Psychiatry is the branch of medicine that deals with the causation, prevention, diagnosis and treatment of mental and behavioral disorders.
A psychiatrist is a medical doctor (an M.D. or D.O.) who specializes in mental health, including substance use disorders. Psychiatrists are qualified to assess both the mental and physical aspects of psychological problems.
People seek psychiatric help for many reasons. The problems can be sudden, such as a panic attack, frightening hallucinations, thoughts of suicide, or hearing "voices." Or they may be more long-term, such as feelings of sadness, hopelessness, or anxiousness that never seem to lift or problems functioning, causing everyday life to feel distorted or out of control.
Because they are physicians, psychiatrists can order or perform a full range of medical laboratory and psychological tests which, combined with discussions with patients, help provide a picture of a patient's physical and mental state. Their education and clinical training equip them to understand the complex relationship between emotional and other medical illnesses and the relationships with genetics and family history, to evaluate medical and psychological data, to make a diagnosis, and to work with patients to develop treatment plans.
Psychiatrists use a variety of treatments – including various forms of talk therapy, medications, psychosocial interventions and other treatments (such as electroconvulsive therapy or ECT), depending on the needs of each patient.
Psychotherapy, sometimes called talk therapy, is a treatment that involves a talking relationship between a therapist and patient. It can be used to treat a broad variety of mental disorders and emotional difficulties. The goal of psychotherapy is to eliminate or control disabling or troubling symptoms so the patient can function better. Depending on the extent of the problem, treatment may take just a few sessions over a week or two or may take many sessions over a period of years. Psychotherapy can be done individually, as a couple, with a family, or in a group.
There are many forms of psychotherapy. There are psychotherapies that help patients change behaviors or thought patterns, psychotherapies that help patients explore the effect of past relationships and experiences on present behaviors, and psychotherapies that are tailored to help solve other problems in specific ways. Cognitive behavior therapy is a goal-oriented therapy focusing on problem solving. Psychoanalysis is an intensive form of individual psychotherapy which requires frequent sessions over several years.
Most medications are used by psychiatrists in much the same way that medications are used to treat high blood pressure or diabetes. After completing thorough evaluations, psychiatrists can prescribe medications to help treat mental disorders. While the precise mechanism of action of psychiatric medications is not fully understood, they may change chemical signaling and communication within the brain, which may reduce some symptoms of psychiatric disorders. Patients on long-term medication treatment will need to meet with their psychiatrist periodically to monitor the effectiveness of the medication and any potential side effects.
The criteria for diagnosis of mental health disorders are laid out in The Diagnostic and Statistical Manual of Mental Disorders, or DSM. Reviewed and modified periodically by experts, in response to new information and understanding of mental dysfunction, the DSM is now in its fifth edition. DSM-5 details more than 20 broad categories of mental disorder:
Antidepressants – used to treat depression, panic disorder, PTSD, anxiety, obsessive-compulsive disorder, borderline personality disorder and eating disorders.
Antipsychotic medications – used to treat psychotic symptoms (delusions and hallucinations), schizophrenia, bipolar disorder.
Sedatives and anxiolytics – used to treat anxiety and insomnia.
Hypnotics – used to induce and maintain sleep.
Mood stabilizers – used to treat bipolar disorder.
Stimulants – used to treat ADHD.
Psychiatrists often prescribe medications in combination with psychotherapy.
Interventional psychiatry describes procedures used when medications and psychotherapy are ineffective in restoring a patient to full health. Electroconvulsive therapy (ECT), a medical treatment that involves applying electrical currents to the brain, is used most often to treat severe depression that has not responded to other treatments. Deep brain stimulation (DBS), vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS), and ketamine treatment are a few of the newer therapies being used to treat some mental health disorders. Psychedelic drugs such as psilocybin are being studied for future treatment potential.
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