Psychiatrist

Medical professionals who treat mental illness using a biomedical technique towards mental disorders and also make use of medications are called psychiatrists. A psychiatrist is a physician who deals in diagnosis, prevention and treatment of mental illness, emotional disorders and addictions. The condition includes anxiety, neurosis, developmental disabilities, depression and substance abuse. Psychiatry has various subspecialties like child psychiatry, adult psychiatry; behavioral medicine etc and psychiatrists have to undergo special training to undertake this task.

Psychiatrists are specialists in mental health and thus

• Study, prevent, make a diagnosis and treat psychological, emotional and behavioral disorders.
  
• They study the physical condition of the patient and adapt the necessary medical actions.
  
• They recommend diagnostic and laboratory tests for the patient depending on the severity of the case.
  
• Psychiatrists give treatments such as psychotherapy, psychoanalysis, cognitive behavior therapy depending on the patient requirement.
  
• Psychiatrists can also prescribe medicines for the patients.

Qualification to be a psychiatrist

• The person has to be a graduate from college and from a medical school.
  
• Should complete four years of residency in the field of psychiatry.
  
• To further specialize in fields such as child psychiatrist, there is additional training.
  
• After completion of this entire course, a psychiatrist will be addressed to as a mental health professional and physician. He/she will clearly differentiate between physical and psychological causes and relate both physical and mental distress.
  
• A board certification is a must to practice psychiatry.

Choosing the right psychiatrist speaks a lot in getting your treatment right. Given below is the guide to choose the right psychiatrist:

• Speak about your prevailing condition to your family physician and if he/she feels you need the help of a psychiatrist then ask for recommendation. Take a copy of your latest medical records if you have one, this will help your psychiatrist on deciding on the drugs for you.
  
• To cross check on any psychiatrist you can get in touch with the nearest psychiatric society or community medical health center. They can help you with information on the qualification of the psychiatrist you have chosen.
  
• A good psychiatrist should always discuss your problem in detail and discuss on why he has chosen any particular treatment for you. There are various therapies available for curing psychiatric problems and so the doctor should educate the patient on them and explain why he has chosen any particular treatment.
  
• Ensure that you provide complete true information about yourself and your condition to the psychiatrist as he/she is also a physician and can choose the right treatment for you depending on your medical background.
  
• Finally check if your insurance covers the entire cost of the treatment or make the necessary arrangements for your course of treatment.
  

Melancholic depression

Melancholic depression is a severe form of depressive disorder or mental illness and is psychotic in nature. It is primarily caused by biological and genetic factors rather than psychological factors. It is a mental state that is characterized by feelings of extreme sadness, hopelessness and loss of interest and pleasure in almost everything. Person with Melancholic depression becomes non-responsive to happy incidents or surroundings even for the short period. Melancholic depression also leads to psychomotor disturbances such as low energy, poor concentration, slowed or agitated movements.

Causes of melancholia

It is believed that certain biological factors and genetic factors play an important role in development of this clinical depression. Studies also show that those who suffer from melancholia generally have a family history of depression disorders. Melancholia may not be an outcome of few negative incidents in life, but surely such events act as a trigger and initiate the problem. Biologically, melancholic depression is believed to be caused by a chemical imbalance or malfunctioning of the neurotransmitters in the brain.

Symptoms of Melancholia

• Little or no response to positive and pleasant events.
  
• Total loss of interest in things.
  
• Low moods in the morning hours associated with low energy levels.
  
• Strong feeling of guilt without any apparent reason.
  
• Psychomotor Retardation with lack of facial expressions, slowing down of speech and body movements. They may also exhibit Psychomotor agitation such as pacing, twirling the hair, gesturing extensively, speaking incoherently, or aggression.
  
• Cognitive impairment such as poor concentration and inattention.
  
• Significant weight loss due to lack of interest in food.
  
• Sleep problems, either insomnia or excessive sleep.
  

A person is diagnosed as suffering from melancholia when constantly experiencing extreme sadness accompanied by any 3 or 4 features mentioned above.

Treatment options

Unlike situational depression which is caused by sad events in life, melancholia is caused by biological disorder. Hence counseling and psychotherapy is probably not the solution. Treatment requires physical intervention via antidepressant drugs and also Electroconvulsive therapy (ECT) or shock treatment in case of extreme severity. Electroconvulsive therapy is recommended only for the severest forms of depressions, when a patient is not responding to antidepressant treatment or is posing a threat to self or others. Electroconvulsive therapy has certain side effects like short and long-term memory loss, hence it is advised only when the situation demands.

Borderline Personality Disorder

Borderline personality disorder (BPD), is a serious mental illness, though less commonly known than schizophrenia or bipolar disorders. It is a form of pathology lying on the border between psychosis and neurosis. Persons with borderline personality disorder often exhibit intense bouts of anger, depression and anxiety. This may last for hours or sometimes a day. Impulsive aggression, self injury, abuse of drug and alcohol are some other symptoms.

BPD sufferers primarily see the world as extremes, either black or white. They either idealize or vilify everyone they meet. They veer between idealized love and distressing hatred and misery. They are known to develop sudden and stormy attachments toward family, friends and loved ones. Their emotions range from great love to intense hatred.

Usually, the diagnosis of BPD on these parameters is done on adults and not on children as signs and symptoms of BPD may go away with maturity. For diagnosis of BPD, five signs should be significantly present:

• Sense of intense fear and abandonment.
  
• Pattern of unstable relationships
  
• Unstable self image
  
• Impulsive and often self destructive behavior
  
• Erratic mood swings
  
• Chronic feelings of emptiness
  
• Inappropriate and undue anger
  
• Periods of paranoia and loss of contact with reality.