What is Psychiatry?

Psychiatry is a medical specialty that deals with the diagnosis, treatment, and prevention of mental, emotional, and behavioral disorders. Psychiatrists are medical doctors who specialize in mental health, including substance abuse disorders. They are qualified to assess both the physical and mental aspects of psychological problems.

People seek psychiatric help for various reasons, such as sudden problems like panic attacks, frightening hallucinations, suicidal thoughts, or hearing "voices." Others may have more long-term issues like persistent feelings of sadness, hopelessness, or anxiety that make everyday life feel distorted or unmanageable. (1)

Overview and Definition 

Psychiatry is a branch of medicine that focuses on the identification, prevention, and treatment of mental health disorders, encompassing problems related to mood, behavior, cognition, and perception.

When assessing patients, psychiatrists generally begin with a case history and mental status evaluation, which may be supplemented with physical exams and psychological tests. In some cases, neuroimaging and other neurophysiological methods may be employed. Mental disorders are typically diagnosed using the clinical criteria outlined in diagnostic manuals.

A combination of psychiatric medication and psychotherapy is now the most commonly used form of treatment for psychiatric conditions, but contemporary practice involves many other methods, such as assertive community treatment, community reinforcement, and supported employment.

Treatment can be administered on either an inpatient or outpatient basis depending on the severity of the disorder and its impact on daily functioning. Those who require inpatient treatment may be admitted to a psychiatric hospital. Research within the field of psychiatry is conducted in collaboration with other professionals, such as epidemiologists, nurses, social workers, occupational therapists, and clinical psychologists. (2)

Education and Training

To become a psychiatrist, an individual must complete medical school and obtain a state license to practice medicine by passing a written examination. This is followed by four years of residency training in psychiatry, which can take up to 14 years to complete for child and adolescent psychiatrists. The first year of residency involves working in a hospital with patients suffering from various medical conditions. 

The following three years are dedicated to learning the diagnosis and treatment of mental health, including psychotherapy and the use of psychiatric medications and other treatments. This training takes place in various settings, such as offices, hospitals, emergency rooms, and community sites like primary care facilities.

Upon completion of their residency, many psychiatrists voluntarily take a written and oral examination by the American Board of Psychiatry and Neurology to become board-certified. They must renew their certification every 10 years. Additionally, some psychiatrists undergo specialized training beyond their four years of general psychiatry residency.

Psychiatrists have the option of pursuing further training in various areas through unaccredited fellowships. For instance, they may receive training in emergency psychiatry, which involves working with patients experiencing a crisis in emergency room settings. Public and community psychiatry involves addressing social determinants of health, while reproductive psychiatry focuses on meeting the mental health needs of pregnant and postpartum women.(3)

Practicing as a Psychiatrist

Psychiatrists undergo extensive training in both medicine and mental health, which enables them to understand the physical and mental aspects of mental health conditions and how they can affect a person's overall well-being.

As part of their work, psychiatrists assess their patients' symptoms, diagnose their mental health conditions, and develop individualized treatment plans that may include medication, psychotherapy, and other types of treatments such as rTMS or electroconvulsive therapy, depending on the patient's needs. They also work with other healthcare professionals, such as psychologists, social workers, and primary care physicians, to provide comprehensive care to their patients.

A psychiatrist's work involves various aspects, including providing immediate care for sudden mental illnesses, assisting patients in managing long-term mental health conditions, offering guidance on lifestyle changes, working with individuals or groups that include their partners, families, or caregivers, providing expert opinions and advice to other healthcare professionals, referring patients to other specialists as necessary, and admitting patients to hospitals if deemed necessary.

Overall, psychiatrists play an important role in helping people with mental health conditions to improve their quality of life, manage their symptoms, and achieve better mental health outcomes.(4)

Procedures Performed

As psychiatrists are licensed medical professionals, they have the authority to request and conduct a complete range of medical and psychological tests, which, when coupled with patient discussions, enable them to gain a comprehensive understanding of the patient's mental and physical condition. Their educational background and practical training prepare them to analyze medical and psychological data, interpret the complex connection between emotional and other medical ailments, consider the impact of genetics and family history, diagnose illnesses, and collaborate with patients to create treatment plans. (5)

In psychiatry, there are several procedures that psychiatrists may perform depending on the patient's condition and needs. Some of the common procedures performed in psychiatry include:

• Medication management: Psychiatrists may prescribe medications to treat mental health conditions such as depression, anxiety, bipolar disorder, and schizophrenia. They monitor the patient's response to the medication and make adjustments to the dosage or medication as necessary.
• Psychotherapy: Also known as talk therapy, psychotherapy involves working with a trained mental health professional to identify and address mental health issues. There are various types of psychotherapy, including cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and psychodynamic therapy.
• Electroconvulsive therapy (ECT): ECT is a procedure used to treat severe depression and other mental health conditions. It involves passing electrical currents through the brain to induce a seizure.
• Repetitive transcranial magnetic stimulation (rTMS): rTMS is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain. It is used to treat depression and other mental health conditions.
• Psychiatric evaluations: Psychiatrists conduct comprehensive evaluations to assess a patient's mental and physical health, including their symptoms, medical history, and family history. This evaluation helps them to make a diagnosis and develop a treatment plan.
• Crisis intervention: In emergencies, psychiatrists may provide crisis intervention to help patients manage acute mental health symptoms and prevent harm to themselves or others.

It is important to note that not all psychiatrists perform all of these procedures, and the type of treatment a patient receives depends on their individual needs and condition. (6)