Psychiatry, << sy KY uh tree, >> is the branch of medicine concerned with the treatment and prevention of mental illness. A psychiatrist is a physician who, after earning an M.D., takes at least four years of training in the treatment of mentally ill patients.
Many techniques are used in treating mentally ill patients. A psychiatrist might discuss problems with one patient; prescribe drugs for another; and combine discussions, drugs, and other therapy for a third.
Some psychiatric therapy takes place in a psychiatrist’s office or in a clinic. But severe cases require hospital care. Many hospitals and clinics employ psychiatric nurses, social workers, and clinical psychologists. These specialists have had special training to help patients solve their problems.
Psychiatric disorders
Mental disorders are characterized by a variety of symptoms, such as abnormal moods or behavior, excessive anxiety, and hallucinations. These symptoms may be upsetting and may interfere with the person’s ability to lead a normal life. The causes of most mental disorders are unknown. Some may arise from emotional conflicts or psychological stress. Others may result from learned behavior patterns or are caused by biological factors affecting the brain. Many mental disorders are believed to result from a combination of emotional, social, and biological factors.
Ways of defining and classifying mental disorders have changed over time. Older classification systems made a distinction between psychoses and neuroses. Psychoses are severe mental disorders in which a person loses touch with reality and experiences such symptoms as delusions and hallucinations (see Psychosis ). Neuroses are milder disorders marked by excessive anxiety (see Neurosis ). Other kinds of mental disorders include dementias and personality disorders. Dementias are abnormalities in thinking or behavior caused by brain injury or brain deterioration. Personality disorders involve a tendency to act in socially unacceptable or self-defeating ways. Most psychiatrists in the United States use the Diagnostic and Statistical Manual of Mental Disorders (DSM), a classification system published by the American Psychiatric Association. This system includes more than 100 mental disorders defined by their symptoms.
Treatment
Psychiatrists use a number of treatments for mental disorders. The two main types of treatments are (1) somatic therapy and (2) psychotherapy.
Somatic therapy
usually involves the use of medications. One commonly used group of medications are neuroleptic drugs, also called antipsychotics. These drugs are used mainly to treat psychosis. Antidepressants are a group of drugs used to control abnormalities of mood. Anxiolytics reduce anxiety and are used chiefly to treat phobias and panic disorder. Lithium carbonate is a drug used to treat bipolar disorder. A person with this disorder experiences alternating periods of sadness and joy.
A type of somatic therapy called electroconvulsive therapy is sometimes used to treat severe depression. In this type of therapy, a mild electric current is passed through the patient’s brain after the patient has been given a drug that causes sleep. See Mental illness (Electroconvulsive therapy [ECT]) .
Psychotherapy
is any form of treatment by psychological means. It is also called talk therapy. Most psychotherapy is based on discussions between the patient and the psychiatrist. The doctor works to build the patient’s confidence and to help the patient develop a more contented outlook toward life. Commonly, the patient and doctor meet for a psychotherapy session once or twice a week for several months. But sessions may occur more frequently or less frequently.
Sometimes groups of 4 to 12 patients participate in group therapy. By meeting as a group with the psychiatrist, the patients help each other understand themselves.
When working with a child, the psychiatrist may use play therapy. The child, instead of talking about his or her problems, acts them out with toys and games.
Two widely used forms of psychotherapy are psychoanalysis and behavior therapy. Psychoanalysis focuses on unconscious thoughts and feelings. According to psychoanalytic theory, the causes of many mental illnesses lie buried in the unconscious. The patient meets with the psychiatrist and talks about whatever comes to mind. The physician helps the patient understand his or her problems by uncovering the causes. Psychoanalysis may last for a number of years. See Psychoanalysis.
Behavior therapy aims to help patients change their behavior rather than help them understand why they act the way they do. Psychiatrists use positive and negative reinforcement to encourage patients to act in a healthier way. Using positive reinforcement, the psychiatrist praises or rewards the patient for “good” behavior. This technique is considered more effective than negative reinforcement, which includes scolding the patient for “bad” behavior.
