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Psychiatry: Mental Health Diagnosis, Therapy & Medication

Psychiatry diagnoses and treats mental health conditions, including depression, anxiety, bipolar disorder, and schizophrenia.

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Overview and Definition

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 (M.D. or D.O.) who specializes in mental health, including substance use disorders. As physicians, psychiatrists are uniquely qualified to understand the complex relationship between the body and the mind. They can order medical laboratory tests, prescribe medications, perform interventional procedures, and provide psychotherapy.

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The Biopsychosocial Model

PSYCHIATRY

Modern psychiatry operates on the Biopsychosocial Model, which posits that mental health is influenced by three interconnected factors:

  • Biological: Genetics, brain chemistry (neurotransmitters), brain structure, and physical health conditions (like thyroid problems).
  • Psychological: Personality, coping skills, emotional intelligence, and self-esteem.
  • Social: Environmental factors, upbringing, trauma, relationships, socio-economic status, and culture.

Effective psychiatric care addresses all three pillars. It is not simply about “fixing” a chemical imbalance; it is about treating the whole person within their life context.

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Psychiatry vs. Psychology

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While both professionals treat mental health conditions, there are distinct differences:

  • Psychiatrists are medical doctors. They focus heavily on the biological aspects of mental illness, and the primary treatment modality often involves medication management (psychopharmacology), though they also provide therapy.
  • Psychologists usually hold a doctoral degree (PhD or PsyD) but are not medical doctors. They specialize in psychological testing and psychotherapy (talk therapy) and typically cannot prescribe medication (depending on the jurisdiction).

At Liv Hospital, psychiatrists and psychologists work together in a multidisciplinary team to provide comprehensive care.

The Scope of Psychiatric Disorders

Psychiatry covers a vast spectrum of conditions, categorized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):

  • Mood Disorders: Conditions that primarily affect emotional state, including Major Depressive Disorder and Bipolar Disorder.
  • Anxiety Disorders: Characterized by excessive fear and worry, such as Generalized Anxiety Disorder (GAD), Panic Disorder, and Phobias.
  • Psychotic Disorders: Conditions causing a detachment from reality, such as Schizophrenia (hallucinations and delusions).
  • Neurodevelopmental Disorders: Conditions usually diagnosed in childhood, such as Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD).
  • Obsessive-Compulsive and Related Disorders (OCD): Characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions).
  • Trauma- and Stressor-Related Disorders: Such as Post-Traumatic Stress Disorder (PTSD).
  • Addiction and Substance Use Disorders: Physical and psychological dependence on alcohol, drugs, or behaviors (gambling).
  • Eating Disorders: Anorexia Nervosa, Bulimia Nervosa, and Binge-Eating Disorder.
  • Geriatric Psychiatry: Focusing on mental health in the elderly, including dementia and Alzheimer’s disease.
PSYCHIATRY

Symptoms and Causes

Mental health conditions are not a sign of weakness or a character flaw; they are medical conditions with specific symptoms and underlying biological causes. Symptoms can vary significantly depending on the disorder, age, and cultural background, but they generally involve changes in emotions, thinking, behavior, or physical well-being.

Common Symptoms and Warning Signs

Recognizing the early signs of mental illness is crucial for effective treatment.

  • Emotional Symptoms:
    • Persistent Sadness: Feeling “empty,” hopeless, or tearful for more than two weeks (Depression).
    • Extreme Mood Swings: Alternating between extreme highs (mania) and deep lows (depression) in Bipolar Disorder.
    • Excessive Worry: Anxiety that is disproportionate to the situation and difficult to control.
    • Apathy: Loss of interest or pleasure in activities once enjoyed (Anhedonia).
    • Irritability or Anger: outbursts that are unprovoked or excessive.
  • Cognitive Symptoms (Thinking):
    • Brain Fog: Difficulty concentrating, making decisions, or remembering things.
    • Delusions: Fixed, false beliefs not based in reality (e.g., believing one is being spied on).
    • Hallucinations: Seeing or hearing things that others do not (e.g., hearing voices).
    • Obsessive Thoughts: Intrusive, unwanted thoughts or images that cause distress.
  • Behavioral Symptoms:
    • Social Withdrawal: Isolating oneself from friends and family.
    • Changes in Habits: Significant changes in eating (overeating or loss of appetite) or sleeping (insomnia or sleeping too much).
    • Substance Use: Increased use of alcohol or drugs to cope.
    • Compulsive Actions: Performing rituals (like hand washing or checking locks) to relieve anxiety.
  • Physical (Somatic) Symptoms:
    • Mental distress often manifests physically as unexplained aches, digestive problems, headaches, or a racing heart (palpitations).

The Critical Warning Sign: Suicidality Thoughts of death, self-harm, or suicide are a medical emergency. Statements like “I wish I weren’t here” or giving away possessions require immediate psychiatric evaluation.

Underlying Causes and Risk Factors

The exact cause of most mental disorders is not fully understood, but research points to a combination of biological, genetic, and environmental factors.

  • Neurochemistry (Brain Chemistry): The brain uses chemicals called neurotransmitters to communicate between nerve cells. Imbalances in these chemicals are linked to mental illness:
    • Serotonin: Regulates mood, sleep, and appetite. Low levels are linked to depression and anxiety.
    • Dopamine: Involved in reward, motivation, and pleasure. Imbalances are linked to schizophrenia (excess) and addiction.
    • Norepinephrine: Involved in the “fight or flight” stress response.
    • GABA: An inhibitory neurotransmitter that calms the brain; low levels are linked to anxiety.
  • Genetics (Heredity): Mental illness often runs in families. While there is no single “depression gene,” multiple genes may interact to increase vulnerability.
  • Brain Structure and Function: Brain imaging studies show that the brains of people with mental illness may look or function differently. For example, the hippocampus (memory center) can be smaller in chronic depression.
  • Prenatal and Perinatal Factors: Exposure to viruses, toxins, alcohol, or severe stress while in the womb can affect brain development.
  • Trauma and Stress: Severe psychological trauma (physical/sexual abuse, war, loss of a parent) can change the brain’s structure and trigger disorders like PTSD or Borderline Personality Disorder.
  • Medical Conditions: Chronic pain, cancer, heart disease, or hormonal imbalances (thyroid) can trigger depression and anxiety.

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Diagnosis and Staging

Diagnosing a psychiatric condition is a meticulous process. Unlike diabetes or high blood pressure, there is rarely a single blood test or X-ray that confirms a mental illness. Instead, psychiatrists rely on clinical interviews, behavioral observation, and diagnostic criteria outlined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). At Liv Hospital, the diagnostic process is comprehensive, ensuring that physical causes are ruled out before a psychiatric diagnosis is confirmed.

The Psychiatric Evaluation

The foundation of diagnosis is the clinical interview.

  • History Taking (Anamnesis): The psychiatrist asks detailed questions about symptoms, their duration, impact on daily life, family history of mental illness, and substance use.
  • Mental Status Examination (MSE): A structured assessment of the patient’s current state of mind. The doctor observes appearance, behavior, speech, mood, affect (facial expression), thought process, and insight.

Collateral Information: With patient permission, gathering information from family members or partners can provide a more objective picture of behavioral changes.

Excluding Organic Causes

Before diagnosing a primary psychiatric disorder, medical mimics must be ruled out.

  • Laboratory Testing: Blood tests to check for:
    • Thyroid Dysfunction: Hypothyroidism can mimic depression; hyperthyroidism can mimic anxiety or mania.
    • Vitamin Deficiencies: Low levels of Vitamin B12 or Vitamin D can cause mood changes and fatigue.
    • Infection/Inflammation: Markers that might suggest an autoimmune cause (like Lupus affecting the brain).
    • Toxicology Screen: To rule out drug-induced psychosis or mood changes.
    • Neuroimaging: CT or MRI scans of the brain are used if there is suspicion of a tumor, stroke, or a neurological condition (such as Multiple Sclerosis) causing the symptoms.
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Psychometric Testing

Psychologists or psychiatrists may administer standardized questionnaires and rating scales to quantify symptom severity.

  • Depression Scales: PHQ-9 or Beck Depression Inventory.
  • Anxiety Scales: GAD-7 or Hamilton Anxiety Rating Scale.
  • Cognitive Testing: The MMSE (Mini-Mental State Exam) or MoCA to screen for dementia or cognitive impairment.
  • Personality Testing: Detailed assessments (like the MMPI) to understand personality structure and coping styles.

"Staging" in Psychiatry

While psychiatry does not use the TNM staging system of oncology, conditions are clinically “staged” based on severity and functional impairment.

  • Acute Phase: Symptoms are severe, active, and disruptive. The patient may require hospitalization or intensive outpatient care.
  • Stabilization Phase: Treatment has started, and acute symptoms are subsiding. The goal is to fine-tune medication and therapy.
  • Maintenance Phase (Remission): Symptoms are minimal or absent. The patient has returned to baseline functioning. The goal is to prevent relapse (recurrence).
  • Treatment-Resistant: Used when a condition (like Depression or Schizophrenia) does not respond to at least two different standard treatments. This “stage” requires advanced interventions, such as brain stimulation techniques.
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Treatment Details

PSYCHIATRY

Psychiatric treatment has evolved significantly from the days of institutionalization. Today, care is personalized, outpatient-focused, and scientifically driven. The most effective treatment usually involves a combination of Psychopharmacology (medication) and Psychotherapy (talk therapy), along with lifestyle interventions and advanced brain stimulation technologies.

Psychopharmacology (Medication Management)

Medications do not “change who you are”; they correct neurochemical imbalances to allow the “real you” to function without the burden of illness.

  • Antidepressants: Used for depression, anxiety, and PTSD.
    • SSRIs (Selective Serotonin Reuptake Inhibitors): Increase serotonin levels (e.g., Fluoxetine, Sertraline). They are generally the first line of treatment.
    • SNRIs: Target both serotonin and norepinephrine.
  • Anxiolytics (Anti-Anxiety): Used for acute anxiety or panic. Benzodiazepines are used for short-term relief, while other options are used for long-term management.
  • Mood Stabilizers: Essential for Bipolar Disorder to prevent the highs (mania) and lows (depression). Lithium and certain anticonvulsants are standard.
  • Antipsychotics: Used for Schizophrenia, psychotic episodes, and sometimes as an add-on for severe depression. They block dopamine receptors to stop hallucinations and delusions.
  • Stimulants: Used primarily for ADHD to improve focus and impulse control by increasing dopamine availability in the prefrontal cortex.

Psychotherapy (Talk Therapy)

Therapy helps patients understand their illness, develop coping mechanisms, and change negative thought patterns.

  • Cognitive Behavioral Therapy (CBT): The gold standard for depression and anxiety. It focuses on identifying and challenging negative, irrational thoughts (“cognitive distortions”) to change behavior.
  • Psychodynamic Therapy: Explores how past experiences and unconscious conflicts influence current behavior.
  • EMDR (Eye Movement Desensitization and Reprocessing): A specialized therapy for PTSD that helps the brain process traumatic memories.
  • Family and Couples Therapy: Addressing the impact of mental illness on relationships and improving communication dynamics.

Interventional Psychiatry (Brain Stimulation)

For patients with treatment-resistant conditions, advanced technology offers new hope.

  • rTMS (Repetitive Transcranial Magnetic Stimulation): A non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain. It is FDA-approved for treatment-resistant depression and OCD. It is painless and does not require anesthesia.
  • ECT (Electroconvulsive Therapy): A highly effective medical treatment for severe, life-threatening depression or catatonia. It involves a brief electrical stimulation of the brain while the patient is under anesthesia. Modern ECT is safe and very different from early depictions in the media.
  • Ketamine Therapy: emerging as a rapid-acting treatment for severe depression and suicidality, administered under strict medical supervision.

Lifestyle and Holistic Management

  • Sleep Hygiene: Restoring a regular sleep-wake cycle is essential for mood regulation.
  • Exercise: Physical activity releases endorphins and acts as a natural antidepressant.
  • Nutritional Psychiatry: Addressing diet and gut health, which influences brain chemistry (the “gut-brain axis”).

The Medical Center

Psychiatry

Mental health care requires trust, privacy, and a stigma-free environment. At Liv Hospital, our Psychiatry Department is designed to provide a sanctuary for healing. We integrate mental health into the general hospital setting, normalizing psychiatric care as a standard part of medical wellness. Our approach is holistic, compassionate, and scientifically rigorous.

Why Choose Liv Hospital for Mental Health?

  • Multidisciplinary Harmony: We do not treat the mind in isolation. Our psychiatrists work alongside neurologists, endocrinologists, and internists. If your depression is caused by a thyroid issue, we find it. If your anxiety is related to a heart condition, we manage it together.
  • Privacy and Confidentiality: We adhere to the strictest standards of patient confidentiality. Our consultation suites are designed for discretion and comfort, ensuring a safe space for open dialogue.
  • Comprehensive Team: Our staff includes board-certified psychiatrists, clinical psychologists, and specialized nurses. This allows us to offer medication management, individual therapy, and psychological testing under one roof.

Specialized Programs and Expertise

  • Treatment-Resistant Depression Unit: We specialize in helping patients who have tried multiple medications without success. Our unit offers advanced evaluations and access to rTMS (Transcranial Magnetic Stimulation) therapy.
  • Psycho-Oncology: A specialized service for cancer patients. We support patients and families navigating the emotional challenges of a cancer diagnosis, treatment, and survivorship.
  • Addiction Medicine: We offer medical management for detoxification and long-term support for substance use disorders, focusing on harm reduction and relapse prevention.
  • Child and Adolescent Psychiatry: We have specialized experts dedicated to the unique developmental needs of younger patients, managing conditions like ADHD, autism, and exam anxiety.

A Patient-Centered Philosophy

At Liv Hospital, we believe that mental health is health.

  • Evidence-Based Care: We follow the latest international guidelines (APA, NICE) for prescribing and therapy.
  • Empowerment: We educate our patients about their diagnosis. We believe that understanding the “why” behind the symptoms is the first step in taking control of recovery.

Whether you are dealing with the stress of modern life, a specific phobia, or a complex mood disorder, Liv Hospital offers the expertise to help you navigate the journey toward mental wellness and resilience.

30
Years of
Excellence

Trusted Worldwide

With patients from across the globe, we bring over three decades of medical expertise and hospitality to every individual who walks through our doors.  

Book a Free Certified Online Doctor Consultation

Doctors

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