Psychiatry

Psychiatry is a part of medicine that studies, diagnoses and treats mental illnesses and abnormal behaviours and conditions that cause problems and make life difficult for people.[1][2] The people who practice psychiatry and treat others who have psychiatric problems are called psychiatrists.

Prescribing psychiatric medication

Psychiatrists are medically qualified doctors. They can legally prescribe medications to their patients to help emotional and behavioral problems. This does not apply to psychologists, who are not qualified to prescribe medicines.[3]

Psychiatrists learn about how the body and the brain work. Psychiatrists must learn about all kinds of illnesses. Sometimes a disease in the body causes the brain to work poorly. Cancer in the pancreas causes depression. Blood sugar problems in diabetes mellitus can cause a bad temper. These are only two examples.

As doctors, psychiatrists learn about how medications can help the brain work better. They also learn how medications sometimes cause problems to the brain. Sometimes psychologists send their patients to a psychiatrist if the patient seems to have a problem that medicine might help. The patient should continue to see the psychologist.

In the 1950s, the first medicine to help patients with bipolar disorder (formally known as manic-depressive illness) was discovered. This was lithium, a type of metal in a powder form. A bit later, the first medicine for psychosis was discovered. Later, medicines to calm people (tranquilizers), to end depression (anti-depressants), to help feelings remain the same each day (mood stabilizers) were discovered.

Medicine for mental illness does not cure. Some of the medicines try to get brain chemicals to be the amounts they are in normal people. Other medicines "slow down how fast the brain works" so people with rapid thoughts can be in control of what they think and how they behave. When the medicines are stopped, symptoms often come back.

Sigmund Freud

The best known psychiatrist is Sigmund Freud, a medical doctor who was trained in neurology. He became certain that hidden thoughts in the brain (which he called the unconscious) could cause physical symptoms and strange behavior in some people. He believed that human behavior was not all caused by the brain, but by things that happened to people when they were babies and young children. His research of this theory – the idea he had – led him to create "talking therapy" – psychoanalysis – where he tried to figure out what could cause the mind to do things like this.[4][5]

He thought that his figuring things out and telling the patients what had caused the behavior would cure the patient. Unfortunately, it usually made no lasting changes. This is why psychiatrists (and psychologists) have gradually figured out many other ways of helping their patients.

Neuropsychiatry

Since the medications for mental illness were first discovered, there have been tools to understand why the mentally ill behave and think in ways that make it not easy for them to live. Doctors do this by studying the brain as directly as they can.

This field of medicine is called neuropsychiatry. The medical doctors who work in the field are called neuropsychiatrists. They hope someday to really permanently cure or fix mental illness by finding ways to change the brain forever. In the meantime, they try to find ways to help by finding better medications.

The science of psychology is studies the way people behave and change. Psychologists apply this what is found to make new ways of helping people change how they behave. Talking therapy and applied psychology were the first important ways of helping people with some problems of regular life. Some kinds of mental illness can be helped some this way, but some kinds cannot be helped. They need medicines instead, then sometimes a psychologist can help the patient a great deal.

Criticism

Controversy has often surrounded psychiatry, and the term anti-psychiatry was coined by psychiatrist David Cooper in 1967.[6] The anti-psychiatry message is that psychiatric treatments may be more damaging than helpful to patients. Psychiatry's history involves what may now be seen as dangerous treatments (e.g., electroconvulsive therapy, lobotomy).[7] Two charismatic psychiatrists who came to personify the movement against psychiatry were R.D. Laing and Thomas Szasz. Some ex-patient groups have become very anti-psychiatric, often referring to themselves as "survivors".[7]

Bessel van der Kolk[8] is also a noted psychiatrist, author, researcher and educator based in Boston, USA. He states that there is a much higher incidence of psychiatrists administering prescribed medications among patients who have government insurance. Since most mental illnesses are trauma-induced, medication has little to no effect. Psychiatrists are supposed to rule out trauma before diagnosing but its more rare than not. Therefore, its often easier to be screened by a psychologist or therapist first. Van Der Kolk often suggests EMDR, meditation, neurofeedback, yoga, mindfulness, sensory integration, and the arts for treatment of trauma or PTSD. Symptoms of trauma are often manifested by anxiety, hypervigilance, depression and behavioral problems that medication really doesn't help on a long-term basis.

Fields of psychiatry

  • Forensic psychiatry – the study of criminals and criminal behavior.[9][10]
  • Addiction psychiatry – study and treatment of chemical addictions.[11]
  • Child and adolescent psychiatry – study and treatment of children and teens[12]
  • Geriatric psychiatry – study and treatment of the aged[13]
  • Psychopharmacology[14][15]

Common psychiatric conditions

Psychiatry Media

References

  1. Gelder, M., Gath, D., & Mayou, R. (1989). Oxford textbook of psychiatry. Oxford University Press.
  2. Kaplan, H. I., & Sadock, B. J. (1989). Comprehensive textbook of psychiatry, Vols. 1-2. Williams & Wilkins Co.
  3. Psychologists can only prescribe medication in Louisiana and New Mexico, which allows clinical psychologists to prescribe medication, with some limits. U.S. Bureau of Labor Statistics Archived 2012-01-04 at the Wayback Machine
  4. Freud, S., & Bonaparte, P. M. (1954). The origins of psychoanalysis (Vol. 216). London: Imago.
  5. Weiss, E. (1990). Sigmund Freud as a consultant: Recollections of a pioneer in psychoanalysis. Transaction Publishers.
  6. Cooper, D. (Ed.). (2013). Psychiatry and anti-psychiatry. Routledge.
  7. 7.0 7.1 Tom Burns (2006). "Psychiatry: a very short introduction". Oxford University Press. {{cite web}}: Missing or empty |url= (help)
  8. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk, MD
  9. Monden, Y. (2003). Principles and practice of forensic psychiatry. CRC Press.
  10. Gunn, J., & Taylor, P. (2014). Forensic psychiatry: clinical, legal and ethical issues. CRC Press.
  11. Brizer, D., & Castaneda, R. (Eds.). (2010). Clinical addiction psychiatry. Cambridge University Press.
  12. Goodman, R., & Scott, S. (2012). Child and adolescent psychiatry. John Wiley & Sons.
  13. Thakur, M. E. (Ed.). (2015). The American psychiatric publishing textbook of geriatric psychiatry. American Psychiatric Pub.
  14. Leonard, B. E. (2003). Fundamentals of psychopharmacology. John Wiley & Sons.
  15. Healy, D. (2009). The creation of psychopharmacology. Harvard University Press.