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Psychiatrists are medical doctors (M.D.'s) who treat people suffering from mental and emotional illnesses that make it hard for them to cope with everyday living or to behave in socially acceptable ways. Psychiatrists treat problems ranging from being irritable and feeling frustrated to losing touch with reality. Some people, in addition to having a mental illness, may also engage in destructive behavior such as abusing alcohol or drugs or committing crimes. Others may have physical symptoms that spring from mental or emotional disorders. People with mental illness were once so misunderstood and stigmatized by society that they were kept, chained and shackled, in asylums. Today society recognizes that emotional or mental illnesses need to be diagnosed and treated just like any other medical problem.
Some psychiatrists run general practices, treating patients with a variety of mental disorders. Others may specialize in working with certain types of therapy or kinds of patients, such as the chronically ill. When meeting a client for the first time, psychiatrists conduct an evaluation of the client, which involves talking with the person about his or her current circumstances and getting a medical history. In some cases, the psychiatrist will give the client a physical examination or order laboratory tests if he or she feels the client's problem may have a physical cause. Next, the psychiatrist decides on a treatment plan for the client. This may involve medications, psychotherapy, or a combination of these approaches.
As medical doctors, psychiatrists can prescribe medications that affect a client's mood or behavior, such as tranquilizers or antidepressants. Scientific advancements in both the understanding of how the human brain functions and the creation of more effective drugs with fewer side effects have helped make medications an important element in the treatment of mental illness. Some psychiatrists will only supervise the medication aspect of a client's treatment and refer the client to another health professional, such as a psychologist, for the psychotherapy aspect of treatment. These psychiatrists often work in private practices and focus on the chemical aspects of a person's illness to find medication to help that client. Other psychiatrists, often those working in hospitals or in small cities and towns, may be the providers of both medication management and psychotherapy.
Psychotherapy, sometimes called talk therapy, is perhaps the best-known type of treatment for mental illness. By having the client talk about problems he or she faces, the therapist helps the client uncover and understand the feelings and ideas that form the root of his or her problems and, thus, overcome emotional pain. Talk therapy can be used with individuals, groups, couples, or families.
Another therapeutic method that some psychiatrists use is behavior therapy or behavior modification therapy. This therapy focuses on changing a client's behavior and may involve teaching the client to use meditation and relaxation techniques as well as other treatment methods, such as biofeedback, a process in which electronic monitors are used to measure the effects that thoughts and feelings have on bodily functions like muscle tension, heart rate, or brain waves. This method allows the client to learn how to consciously control his or her body through stress reduction.
Free association is a technique in which the client is encouraged to relax and talk freely. The therapist's aim is to help the client uncover troubling subconscious beliefs or conflicts and their causes. Dreams may also be examined for hints about the subconscious mind. Subconscious conflicts are believed to cause neurosis, an emotional disorder in which the patient commonly exhibits anxious behavior.
In addition to those working in general psychiatry, there are psychiatrists who specialize in working with certain groups or in certain areas. These specialists include the following:
Child psychiatrists work with youth and usually their parents as well.
At the opposite end of the age scale are geriatric psychiatrists, who specialize in working with older individuals.
Industrial psychiatrists are employed by companies to deal with problems that affect employee performance, such as alcoholism or absenteeism.
Forensic psychiatrists work in the field of law. They evaluate defendants and testify on their mental states. They may help determine whether or not defendants understand the charges against them and if they can contribute to their own defense.
Other health professionals who may work with mentally ill people include psychologists, who may see clients but are unable to prescribe medications because they are not physicians, and neurologists, physicians specializing in problems of the nervous system. In some cases, a person's disturbed behavior results from disorders of the nervous system, and neurologists diagnose and treat these conditions.