Psychiatry is a medical specialty that deals with mental illness. The name is derived from Greek roots that mean doctor or healer of the soul or mind. A psychiatrist is a medical doctor (physician) whose training includes 4 years of medical school and 4 years of residency training. Additional training is needed to sub specialize in fields such as Child & Adolescent Psychiatry or Forensic Psychiatry.
The residency training includes rotations in internal medicine, neurology, and rotations in the different elements of the discipline such as medication management, inpatient treatment, college mental health, forensic psychiatry, and so on.
A related field is psychology (knowledge of the mind) which is often confused with psychiatry. Psychologists do not go to medical school but attend graduate school. There are many different areas of focus in psychology such as experimental psychology, clinical psychology, social psychology, neuropsychology, and many others. Clinical psychologists provide diagnosis and treatment for mental illness but also help people deal with stress, grief, and the like. Psychologists can perform testing, which can aid with diagnosis and help evaluate the success of treatment. In most states psychologists cannot prescribe medications nor other "medical" treatments such as ECT or transcranial magnetic stimulation.
Psychiatrists must learn about medical illnesses that can cause mental illnesses. Examples include dementia from Parkinson's Disease, anxiety-like symptoms from hyperthyroidism (over active thyroid gland), hyper sexuality from traumatic brain injury, depression as a side effect of Interferon treatment of Hepatitis C Disease, and many others. They must also learn to diagnose and treat a wide range of mental illnesses such as major depressive disorder, panic disorder, ADHD, schizophrenia, bipolar disorder, borderline personality disorder, and the large number of other illnesses found in the Diagnostic and Statistical Manual of Mental Disorders.
Unlike most specialties in medicine, psychiatry has received a lot of criticism over the years from people or organizations who have challenged the scientific basis of psychiatry and the efficacy of its treatments. In reality, modern psychiatry uses the same research methodology as the rest of medicine with an emphasis on double-blind controlled studies. However, the brain is the most complex organ in the body and there are few clinically available tests such as imaging studies that can help with diagnosis. However, that is rapidly changing, and functional brain imaging studies are teaching us a lot about how the brain works.
Thanks to extensive research, we now have at our disposal a large number of medications that can be used to treat many mental disorders. Likewise, there are a number of forms of psychotherapy (talking therapies) that have been shown to benefit illnesses such as depression, anxiety, insomnia, and others. Finally, thanks to modern anesthesia, ECT has become a safe and effective treatment for depression, mania, and others There are also other physical modalities that can be successfully used.
The future of psychiatry and the care of people with a mental illness looks bright.
Peter M. Hartmann, MD
Family Medicine & Psychiatry
