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Psychiatry
Overview
Overview
Psychiatry is the speciality of medicine that deals with diagnosing, treating, and preventing behavioural, mental, and emotional disorders.
Psychiatrists are doctors who treat mental health disorders and deal with substance abuse disorders. They can assess the mental and physical aspects of psychological issues.
In short, psychiatrists are medical doctors who treat mental health disorders.
What is the difference between a psychiatrist and a psychologist?Though both deal with mental health disorders and often work together, they are different. Psychiatrists are medical doctors (MBBS, MD), and psychologists are from a non-medical background as they study psychology, and some of them do PHD in psychology as well. In other words, psychologists are counsellors who provide mental health counselling or talk therapy and also carry out psychometric tests if needed. However, psychologists are not trained to deal with deep-rooted medical conditions and do not have the authority to prescribe medicines. Hence, if a serious mental health issue is suspected, it is imperative to consult a psychiatrist.
Psychiatrists are licensed to order or perform an entire range of medical tests and psychological tests to examine a patient. They are trained to comprehend the complex relationship that exists between emotional and medical ailments, in addition to relationships between genes and family history. With all this, they evaluate medical and psychological data to formulate a diagnosis and treatment plan.
What does a psychiatrist treat?A psychiatrist is a specialist who diagnoses, treats and manages a broad range of mental illnesses and mental health issues, including:-
- Schizophrenia
- Bipolar disorder
- Insomnia and sleeping problems
- Addiction, including gambling, drugs, alcohol, and certain behaviours
- Depression
- Suicidal thoughts
- Self-harm
- Obsessive thoughts
- Violent outbursts
- Eating disorders, such as anorexia and bulimia
- Hallucinations
- Attention deficit hyperactivity disorder (ADHD)
- Memory problems
- Neurodevelopmental disorders like autism spectrum disorder or intellectual disability
- Body image issues
- Delusional thinking
- Post-traumatic stress disorder (PTSD)
- Constantly feeling on edge, agitated, or unable to relax, anxious, stressed or worry
During the initial visit, they enquire about the symptoms and personal, family, and medical history and conducted a mental status examination. In addition, it may also involve a physical examination and tests.
They may also refer to manuals like the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or ICD-10 to determine the type of mental illness that the patient may have. These manuals contain information about mental ailments that are used by doctors and insurance companies for reimbursement purposes.
When to see a Psychiatrist?A psychiatrist should be consulted when an individual is experiencing any of the following:
- Inability to Control Emotions: Feeling sad, upset, frustrated, depressed or hopeless constantly and not able to deal with such emotions needs psychiatric assistance. Excessive emotions can be detrimental to mental as well as physical health. Psychiatrists can help deal with these emotions and prevent triggers.
- Altered Sleeping Patterns: Sleep quality greatly affects mental health. Often, people struggling with mental health issues have trouble sleeping and may either wake up too early or repeatedly at night. Inadequate sleep has a major impact on routine, performance and emotions. Hence, consulting a psychiatrist may help deal with such issues.
- Substance Use: Substance use, like alcohol and drugs, can be problematic, and they are recognised as a mental health disorder.Psychiatrists can help reduce and eventually eliminate substance abuse.
- Disappointing Performance at School or Work: Psychiatric evaluation may be necessary if an adolescent or child struggles academically or misses school frequently. Some important signs are missing deadlines or finding it tough to focus on the work at hand.
- Withdrawal from Social Situations: It can be seen in many mental health disorders, including depression, anxiety or psychosis.
- Unexplained Physical Illnesses: An individual's mental and physical health is closely related to each other. If any of them suffers, the other is greatly affected. Psychiatrists can diagnose unexplained and frequent ailments that do not have any physical cause. Common symptoms of such problems include stomach aches, headaches, and vague pains.
- Excessive Anxiety: A psychiatrist can help deal with emotions such as anxiety, stress, sorrow, or worries. In addition,
- Suicidal or self-harming thoughts.It is imperative to speak to a psychiatrist if one feels suicidal.
- Violent or agitated behaviour. Sometimes violent and agitated behaviour is the result of an underlying mental health issue, so seeking treatment can help.
- Behavioural addictions. Behavioural addictions like excessive porn use, internet use or gaming may require psychiatric intervention.
- Sexual health issues. Sexual issues like reduced libido, premature ejaculation, erectile dysfunction and anorgasmia often have underlying mental health components and seeking treatment with a psychiatrist may help.
- Odd, eccentric behaviour. Odd behaviour like talking to self, impaired self-care, odd gestures, and suspiciousness may indicate an underlying severe mental health issue, and psychiatric help should be taken.
- Patients with Neuro-developmental issues like autism and intellectual disability may also need psychiatric help to manage certain symptoms.
After making a diagnosis, psychiatrists inform the patient or guardian about the treatment plan and schedule appointments accordingly. The treatment may involve:
- Psychotherapy or talk therapy
- Medications
- Brain stimulation therapies
Some common medications they may prescribe:
- Antidepressants
- Antipsychotic medications
- Stimulants
- Hypnotics
- Sedatives and anxiolytics
- Mood stabilisers
In many setups, psychiatrists and psychologists work alongside each other to treat mental health conditions. In some cases, the psychiatrist may also make an initial assessment and diagnosis before referring the patient to a psychologist for additional therapy. Some of the therapies that may be recommended include:
- Cognitive behavioural therapy (CBT) and dialectical behavioural therapy (DBT)
- Psychodynamic psychotherapy
- Group therapy
- Couples and Family therapy
- Creative arts therapy:Uses art, dance, drama, or music
- Play therapy: It encourages children to talk and express themselves through pretend play.
Review
Reviewed by Dr. Madhusudan Singh Solanki Senior Consultant & Head – Department of Mental Health And Behavioural Sciences on 20-Feb-2023.
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