– Psychiatry –
I have been working as a psychiatrist in the last decade. In my office I consult every day patients with a wide range of mental disorders – sleep disorders, depression, bipolar disorders, addiction among others. I use my extensive knowledge of the human mentality to diagnose the precise condition of the patient and decide what would the best treatment for the current case – psychotherapy, medication and if hospitalization would be required.
As a psychiatrist, I am a physician who is specialized in diagnosing and treating both the physical and mental psychological disorders.
So, what is psychiatry?
Psychiatry is a medical science that is focused on all the aspects of the human mental health. The protection, rehabilitation and strengthening of mental health, the pathogenesis, pathoanatomy, physiology and treatment of all psychiatric disorders and disturbances. Psychiatry is the second largest division of the clinical medicine sciences (besides Physiatry).
Most psychiatrist choose a specific field of psychiatry and specialize and work in it – some of the numerous sub-specialties of psychiatry are: Addiction psychiatry, forensic psychiatry, neuropsychiatry, children’s and geriatric psychiatry (of old age) and preventive psychiatry. Unlike psychologists, the psychiatrists are medical doctors, who diagnose, treat mental illnesses, and can prescribe drugs.
Psychiatric disorders and treatment:
In my work as a psychiatrist, I sometimes consult patients in the emergency room. This is a truly intense, stressful work. There you have to make a rapid diagnosis and treatment decisions. The diagnosis is usually made through the clinical interview, mental status exam, the records for the patient and his family, lab tests (including drug screen) and, if necessary, additional psychological tests and brain imaging.
Some of the patients are sent home with advises to follow, while other are admitted to the clinic. The treatment would usually be a combination of drug prescription (it can be in oral form or muscular injections) and psychological therapy. Electroconvulsive therapy (or shock therapy) may also be used and as a last line of intervention in severe depressions and mania.
We have a lot of patients with major depression disorders. When a patient comes to my office with a mental complaint i would do a check on the medical history of the patient, since depression can be caused by hormone abnormalities, side effects of medication and other medical conditions. Psychotherapy is my preferred treatment for patients with depression. While the condition of a mild depression can be improved by itself over time or with physical exercises, the talking therapy can be of help for moderate cases.
In psychotherapy we use two methods:
1) Cognitive Behavioral therapy helps the patient improve by changing his or her way of thinking and dealing with the problems in a more positive way;
2) Counselling is the other type of talking therapy, which consists in listening with empathy to the patient and helping to deal with negative thoughts and feelings.
The talking therapy can be used to help with many other mental disorders. Establishing a therapeutic relationship with the patient, understanding and empathy is of significant importance for the success of the therapy.
Some of the patients who come with cases of severe depression are hard to manage, with some of them contemplating suicide. Antidepressant drugs that deal with the symptoms of depression, often in a combination with a talking therapy are prescribed for the treatment of these patients. When anti-depression medicine fails to work or the patients are a threat to themselves and others, electroconvulsive therapy can be used. It is one of the safest and effective methods of treating severe depression.
We work with numerous cases of Dementia, which refers to various conditions that are related to various brain diseases that cause loss of memory, difficulties with language and decrease in the ability to think. This is in most cases caused by aging – Alzheimer’s disease is responsible for about 70% of all cases, but we need to check all patients for hypothyroidism and vitamin B12 defficiency – only in these cases the condition is reversible.
People with Alzheimer’s disease have trouble finding words, lose their short-term memory, easily get lost in new places and often repeat questions. Choosing the treatment for a person with this condition is always individual – it may include cholinesterase inhibitors, a suggestion in lifestyle change, behavioral and cognitive intervention, however the benefits are rather small, since there is no cure for dementia.
The patients with varieties of Psychosis we usually find in the psychiatric emergency room with alterations in the perception of reality – most of them experiencingmay visual hallucinations, some are hearing voices or believe that their mind is being read, others have delusions, disorganized thinking and Catatonia.
Sometimes we have to involuntarily hospitalize the patient. Full recovery from the conditions of psychosis is possible, but it is important to get help as early as possible. The symptoms mentioned may be found in the relatively uncommon condition of a brief psychotic disorder (not caused by a drug, schizophrenia or bipolar disorder) which usually occurs for a shorter period.
In most of our cases this is caused by stress, death in the family or experienced by women after giving birth. Schizophrenia, on the other hand, is a chronic disease that may be due to genetic reasons, resulting in a different brain chemistry and structure of the patients.
The first symptoms of schizophrenia appear during puberty and the it is more common when there are cases of the disease among family and relatives. There is no cure for schizophrenia, but the symptoms like hallucination can be reduced with anti-psychotic drugs and psychosocial therapy. Some of the patients manage socialize and live a highly productive life thanks to the medication and ongoing therapy.