Psychiatry

What is Psychiatry

Psychiatry is a medical discipline that emphasizes examining, identifying, and managing psychological or mental dysfunctions. Psychiatrists are medical doctors specializing in the diagnosis and treatment of mental health disorders. As per the World Health Organization, one in every eight individuals worldwide lives with a mental disorder, prompting diverse reasons for seeking psychiatric assistance, from sudden panic attacks to hallucinations.

Common Psychological Disorders

• Anxiety Disorders: The conditions marked by excessive worry, fear, or anxiety that interfere with daily life, including panic attacks, phobias, and generalized anxiety.
• Depression: This mood disorder is characterized by persistent feelings of sadness, loss of interest or pleasure, and changes in sleep, appetite, and energy levels.
• Schizophrenia: It is a severe mental disorder involving distorted thinking, hallucinations, delusions, and impaired social and occupational functioning.
• Personality Disorders: These disorders are marked by extreme thinking, feeling, and behavior that deviate from societal norms, leading to difficulties in relationships and daily functioning.
• Addictive Behaviors: These are compulsive, uncontrollable behaviors that lead to substance abuse or addiction to substances such as drugs or alcohol or other illegal activities despite negative consequences.
• Neurodevelopmental Disorders: These include disorders of intellectual development, such as attention-deficit disorder, autism, mental retardation, conduct disorders, cerebral palsy, and impairments in vision and hearing. Neurodevelopmental disorders are behavioral and cognitive challenges emerging during the developmental period, significantly affecting specific intellectual, motor, language, and/or social functions.
• Eating Disorders: These include abnormal eating habits and attitudes towards food, often resulting in severe disturbances in body weight, self-image, and mental health.

Symptoms

Symptoms of psychiatric disorders include: 

• Confused thinking and reduced concentration
• Inability to manage stress
• Prolonged sadness
• Trouble in understanding situations 
• Withdrawal from activities
• Fatigue, fear, or worry 
• Extreme mood swings
• Detachment from reality
• Marked changes in eating habits and altered sex drive
• Suicidal thoughts, substance abuse, anger, and violence

Diagnosis

Psychiatric clinical assessments provide a structured method to observe and assess psychological functioning. Referencing the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), this evaluation encompasses attitude, behavior, cognition, judgment, mood, perception, and thought processes. Psychiatrists utilize psychological tests tailored to the suspected condition of an individual to identify characteristic symptoms and gauge their intensity. 

Like many medical conditions, diagnosing mental illness often involves a process of elimination known as a differential diagnosis. This approach combines mental status examinations and biomedical tests to differentiate the presumed cause from other conditions with similar symptoms.

The tests might include:

• Brain imaging studies, such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) to check for tumors, hemorrhages, or lesions
• Electroencephalogram (EEG) to identify irregularities in brain electrical activity, including epilepsy, head injury, or cerebral blood obstruction
• Blood tests to evaluate blood chemistry, electrolytes, and liver and kidney function that might impact the brain directly or indirectly
• Drug tests to check for illicit drugs in the blood stream
• STD screening for infections like syphilis, HIV, and others that can affect the brain

Treatment

The treatment of mental disorders is multidisciplinary. Each treatment approach aims to alleviate symptoms, improve functioning, and enhance overall well-being to achieve long-term stability and recovery in individuals with mental disorders.

• Psychotherapy: It involves regular sessions to explore thoughts, behaviors, feelings, and relationships. It aims to help individuals solve their problems by understanding internal patterns and external influences.
• Medications: Often, a combination drug therapy is used, requiring ongoing adjustments for optimal effect. 
• Antidepressants for depression, anxiety, eating disorders, and borderline personality disorders
• Antipsychotics or neuroleptics to treat psychosis 
• Mood stabilizers for bipolar disorder and schizoaffective disorder
• Anxiolytics for anxiety disorders
• Stimulants for ADHD and narcolepsy
• Other Treatments:
• Deep Brain Stimulation (DBS): Implanting electrical probes to stimulate brain parts in severe depression, dementia, OCD, or substance abuse
• Electroconvulsive Therapy (ECT): Delivering electrical currents externally delivery of electrical currents for severe bipolar disorder, depression, or catatonia
• Psychosurgery: Surgical techniques like cingulotomy, subcaudal tractotomy, and limbic leucotomy to sever brain circuits to treat severe OCD and depression. Such surgery is used when mental disorders are resistant to other treatments

Prevention and Lifestyle Modification

Preventing mental illness involves understanding various influences on our mental health, such as personal history and social circumstances. While it’s impossible to prevent all mental health issues, many can be mitigated with proactive measures adopted by individuals, families, and society.

Some of these measures are as follows:

• Share feelings to feel supported and less isolated.
• Ensure adequate sleep, as it impacts mental well-being.
• Maintain a balanced diet for improved mood.
• Engage in physical activity for overall mental and physical health.
• Stay mindful and present in the moment.
• Foster supportive relationships for stress management.
• Engage in caregiving or volunteering activities for a sense of purpose.

For those at higher risk, the responsibility of family or friends is to:

• Recognize that multiple factors contribute to mental health, including genetics, environment, and life experiences
• Focus on understanding personal biology, environment, and experiences to develop tailored self-care approaches

The responsibility of every citizen in the country to prevent complications of mental health includes:

• Promoting good mental health for everyone in the community through initiatives like anti-stigma campaigns and emotional education, such as Mental Health Awareness Week
• Targeting support towards those at higher risk of mental health issues
• Supporting individuals living with mental health challenges, maintaining their well-being

Psychiatric or mental health disorders affect a significant portion of the global population, emphasizing the need for understanding, diagnosis, and effective treatment. Individuals can find relief and stability with a multidisciplinary approach, including psychotherapy, medications, and innovative interventions. Prevention efforts, encompassing societal initiatives and individual lifestyle modifications, are crucial in promoting mental well-being for all, ensuring a healthier and more resilient society.