What is Psychiatry?

Psychiatry is a medical specialty focused on the improvement of people’s mental well-being.   Practitioners of psychiatry are called Psychiatrists and, in the United States, may be D.O.’s or M.D.’s.

Psychiatrists use therapy and medications to treat specific symptoms of mental illness.  They also work with people on helping them gain insight into themselves and their relationships to improve their mental well-being.
Psychiatric illnesses, like all medical illnesses, vary greatly in their severity and presentation.  Some people experience a short course with relatively minor symptoms, while others have chronic symptoms that require long-term treatment.   The causes of psychiatric illness are broad.  It is now widely accepted among psychiatrists that there is a combination of “nature” (genetic) and “nurture” (environmental factors) that lead to a person’s exhibiting symptoms of psychiatric illness.  Psychiatrists engage in thorough evaluations that explore these areas to diagnose and treat people.

It is a common misconception that most psychiatric illnesses are the result of a person’s behavior or “choice”.  This is not the case for the vast majority of people suffering from mental health problems.  Illnesses from anxiety disorders to schizophrenia are real illnesses that require medical intervention, just like diabetes or heart failure.  The intensity and duration of treatment depends on the severity of the illness.  Psychiatry has come a long way in the last few decades in terms of the discovery of biological processes that are out of balance and medications to help restore balance.  Where some people were previously hospitalized for months at a time, they are now able to be treated as outpatients.
Psychiatrists are trained in several areas and may specialize.  These specialties include:

  • Child and adolescent psychiatry
  • Adult psychiatry
  • Psychiatry of Old Age (Psychogeriatrics)
  • Learning problems
  • Consultation with other medical fields (consultation-liason)
  • Emergency psychiatry
  • Addiction psychiatry
  • Forensic psychiatry
  • Eating disorders

Psychiatrists use the DSM (Diagnostic and Statistical Manual of Mental Disorders) as the standard system to diagnose their patients.  This system is periodically updated and is currently in its fourth edition.   Each edition is reviewed and updated to meet contemporary standards.  The fifth edition is due out by 2011.

The DSM is based on five axes of functioning:

  • Axis I: Psychiatric disorders
  • Axis II: Personality disorders and mental retardation
  • Axis III: General medical conditions
  • Axis IV: Social functioning and impact of symptoms
  • Axis V: Global Assessment of Functioning (described using a scale from 1 to 100)

Common axis I disorders include substance dependence and abuse; mood disorders, mainly depression and bipolar mood disorder; psychotic disorders such as schizophrenia and anxiety disorders.
Axis II disorders involve character problems (usually focused around problems in relationships) including borderline personality disorder and antisocial personality disorder, among others.

Professional requirements

In general, being a qualified medical practitioner is a prerequisite for entering training to become a psychiatrist, though the process and time spent may vary from country to country.
In the United States, psychiatrists can be board certified as specialists in their field. After completing four years of college, then 4 years of medical school, these physicians practice as psychiatry residents. After completing their training, psychiatrists take written and then oral board examinations administered by the American Board of Psychiatry and Neurology (ABPN).