an eating disorder characterized by binge eating followed by compensatory purging or other methods to avoid weight gain or relieve physical symptoms after binge eating. 

In most cases, purging involves vomiting, but it can also be caused by laxatives, excessive exercise, or fasting.

People who have bulimia are often secretive about their condition due to feelings of shame or guilt. 

They may go to great lengths to hide their symptoms, so family and friends may fail to notice the signs that something is wrong.

Physical Symptoms

The first sign of self-induced vomiting in patients with bulimia nervosa is a tell-tale pattern of dental erosion, which is typically found on the internal surface of the teeth. 

Bulimia is linked to more than just oral health problems. 

Other symptoms include:

  • Bloodshot eyes
  • Calluses on the back of the hand
  • Swelling of hands and feet
  • Swollen glands and roundness in the jaw area
  • Tooth cavities
  • Tooth sensitivity
  • Vomiting blood
  • Yellowing, graying, spotted, or decaying teeth
  • Chest pains
  • Chronic bouts of constipation (resulting from laxative abuse)
  • Heart palpitations
  • Lightheadedness or loss of balance (may experience fainting)
  • Mouth ulcers
  • Stomach aches
  • Electrolyte imbalances and dehydration
  • Frequent sore throat
  • Headache


Other visible physical signs of purging include puffy cheeks. 

Also visible are the calluses on the hand that result from inserting it in the mouth to cause vomiting. 

These are known as Russell’s sign. 

This sign may not even be visible later in the illness since the person may be able to vomit without mechanical stimulation.

Behavioral Symptoms

Family members and friends are most likely to notice the following behavioral symptoms:

  • Creation of schedules or rituals that allow for binging and purging
  • Fatigued appearance
  • Frequent trips to the bathroom
  • Large amounts of food that are missing from the cabinets or pantry; large amounts of food packaging in trash cans or vehicles
  • Exercising a specific amount to burn off the calories that have been taken in
  • Extreme eating habits
  • Uses drugs or detox teas as a way to suppress appetite
  • Withdrawal from friends, families, and usual activities
  • Talks about dieting, calories, food or weight so much that it gets in the way of regular conversation
  • Desperation to exercise even when it gets in the way of other activities
  • Evidence of binge eating including stashing food, stealing food, and eating large amounts in one sitting
  • Evidence of purging such as always needing to go to the restroom or showering after meals or packages of laxatives or diuretics

Emotional Symptoms

Even when they are unaware of binging and purging behaviors, family and friends are often able to recognize emotional symptoms. 

These emotional issues are not unique to bulimia nervosa, but can still cause concern.

  • Depression
  • Extreme irritability
  • Mood swings
  • Self-esteem, self-worth, or attractiveness determined by appearance and weight
  • Strong need for approval
  • Extremely self-critical
  • Feeling out of control

Psychiatry Frequently Asked Questions

Psychiatrists treat more complex mental diseases, psychologists treat less severe conditions. 

In general, psychologists treat conditions that do not require medication. 

Behavior problems, learning difficulties, anxiety, and mild depression fall into this category.

Psychiatry is the branch of medicine concerned with the diagnosis, treatment, and prevention of mental, emotional, and behavioral disorders. 

A psychiatrist is a medical doctor (an M.D. or D.O.) who specializes in mental health, including substance abuse issues.

PTSD is characterized by intense, disturbing thoughts and feelings that persist long after the traumatic event has ended. 

Through flashbacks or nightmares, they may relive the event, and they may feel distant or detached from other people.

ADHD can affect both children and adults. 

There are a number of symptoms, including an inability to focus, a tendency to be easily distracted, hyperactivity, and poor organization skills. 

However, not everyone with ADHD experiences all of these symptoms. 

Symptoms vary from person to person and tend to change with age.

ADHD is one of the most common neurodevelopmental disorders in children. 

The disorder is usually diagnosed in childhood and lasts into adulthood. 

A child with ADHD may have difficulty paying attention, controlling impulsive behaviors (acting without considering the consequences), or be overly active.

Anything that triggers stress, anxiety, or a sense of being out of control can trigger an OCD episode. 

Having cancer, for example, can trigger obsessions and compulsions, especially related to cleanliness.

Obsessive-Compulsive Disorder (OCD) is a common, long-term disorder in which a person has uncontrollable, recurring thoughts (obsessions) and/or behaviors (compulsions) that they feel compelled to repeat repeatedly.

Mood and behavior may change suddenly. 

Family members may witness dissociative identity disorder patients forgetting or denying things they have said or done. 

When someone “switches,” family members often notice the sudden, startling change.