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Psychiatry is the branch of medicine concerned with the
diagnosis and treatment of mental illness. A psychiatrist is a doctor who,
after qualifying in medicine completes several more 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, psychiatric 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 behaviour, excessive anxiety, and hallucinations. These symptoms
often upset the person who experiences them 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 behaviour patterns. Still others are caused by
biological defects in 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 . Neuroses are milder disorders marked by excessive
anxiety. Other classes of mental disorders include organic disorders and
personality disorders. Organic disorders are abnormalities in personality or
behaviour caused by brain injury or brain deterioration. Personality disorders
involve a tendency to act in socially unacceptable or self-defeating ways.
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 is neuroleptic drugs, sometimes called
antipsychotics. These drugs are used mainly to treat psychosis.
Antidepressants are a group of drugs used to control gloominess. Anxiolytics
reduce anxiety and are used chiefly to treat neurosis. Lithium carbonate is a
drug used to treat bipolar disorder, also called manic-depressive disorder. A
person with this disorder experiences alternating periods of sadness and joy.
A type of somatic therapy called electroconvulsive therapy (ECT) is sometimes
used to treat long-standing mental illness, including severe depression. In
this type of therapy, a mild electric current is passed through the patient's
brain after the patient has been anaesthetized (given a drug that causes
sleep).
Psychotherapy is any form of treatment by psychological means. There
are many types of psychotherapy. 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 three or more patients participate in group therapy. By
meeting as a group with the psychiatrist, the patients help each other
understand themselves. The doctor may encourage the patients to act out their
problems in psychodramas.
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 behaviour
therapy. Psychoanalysis focuses on unconscious thoughts and feelings.
According to psychoanalytical theory, the causes of many mental illnesses lie
buried in the unconscious. The patient visits the psychiatrist and talks about
whatever comes to mind. The doctor helps the patient understand his or her
problems by uncovering the causes. The patient may continue psychoanalytical
treatment for a number of years.
Behaviour therapy uses rewards and punishments to encourage patients to act in
a healthier way. The goal of behaviour therapy is to try to help patients
change their behaviour rather than to help them understand why they act the
way they do. The psychiatrist may praise or reward the patient for "good"
behaviour. This technique, called positive reinforcement, is considered to be
more effective than negative reinforcement, such as scolding the patient for
"bad" behaviour.
Additional resources
Asen, Eia. Psychiatry For Beginners. Writers and Readers, London, 1986.
Greenberg, Harvey R. Hanging In: What You Should Know About Psychotherapy.
MacMillan Publishing, New Jersey, U.S.A., 1994.
Maxmen, J.S. The New Psychiatry. New American Library, New York, 1986
McKoy, Kathy. A Teenager's Guide to Friends, Failure, Sexuality, Love,
Rejection, Addiction, Peer Pressure, Families, Loss, Depression, Change and
other Challenges of Living. Berkley Publishing Group, New York, 1996.
Stafford, Clark David. Psychiatry For Students. 7th ed. Unwin Hyman, London,
1990.
Taylor, Michael A. General Hospital Psychiatry. Collier MacMillan, Oxford,
U.K., 1985.
Thompson, Chris. Origins of Modern Psychology. John Wiley, Chichester, West
Sussex, U.K., 1987.
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