Five Things You Don’t know About Psychiatry

by Stephen B. Seager, MD

Few things are more misunderstood than mental illness.  People once thought mental illness was caused by demon possession, sin or witchcraft. Often the mentally ill were cruelly mistreated or killed.  You might think those days are long over, but superstition and ignorance are hard to overcome. It wasn’t so long ago that we were taught that our secret thoughts and fears caused mental disorders. Until recently, treatment for mental illness happened in distant and dismal state run asylums (think about “One Flew Over the Cuckoo’s Nest” – that isn’t far off the mark). The mentally ill were feared and shunned. But in the last 20 years, things have changed dramatically.

Generally speaking, we know more than we did about psychiatry. Despite this, however, many people remain unclear about the actual cause of mental illness and its treatment. The good news is there’s so much more room for optimism and hope than there ever was before. Here are five things about mental illness and psychiatry you probably don’t know and that will probably make you feel a whole lot better about the subject:

1) Psychiatric illness is real.

Mental illness or “brain disease” is a disease of the brain just as heart disease is disease of the heart. Like almost every other illness, including diabetes, high blood pressure, arthritis, etc., psychiatric disorders start in your genes. Freud was wrong. Mental illness does not come from a person’s thoughts or dreams, nor is it caused by a difficult childhood, bad parenting, or stress. “Being strong” or having willpower won’t make it go away. People with a mental illness usually need to visit their doctors for a diagnosis and to get  treatment.

2) Psychiatric illness is very common.

Twenty per cent of all Americans will suffer from a mental disorder serious enough to require treatment. And no one is immune. Rich and poor, men and women, old people and children of all ethnicities can suffer from mental illness. It’s nothing to be ashamed of. It’s a part of life for many people.  Those of us who do not suffer from a mental disorder most likely work with someone who does, or have a family member or a friend with a psychiatric illness. In short, psychiatric illness will affect nearly all of us at one time or another.

3) Psychiatrists give medicines for mental illness.

That’s what doctors do. They give medicine. Psychiatric illness is no different from other type of illness. Since it was discovered that brain cells talk to each another using chemical signals, that’s where the aim of brain disease treatment has been focused. Brain disease results when brain chemicals get out of whack. Psychiatric medicines attempt to return these chemicals to normal. Psychiatrists give medications for the same reasons that all physicians do: they work.  They make people’s lives better.

Psychiatric medications are serious business. Like all medications, they can have side effects. Some may be habit forming, and others require monitoring of blood levels. Some may conflict with other medications you are taking. It may take some time to find the medication or the right combination of medications, so don’t give up. Many newer psychiatric medications are much safer and less prone to side effects than those used in previous generations.  Psychiatric medications, these days, don’t make people turn into “zombies.” They don’t change your personality or control your thoughts. They are specific medications given for specific reasons. They make sick people well.

4) Therapy helps nearly everything.

Therapy’s benefits aren’t limited to helping brain disorders. It turns out almost every disease improves with therapy. Diabetics’ blood sugar is more easily controlled. Your high blood pressure can be lowered. Arthritis hurts less. As psychiatry has become part of general medicine, therapy should become part of general medicine as well. Most psychiatrists no longer do therapy, which is actually a good thing, since now it’s the job of specially trained therapists. Therapy is extremely helpful for most people who choose to use it.  Don’t be turned off because of the stereotype of a neurotic comedian lying down on a “shrink’s” couch a few times a week for recreation and whining endlessly. The truth is that therapy has a beginning, a middle, and an end … and it’s anything but a joke.

Most therapists no longer look for the “root” of problems and muck around endlessly in childhood memories. This simply proved to be of limited value. What does work is called Cognitive Behavioural Therapy (CBT) the short version of which is: it doesn’t matter why you are doing that or thinking that. We’ll teach you a new way to think and behave. It’s a much faster and longer lasting than anything you’ll see in films or read about in novels.

5) Hospital stays for mental disorders are short.

Nearly all brain diseases are treated in the doctor’s office, although sometimes people are sick enough to need hospitalization. With the discovery of many new helpful medications, the average hospital stay for a mental illness is often less than for other problems. It’s frequently no more than a week. Then most people return home and resume their normal lives. And, yes, most medical insurance covers the cost of hospital stays for mental disorders.

Modern psychiatry is a full-fledged branch of medical science. Both accurate diagnosis and effective treatment is available for mental disorders. Psychiatrists can now lift the depressed from the depths of despair. They can quiet tormenting voices, bring relief to the anxious and obsessed, and safely help patients navigate across the chasm of suicidal thoughts without tumbling in. The modern psychiatrist has an arsenal of tests and medicines that bring relief from human suffering that could only be dreamed about in past generations.

Stephen B. Seager, MD is a practicing psychiatrist. He is author of “The God Gene.”

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