Psychiatry is the branch of medicine focused on the diagnosis, treatment and prevention of mental, emotional and behavioral disorders.
A psychiatrist is a medical doctor (an M.D. or D.O.) who specializes in mental health, including substance use disorders. Psychiatrists are qualified to assess both the mental and physical aspects of psychological problems.
People seek psychiatric help for many reasons. The problems can be sudden, such as a panic attack, frightening hallucinations, thoughts of suicide, or hearing "voices." Or they may be more long-term, such as feelings of sadness, hopelessness, or anxiousness that never seem to lift or problems functioning, causing everyday life to feel distorted or out of control.
A Board Certified Psychiatrist has completed required training, is in possession of an unrestricted medical license, fulfills all ABPN-required maintenance of certification activities and has passed an ABPN exam every 10 years.
Patients can be assured that an ABPN board-certified psychiatrist has specialized skills and knowledge to diagnose and treat problems ranging from emergencies to the long-term medical management of psychiatric disorders.
Mental illnesses are health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work or family activities.Mental illness is common. In a given year:
Mental illness is treatable. The vast majority of individuals with mental illness continue to function in their daily lives.
Major mental illnesses such as schizophrenia or bipolar disorder rarely appear “out of the blue.” Most often family, friends, teachers or individuals themselves begin to recognize small changes or a feeling that “something is not quite right” about their thinking, feelings or behavior before a illness appears in its full-blown form.
Learning about developing symptoms, or early warning signs, and taking action can help. Early intervention can help reduce the severity of an illness. It may even be possible to delay or prevent a major mental illness altogether.
Bipolar disorders are brain disorders that cause changes in a person’s mood, energy and ability to function. Bipolar disorder is a category that includes three different conditions — bipolar I, bipolar II and cyclothymic disorder.
People with bipolar disorders have extreme and intense emotional states that occur at distinct times, called mood episodes. These mood episodes are categorized as manic, hypomanic or depressive. People with bipolar disorders generally have periods of normal mood as well. Bipolar disorders can be treated, and people with these illnesses can lead full and productive lives.
Obsessive-compulsive disorder (OCD) is an anxiety disorder in which time people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). The repetitive behaviors, such as hand washing, checking on things or cleaning, can significantly interfere with a person’s daily activities and social interactions.
Many people have focused thoughts or repeated behaviors. But these do not disrupt daily life and may add structure or make tasks easier. For people with OCD, thoughts are persistent and unwanted routines and behaviors are rigid and not doing them causes great distress. Many people with OCD know or suspect their obsessions are not true; others may think they could be true (known as poor insight). Even if they know their obsessions are not true, people with OCD have a hard time keeping their focus off the obsessions or stopping the compulsive actions.
A diagnosis of OCD requires the presence of obsession and/or compulsions that are time-consuming (more than one hour a day), cause major distress, and impair work, social or other important function. About 1.2 percent of Americans have OCD and among adults slightly more women than man are affected. OCD often begins in childhood, adolescence or early adulthood; the average age symptoms appear is 19 years old.
Cognitive Behavioral Therapy (CBT) is a form of psychotherapy that treats problems and boosts happiness by modifying dysfunctional emotions, behaviors, and thoughts. Unlike traditional Freudianpsychoanalysis, which probes childhood wounds to get at the root causes of conflict, CBT focuses on solutions, encouraging patients to challenge distorted cognitions and change destructive patterns of behavior.
CBT rests on the idea that thoughts and perceptions influence behavior. Feeling distressed, in some cases, may distort one’s perception of reality. CBT aims to identify harmful thoughts, assess whether they are an accurate depiction of reality, and if they are not, employ strategies to challenge and overcome them.
CBT is appropriate for people of all ages, including children, adolescents, and adults. Evidence has mounted that CBT can benefit numerous conditions, such as major depressive disorder, anxiety disorders, post-traumatic stress disorder, eating disorders, obsessive-compulsive disorders, and many others. Research also indicates that CBT can be delivered effectively online, in addition to face-to-face therapy sessions.
Acceptance and Commitment Therapy (ATC) invites people to open up to unpleasant feelings, and learn not to overreact to them, and not avoid situations where they are invoked. Its therapeutic effect is a positive spiral where feeling better leads to a better understanding of the truth.
Learn more about Acceptance and Commitment Therapy (ATC)
Bipolar disorders are brain disorders that cause changes in a person’s mood, energy and ability to function. Bipolar disorder is a category that includes three different conditions — bipolar I, bipolar II and cyclothymic disorder.
People with bipolar disorders have extreme and intense emotional states that occur at distinct times, called mood episodes. These mood episodes are categorized as manic, hypomanic or depressive. People with bipolar disorders generally have periods of normal mood as well. Bipolar disorders can be treated, and people with these illnesses can lead full and productive lives.
Evidence-based medicine (EBM) is rapidly becoming the norm. It is taught in medical schools and is encouraged by both government agencies and insurance plan providers. Yet, there is little proof that this model can be adapted to fit psychiatry.
EBM supposedly allows the clinician to offer the most effective treatment for each patient.1,2 This goal is laudable, but the model is not appropriate for psychiatry because precise and stable diagnostic criteria are lacking in our specialty. Treatment outcomes in psychiatry are not defined by remission or cure. Instead, fractional reductions in the number and severity of symptoms are accepted, as measured by rating scale scores. Evidence-based psychiatry (EBP) is an untested hypothesis; for this theory to be either useful or valid, 3 basic assumptions must be examined.
• Is the diagnostic system valid?
• Are the data from clinical trials assessing efficacy and safety sound?
• Are the conclusions in a form that can be applied in clinical practice?
Definitions
The paradigms that define EBM (and EBP) are based on data in published clinical studies. Each study is assessed according to the methods used to collect the data and a value placed (by the reviewer) on its quality. EBM uses 3 types of evidence3:
• Grade A: Randomized clinical trials, homogeneous populations, placebo-controlled.
• Grade B: Randomized clinical trials, heterogeneous populations, not placebo-controlled.
• Grade C: Observational studies, case collections, open clinical trials.
The strength of the evidence decreases from Grade A to Grade C, with more weight given to Grade A than to Grade C studies.
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