Psychiatrists: Doctors for Mental Health Treatment
Written by Dr Spurti Psychiatrist
Last updated on 19 August 2020
The magnitude and burden of mental health disorders
WHO (2003) defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity – a mentally fit person is someone who can recognize their abilities, cope with the everyday stressors of life, work productively, and make a meaningful contribution to society. But mental illness, on the other hand, is a disability that affects the entire society, and no one group is immune to it. And if you were to go by the WHO statistics, they are staggering:
- Each year, depression and anxiety cost the global economy 1 trillion USD. Mental health is intrinsically woven into all areas of your life and can affect schooling, employment, relationships, family, friends and community.
- The last decade (to 2017) saw a rise in mental illnesses by 13% due to changes in the demography (change in population due to birth, ageing, deaths, migration, race, ethnicity, gender, education, employment etc.)
- Suicide is the second leading cause of death among 18 – 29-year-olds. One million people commit suicide every year.
- One in every five individuals suffers from a mental health condition in post-conflict regions.
- Persons with severe mental illnesses die prematurely by two decades.
- 4 out of 6 leading causes of years lived with disability (YLD) are due to neuropsychiatric disorders, namely depression, substance abuse, schizophrenia and bipolar disorders. YLD is a mathematical equation scientists use to measure years of healthy life lost due to disability.
- 1 in 4 families has at least one individual with a mental health condition.
Even though no one is immune to mental illness, the risk is relatively higher with the vulnerable in our societies: children, women, adolescents, unemployed, migrants, refugees and the elderly.
Table of Contents
- When to Visit?
- Educational Qualification
- Finding a good psychiatrist
- Choosing the right psychiatrist
Who is a psychiatrist?
Usually, when you fall sick, the doctors diagnose the disease by looking at your symptoms – by checking for abnormalities in the temperature, blood pressure, heart rate, injuries, infection etc. These symptoms are called somatic symptoms, i.e., visible symptoms related to the body.
But how about when all your blood reports, vitals, scans and X-rays are normal, and you still feel unwell? The group of illnesses that manifest little to no physical symptoms (non-somatic symptoms) falls under the branch of medicine called psychiatry, and the doctors who treat them are called psychiatrists.
What does a Psychiatrist do?
Psychiatrists, unlike psychologists, are doctors licenced to prescribe mood and thought altering drugs to treat a patient.
Psychiatrists do not perform any surgery.
To be more precise, psychiatry is that branch of medicine that treats mental health disorders associated with non-somatic symptoms found in the neurological examination of the nervous system.
Some mental health diseases treated by psychiatrists are anxiety, depression, Obsessive-Compulsive Disorder (OCD), panic attacks, psychosis, delusions, hallucinations etc.
How often should you see a Psychiatrist?
The frequency of your visit to a Psychiatrist depends on the severity of your mental health condition. In severe cases, you may have to see the Psychiatrist more often, i.e., once or twice a week, and as your mental health improves, you may have to visit them for medication and therapy less frequently. You may need to speak with your Psychiatrist as to what the best treatment is going forward.
What degrees do you need to be a Psychiatrist?
Psychiatrists have an MBBS and an MD in Psychiatry.
How to find a good Psychiatrist?
To find a good Psychiatrist, speak to a family member or friend who can refer you to a good Psychiatrist. You could also search online for doctors; mfine does a great job of providing services closest to you, i.e., they’d connect you with doctors near you. Usually, there are ratings and reviews online for the quality of services provided to help you decide what’s best for you.
How to choose a Psychiatrist?
Choosing the right doctor is one of the most important and personal decisions you would make. Following are seven essential tips to help you choose the right Psychiatrist:
- Research. There are many Psychiatrists out there. Decide upon the one you would be comfortable with; someone with a good reputation, communication and soft skills.
- Get the proper referrals. Speak with your family members, colleagues, friends to help you connect with the right Psychiatrist.
- Check for licencing and credentials of the Psychiatrist.
- Consider the years of experience of the Psychiatrist.
- Consider the gender of the doctor depending on if you would want to disclose your health condition to them.
- Consider the communication style of the Psychiatrist; choose a doctor you would gel along with quickly. Developing a rapport helps in communicating efficiently with the doctor. If possible, read patient reviews to help you make the right decisions.
- It’s good to know if you would be covered under the insurance plan that you have.
At MFine, we treat your health as our top priority. Book an online appointment, and our specialists will get in touch with you shortly!
- Ask the doctor about your symptoms, problems, medications, and more during your consultation.
- You may have to submit your medical history and records if any, so the doctor can better understand your condition.
- Post teleconsultation, you could also follow up with your doctor online.
- Additionally, you can also buy medicines online and get lab tests done using the MFine app, all from the comfort of your home.
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Therapy services offered by psychiatrists
Psychiatrists may also have additional licenses to provide therapies.
However, if they aren’t licensed, they’d be able to connect you with a licensed mental health professional or a psychologist. Here are some therapies you may want to consider for you or your dear ones:
Cognitive Behavioural Therapy (CBT)
It assumes that behaviour arises out of your thought patterns. i.e., when you think positive, you behave positively and are more likely to have a positive emotional response to everyone around you. Conversely, when you have a distorted sense of life, you will most likely end up being miserable.
CBT, therefore, focuses on correcting destructive or disturbing thought patterns to bring about a positive change in behaviour, mood and emotional responses.
Typically, a CBT will require you to sit for therapy sessions over several weeks or months. Your therapist will inquire about your family, relationships, job, schooling, childhood experiences etc., and analyze your thought patterns. They may then suggest ways or help you take the proper steps to address your thought patterns.
CBT involves a confidentiality clause: what’s been shared in the therapy session is not disclosed to a third person. However, that does not protect you from severe crimes you commit, such as murder or rape. In such cases, your therapist will have to cooperate with the law and enforcement agencies and disclose such sensitive information to the police or the court.
Emotional Freedom Techniques (EFT)
It is a popular therapy that involves tapping calming points on your face, arms and palms and chanting reassuring statements to yourself; it may sound something like this: Even though I am nervous, I can win this game for my team.
EFT is a form of hypnotic therapy that treats pain, emotional distress, anxiety and post-traumatic stress disorder (PTSD). In an EFT session, the therapist will inquire about your family, relationships, job, schooling, childhood experiences etc., and then lead you through a step by step process of tapping techniques and chanting.
EFT, however, isn’t backed by science nor empirical data.
It is also called talk therapy; it involves sharing your life experiences in a group setting with like-minded people or with people going through the same struggles as yours, in their lives. Psychotherapy provides a safe environment for participants to vent their emotions healthily without worrying about being judged; what’s said in the group stays with the group.
Usually, the psychotherapist will lead the group discussions in a meaningful direction that benefits everyone in the group. Psychotherapy sessions can also be done one on one with the psychotherapist.
Psychotherapy methods are used in Alcoholic Anonymous (AA) meetings to treat alcoholics and also their families. Alcoholism is a disease that affects both the alcoholic and their family; while the alcoholic drinks, their family goes through immense emotional pain and shame in the society. They both become patients of different mental disorders. Therefore, they both require separate psychotherapy sessions: one to heal from alcoholism and the other from emotional scars caused by the alcoholic.
What are some mental health conditions treated by psychiatrists?
Psychiatrists diagnose mental health disorders as per the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) guidelines.
DSM – 5 is the standard manual used by mental health professionals in the United States; it comprises what mental illness is and what isn’t, their diagnosis, symptoms, etc. DSM – 5 is used by mental health professionals across the globe, including India. Basic guidelines given in DSM – 5, below are some mental illnesses diagnosed by psychiatrists:
We all feel sad and hopeless from time to time, but that doesn’t necessarily mean we have depression. In fact, going through the ups and downs of life is the only constant we’ll have in our lifetime, and most often than not, it can be for our good; adversities make us resilient, wiser and stronger. However, we need to be able to draw the line between feeling sad and being clinically depressed.
But, how do we know if we are sad or clinically depressed?
DSM – 5 outlines the following guidelines to diagnose major depressive disorder or clinical depression:
- Persistent feeling of sadness, having low mood or loss of interest for at least two weeks. These feelings must be accompanied by at least five of the following symptoms of depression.
- Loss of appetite; weight loss or weight gain
- Insomnia or excessive sleep
- Fatigue or feeling of lethargy
- Feeling hopeless, worthless, or guilty.
- Loss of concentration
- Agitated mood
If you have had the above symptoms persistently for more than two weeks, it’s time you see a psychiatrist.
Similarly, like depression, DSM – 5 helps discern between what’s anxiety and what isn’t.
- Persistent feeling of anxiety and worry for at least six months.
- The person finds it difficult to control the worry. These feelings must be accompanied by at least three of the following anxiety symptoms for at least six months.
- Muscle tension
- Sleep disturbances
- Unable to concentrate
Anxiety can also be caused due to an imbalance of neurotransmitters in your brain. Consult a psychiatrist if you have had the symptoms mentioned above.
Obsessive-Compulsive Disorder (OCD)
It is an irrational behaviour that drives people to do something repetitively (compulsion)—for example, repeatedly washing hands because one is obsessed with cleanliness or repeatedly closing the door because of their irrational obsession with security. Symptoms of OCD as per DSM – 5 include
The presence of obsession, compulsion, or both.
Recurring and persistent thoughts
It is a chronic brain disorder in which a person isn’t in touch with their reality. For example, a schizophrenic person may firmly believe that someone is out there to harm them or someone is watching them (even though that may not be the case). As per DSM – 5, a schizophrenic person may exhibit one or more of the following symptoms:
- Hallucinations: visual, olfactory, auditory. They’d have conversations with imaginary persons or would be able to smell things not around, such as blood or flowers; it could be anything.
- Delusions: It’s an irrational thought or fear that isn’t real. A schizophrenic person may say something like X Y Z person is out there to harm them, and they’d go to great lengths to negate the perceived threat.
- Disorganized speech: murmuring, slurring etc
- Disorganized thoughts. They’d have conversations without any logical flow. They may be talking about their mom at one time, and then they’d rant about something irrelevant like smoking, cars, music, etc.
It’s an extreme mood disorder accompanied by alternating episodes of depressive and manic (showing wild, deranged excitement and energy) phases.
Symptoms of the depressive episode:
- Loss of motivation
- Suicidal thoughts
- Loss of interest in daily activities
Symptoms of manic episode:
- A feeling of absolute happiness
- Extreme irritability or rage
- Delusions: they may claim to have a special connection with God, celebrities, or dead persons.
- Impulsive and risky behaviour such as reckless driving, extreme sexual behaviour etc.
- Overly high self-esteem and belief in one’s capabilities (even though that may not be true).
Episodes of mania and depression may alternate and persist many days or weeks. Consult a psychiatrist if you suspect any of your loved ones may be bipolar.
What causes mental illnesses?
The exact cause of mental illness is not known; however, they are thought to be caused by a combination of genetic, biological, physiological and environmental factors. Some illnesses may be caused due to an imbalance of neurotransmitters in the brain. For example, abnormalities in dopamine levels have been associated with clinical depression, Parkinson’s disease, schizophrenia, addiction, and Huntington’s disease.
Similarly, abnormalities in serotonin levels have been associated with anxiety and panic attacks.
Tetrahydroisoquinoline (THIQ) has been associated with alcohol and heroin addiction. THIQ is an external chemical substance found only in the brain of heroin and alcohol addicts and not anyone else.
What's the difference between a psychiatrist and a psychologist?
Both psychiatrists and psychologists are mental health professionals who treat thought, mood and emotional disorders. But their differences lie in their educational background and practice.
Psychiatrists are medical doctors with a license to prescribe medications. And psychologists are non-medical mental health professionals with a license to provide counselling and therapies.
What is ADHD?
Attention Deficit Hyperactive Disorder or ADHD is a neurological disorder most often diagnosed in children. It’s a mental health condition characterized by hyperactivity and inattention; an ADHD child will most likely not pay attention to their parents or teachers. They are constantly on the move, uncontrollable, running around, climbing chairs, tables, or anything that’s around.
Here’s an interesting fact about ADHD. Michael Phelps, the most celebrated Olympian of all time, with 28 Olympic medals, including 23 golds, was diagnosed with ADHD as a child. So to channelize his energy, his parents put him in a swimming pool, and the rest they say is history.
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