Psychiatrists are medical doctors specializing in psychiatry, the branch of medicine dealing with illnesses of the psyche (mind). Psychiatrists diagnose and treat mental, addiction, emotional and psychotic disorders. Although in past decades it was not uncommon for psychiatrists to specialize in psychotherapy or psychoanalysis, and treat patients without the use of medication, in recent years psychiatrists have become more likely to concentrate only on prescribing psychotropic medication, and then sending their patients to other practitioners for ongoing psychotherapy.
Psychiatrists work in a variety of settings, including hospitals, clinics, rehabilitation facilities, educational institutions and private practices. They often act as consultants to other professionals, including lawyers and law enforcement personnel. Unlike other mental health care professionals, psychiatrists are medical doctors, licensed to prescribe medication.
After receiving an undergraduate degree, psychiatrists begin their professional careers by completing medical school and earning their MDs. They go on to four years of residency, usually working in a hospital's psychiatric department or at a psychiatric hospital. Psychiatrists often pursue a subspecialty, deciding to work, for example, only or primarily with children and adolescents.
Psychiatrists may specialize in various psychiatric subcategories. Sometimes they focus on a treating a single condition, such as eating disorders, or sometimes in treating patients in a certain age group, such as the elderly. Psychiatric specialties include those listed below.
Addiction psychiatry treats impulse-control disorders. Addictions to alcohol and drugs, gambling, food and sex, among others, are treated in this specialty.
Child and Adolescent Psychiatry
Psychiatrists who work in child and adolescent psychiatry focus on the needs, behavior patterns and mind sets of, and influences on, those 18 years old and younger.
Community psychiatry takes a public health perspective, focusing on detecting, preventing and treating emotional and behavioral disorders specific to a community. Outreach programs are often used in this specialty.
This field deals with cross-cultural boundaries. Psychiatrists who work in this field pay close attention to the habits, perspectives and problems of various ethnic groups. In diagnosing and treating patients, they carefully tailor their methods to meet patients' cultural, as well as medical, needs.
Developmental psychiatry focuses on the origins and evolution of psychiatric disorders, focusing on changes to the brain that happen during fetal development and early childhood.
Psychiatrists who specialize in treating eating disorders help patients to alter their perceptions of their bodies and behaviors relative to eating, nutrition and exercise. Conditions treated include anorexia nervosa and bulimia.
Emergency psychiatry deals with urgent situations in which the health, well-being or life of a patient is at stake. It encompasses a patient's violence toward others, and tendency to self-injure.
Forensic psychiatrists work as consultants to law enforcement agencies and attorneys, and often offer impartial expert testimony in legal cases.
Geriatric psychiatrists focus on elderly patients. Because older patients tend to have more medical issues than younger ones, geriatric psychiatrists often assist in chronic-pain management, and hospice and palliative care. They also treat patients with memory disorders, such as Alzheimer's disease.
Neuropsychiatry deals with the interaction between emotional or psychiatric issues and those involving the central nervous system. Neuropsychiatrists may employ electroconvulsive therapy (ECT) as part of treatment.
Psychosomatic medicine focuses on the relationship between the body (soma) and mind. Psychiatrists in this field investigate and treat the underlying psychiatric disturbances that are causing or exacerbating physical symptoms. Although almost all physical illness can affect the mind and vice versa, psychosomatic medicine treats patients whose physical symptoms are believed to have a primarily psychiatric cause.
Sexual and Gender Psychiatry
Sexual and gender psychiatry is a relatively new specialty. It treats psychiatric issues that arise from sexual orientation, sexual dysfunction and gender identity disorder.
Psychiatrists practicing this specialty are concerned with disorders that affect sleep patterns and behavior. Depression, anxiety and substance abuse are often associated with sleep disorders.
Types of Psychiatric Treatment
There are various types of treatments a psychiatrist can use. Which one is chosen depends on a patient's symptoms and overall emotional condition. Very often, more than one type is used. Types of psychiatric treatments, which can be used alone, sequentially or in combination, include:
- Behavioral therapy
- Cognitive therapy
- Dialectical therapy
- Family-focused therapy
- Interpersonal therapy
- Psychotherapy (talk therapy)