The lack of objective medical tests in psychiatry is a common criticism of the field. According to some, being a doctor means using physical exams, lab work or imaging to evaluate patients. Indeed, oncologists can find a tumor on a CT scan. Cardiologists can diagnose a heart attack with blood tests or an electrocardiogram.
Despite public misconceptions, psychiatrists do much of the same. We use objective tests all the time to evaluate patients with mental illness. (And I don't mean inkblots.)
Say a middle-aged man visits a doctor's office because he's been experiencing confusion and memory problems. His family says his speech sounds different. The man has become delusional about his neighbors, convinced they are poisoning his food. He has no other medical history, other than a rash on his genitals years before.
A century ago, doctors might have diagnosed him with "general paresis of the insane." He might have been confined to an asylum and left in squalid conditions. Yet today, we know this disorder by another name—neurosyphilis. It's a neuropsychiatric disorder caused by the presence of bacteria that cause syphilis in the brain. We can send off a lab test to identify this disease, and penicillin often cures patients.
This is far from the only example. In the 19th century, a German neurologist named Carl Wernicke found a series of three patients—two of whom were alcoholics—who suffered from strange symptoms including impaired eye movements, confusion, and poor balance. Around the same time, a Russian psychiatrist named Sergei Korsakoff discovered that patients with chronic alcoholism sometimes developed peripheral neuropathy, memory impairment, and psychiatric disturbances. Both physicians published papers describing these disorders, and the overlapping conditions later came to be known as Wernicke-Korsakoff syndrome.
In the years following, medical professionals identified more and more patients with these findings. But no one knew what caused the symptoms. The syndrome was often referred to as "alcoholic insanity." Decades of research and the Nobel Prize-winning work of Dr. Christiaan Eijkman helped identify a vitamin called thiamine,, the deficiency of which was eventually found to be the cause of these conditions. We now routinely treat alcoholic patients with thiamine to prevent Wernicke-Korsakoff syndrome, and scans like brain MRI help confirm the diagnosis.
In psychiatry, we use blood work and imaging every day to evaluate patients with symptoms of mental illness. A vegan suffering from crippling depression might have B12 deficiency, while a patient who abuses IV drugs with progressive delusions and aggression could have HIV encephalopathy. A college student with anxiety, palpitations, and sensitivity to heat would raise alarms for hyperthyroidism.
This is a common theme in the history of psychiatry. Disorders treated under the domain of mental illness cross over into the realm of other medical specialties once an underlying cause is discovered. A patient might seek treatment for mental health issues, but once a medical reason for these symptoms is found, other doctors often then assume their care. "We'll take it from here," our colleagues say.
So the purview of psychiatry has largely remained limited to diseases that defy explanation. Our specialty has been relegated to the medicine of the unknown. We can't yet test your blood for schizophrenia. We're unable to diagnose bipolar disorder on imaging. We're left with the Diagnostic and Statistical Manual of Mental Disorders and its inherently subjective criteria for defining illness.
Over the coming decades, research into the brain will drive mental health diagnoses and treatment in new directions. Yet what happens to the field of psychiatry as we continue to discover the underlying causes of mental illness? Does its scope of practice shrink ever further? Does the specialty fade further into irrelevance?
For example, recent studies have found associations between mania and elevated uric acid levels in the blood. Giving medications (e.g., allopurinol) that lower serum uric acid for bipolar patients with mania has been found to improve treatment responses in randomized placebo-controlled trials. If this relationship were to be true, could bipolar disorder become another everyday medical condition, just like gout?
Scientists have taken similarly unique approaches towards tackling depression. Some have proposed that depression might be caused by autoimmune responses to infection, as depressed patients are often fatigued with low appetite and other symptoms commonly seen among infected patients. What's more, depressed patients commonly have elevated inflammatory markers in their blood. Might depression one day be treated by autoimmune specialists? Could immunotherapies eventually cure the blues?
One day, we'll find out and, depending on the answers, you may be visiting a different kind of doctor for your mental health. If you happen to see a psychiatrist though, don't be surprised if we ask you to stop by the lab on your way out.
Source: Nathaniel P Morris, Mental Illness in a Test Tube, Scientific American, November 17, 2016.
Most people know how to help someone with a cut or a scrape. But what about a panic attack?
The need for holistic treatment focusing on the person is increasingly becoming of paramount significance, especially when there is a growing body of evidence that suggests that physical and mental health are intrinsically interlinked and that one cannot treat each separately.
New apps promise to diagnose mental health problems. But there are reasons to be cautious.
England is in the midst of a unique national experiment, the world’s most ambitious effort to treat depression, anxiety and other common mental illnesses.
The rapidly growing initiative, which has gotten little publicity outside the country, offers virtually open-ended talk therapy free of charge at clinics throughout the country: in remote farming villages, industrial suburbs, isolated immigrant communities and high-end enclaves. The goal is to eventually create a system of primary care for mental health not just for England but for all of Britain.
If politicians were serious about preventing and treating mental health, they would be tending to our broken mental health care system. What should politicians actually talk about when they talk about mental health? We compiled a list of priorities—and, spoiler alert, bringing back mental institutions did not make the cut.
Co-opted by brands and covered to death by every outlet going, has mental health content lost all meaning?
People who are chronically lacking in social contacts are more likely to experience elevated levels of stress and inflammation. These, in turn, can undermine the well-being of nearly every bodily system, including the brain.
Employers try to destigmatize mental illness, offer programs to help.
But the convenient cries of “mental health” after mass shootings are worse than hypocritical. They’re factually wrong and stigmatizing to millions of completely nonviolent Americans living with severe mental illness.
Frustrated by the failures in his field, Tom Insel, a former director of the National Institute of Mental Health, is now trying to reduce the world’s anguish through the devices in people’s pockets.
Do you ever get so busy that you neglect to take care of yourself?
If so, you’re not alone. Many of us lead busy lives where we’re consumed with taking care of others and accustomed to putting their needs before ours. While compassion and caring are wonderful traits, too little self-care leaves us emotionally depleted, exhausted, and ultimately, not much good to anyone else — especially ourselves.
Here are several ways to make yourself a priority in your life.
Getting treatment should be embraced, not denied. It’s time to do better ― with each other and as a country.
Did you know that 20% of millennials report suffering from depression? That’s higher than both Boomers and Gen X. For 18% of those reporting, their depression resulted in problems with absenteeism.
Mental health for years has been inadequately addressed, partly because the tools we had on offer were hard to scale, and partly because some of the most powerful tools in brain health were stigmatised and turned into scheduled drugs, effectively halting any progress that could be made to prove their efficacy...
Does a full moon really trigger strange behavior?
Recent questions about the validity of diagnostic criteria for mental illness have raised deeper questions about the current state of psychiatry.
Sensationalist coverage and our brains contribute to misunderstandings about mental health.
The Duke of Cambridge wants to end stigma around mental health.
The rethinking comes at a time of disconcerting awareness that mental health problems are far more pervasive than we might have imagined. The World Health Organization estimates that one in four people will have an episode of mental illness in their lifetime.
Strangely, I wasn’t worried. Like so many patients with mental illness, whose brains I had studied for a lifetime, I was losing my grasp on reality.
Rather than relying on symptoms, scientists are developing a “brain circuits first” approach to mental health.
As more patients seek help, advocates scramble to expand providers’ ranks.
Is the appearance of mental illness in young people a matter of environment or biology?
As psychiatric disorders become attributable to specific, testable causes, will psychiatry become obsolete?
The Duke and Duchess of Cambridge and Prince Harry are spearheading the Heads Together campaign to end stigma around mental health. Heads Together aims to change the national conversation on mental health and wellbeing, and is a partnership with inspiring charities with decades of experience in tackling stigma, raising awareness, and providing vital help for people with mental health challenges.
By signing this pledge, you’re taking a stand against the mental illness stigma. Pass it on. Print it out. Tape it up. It can serve as a reminder to start more conversations and stop the labeling. Together, we can Make It OK.
AllPsych Online is one of the largest and most comprehensive psychology websites on the Internet. Inside the site you'll find over over 920 individual, cross referenced, web pages and an estimated 3000 pages of printed material.
APA's Help Center is your online resource for brochures, tips and articles on the psychological issues that affect your physical and emotional well-being, as well as information about referrals.
We, at The Anxiety Panic Attack Resource Site, invite you to take your time and read the comprehensive information we have gathered over the years so you can make an informed decision as to the best course of treatment that would best fit you.
APRIL is a charity seeking to create awareness that many every day medicines and anaesthetics can induce psychiatric adverse reactions (ADRs) or withdrawal effects including depression, anxiety, insomnia, agitation, self harm, suicidal thoughts and actions, or violence towards others.
A free, up-to-date, and readily available source of mental health news, illness information, treatment options, and resources in the community is a critical component of the overall recovery process.
No driving, parking or sitting in a waiting room. Connect with your counselor from your home, from your office or on the road. You just need a computer, tablet or smartphone.
A spiritual journal into mental health.
The Brain & Behavior Research Foundation is committed to alleviating the suffering caused by mental illness by awarding grants that will lead to advances and breakthroughs in scientific research.
Electronic magazine on neuroscience.
BrainConnection.com is dedicated to providing accessible, high-quality information about how the brain works and how people learn. Many discoveries are being made in areas that relate to the human brain, including language, memory, behavior, and aging, as well as illness and injury.
The GNIF Brain Blogger covers topics from multidimensional biopsychosocial perspectives. It reviews the latest news and stories related to neuroscience, psychiatry, and neurology. It serves as a focal point for attracting new minds beyond the science of the mind-and-brain and into the biopsychosocial model.
BrainLine is a national multimedia project offering information and resources about preventing, treating, and living with TBI. BrainLine includes a series of webcasts, an electronic newsletter, and an extensive outreach campaign in partnership with national organizations concerned about traumatic brain injury.
BrainPhysics.com is a growing mental health community. Our goal is to bring people together around mental health-related issues by providing concise, up-to-date information and a meeting place for patients and those who care about them.
Book an appointment with one of our licensed therapists or
psychiatrists. Meet with them through your computer or smart phone.
Learn how to take care of your mental health. Get the facts about mental illness. Find help for yourself or others.
The Citizens Commission on Human Rights (CCHR) is a non-profit, non-political, non-religious mental health industry watchdog whose mission is to eradicate abuses committed under the guise of mental health.
The Child Advocate and Child Mental Health are devoted to children and the parents and professionals that work with them and advocate for them. The Child Advocate Network is a national network.
Dr. Charles Parker reports core scienc findings for everyday Psych problems.
Come on in and make yourself at home! Take psychological self-tests and quizzes, check symptoms of common disorders, look up medications, compare types of counselling and psychotherapy, or learn about secure online therapy.
Dementia.org is not just another medical information website. We provide practical, actionable information and “real world” reviews of research to help anyone impacted by dementia in any of its forms.
EFT is based on a new discovery that has provided thousands with relief from pain, diseases and emotional issues. Simply stated, it is an emotional version of acupuncture except needles aren't necessary.
Help is Only a Click Away...Psychologists study and understand brain/behavior processes from a scientific viewpoint and apply this knowledge to help people understand, explain and change behavior.
Search through Find-a-Therapist's directory of verified therapists, psychologists, marriage and family counselors, social workers, licensed professional counselors and psychiatrists.
FindaPsychologist.org is an online consumer resource featuring psychology-related videos, articles, and in-depth topics, as well as, an extensive, freely available directory of 11,000 credentialed psychologists. FindaPsychologist.org is a product of the National Register of Health Service Providers in Psychology.
Enhance your memory, focus and brain speed with our award winning brain training program designed by neuroscientists.
We offer FREE hypnosis mp3's and a growing selection of self-help articles. Hypnosis and guided meditation can help with problems such as quitting smoking, addictions, weight loss, phobias, lack of confidence, IBS, stress, insomnia and much more.
The mission of FFF is to impact, in a positive way, the lives of all those affected by anxiety, depressive and related disorders through advocacy, education, research and community support.
Helping People Find Therapists & Advocating for Ethical Therapy.
Happify is the single destination for effective, evidence-based solutions for better emotional health and wellbeing in the 21st century.
Welcome to HealthyPlace.com. HealthyPlace.com is the largest consumer mental health site, providing comprehensive, trusted information on psychological disorders and psychiatric medications from both a consumer and expert point of view. We have an active mental health social network for support, online psychological tests, breaking mental health news, mental health videos, a live mental health tv and radio show, unique tools like our "mood journal" and more.
In thousands of ways, social workers help people help themselves. People of every age. From every background. In every corner of the country — wherever we’re needed — starting here and now. Welcome to your source for professional advice, inspiring stories — even a social worker directory. Social workers. Help starts here.
Helpguide's mission is to empower you and your loved ones to understand, prevent, and resolve health challenges.
The National Center for Health and Wellness is an organization dedicated to providing free resources containing information related to issues concerning overall health and wellness. We research both traditional and alternative forms of wellness support to present a comprehensive and well-balanced picture of health.
Internet Mental Health is a free encyclopedia of mental health information created by a Canadian psychiatrist, Dr. Phillip Long.
Invisibilia is a series about the invisible forces that shape human behavior. The show interweaves personal stories with scientific research that will make you see your own life differently.
I've written extensively about Borderline Personality Disorder, Psychology, Regression, Patient Rights, 5150, and Infantilism issues.
Where knowledge junkies get their fix.
Mental Health America (formerly known as the National Mental Health Association) is the country’s leading nonprofit dedicated to helping ALL people live mentally healthier lives.
MentalHealthDaily.com was established in 2013 as a way to document any information and updates in the field of mental health. Author and creator, GLOOM, has struggled with severe anxiety, crippling depression, addictions, and various personality disorders throughout the years. This blog serves as a way for me to keep track of what’s going on in the field of mental health and share insights I’ve learned along my journey through life.
There is no Health without Mental Health! Mental health is an essential part of any citizen's health and well being. As such, it is an essential component of communities. Good mental health is a basic human right. Factors that adversely affect mental health represent a major and growing threat to economic, social and public health in the world.
We are committed to reducing the suffering caused by mental ill health and to help everyone lead mentally healthier lives. We help people to survive, recover from and prevent mental health problems.
Your partner in mental wellness.
The MentalHelp.net website exists to promote mental health and wellness education and advocacy.
We’re Mind, the mental health charity.
We’re here to make sure anyone with a mental health problem has somewhere to turn for advice and support.
How can we help you?
This is a place for youth and emerging adults to access info, resources and tools during tough times. Help yourself. Help each other. Share what you live and know.
MindTools.com is here to help you learn the practical, straightforward skills you need to excel in your career.
NAMI is the National Alliance on Mental Illness, the nation's largest grassroots organization for people with mental illness and their families. Founded in 1979, NAMI has affiliates in every state and in more than 1,100 local communities across the country.
The National Association of Counsellors, Hypnotherapists and Psychotherapists is the only registered charity in the UK that represents the interests of the general public and all three professions of clinical psychotherapy.
Our belief is that counselling (and related therapies) should be seen as a vocation (not just a job but a worthy occupation) and that the relationship between counsellor and client is important for the outcome of therapy.
Welcome to NetworkTherapy.com, a leading provider of mental health resources and marketing solutions for the growing online mental health community. Since the formation of NetworkTherapy.com in March of 2000, our focus has been centered on providing fast and reliable access to our national network of over 3,000 mental health providers.
Information for professionals and patients with quick notes and extensive links.
Neurotransmitter.net exists to improve online access to biomedical information in fields such as neuroscience, pharmacology, and psychology.
Orthomolecular medicine describes the practice of preventing and treating disease by providing the body with optimal amounts of substances which are natural to the body.
Out of Bounds is an integral part of The Mental Fitness Center.
Psychosis occurs in a number of serious mental illnesses and not just schizophrenia, eg depression, bipolar disorder (manic-depressive illness), puerperal psychosis and sometimes with drug and alcohol abuse. It can also occur in a number of neurological conditions and with drugs not associated with abuse.
Beautiful mental health quotes to reflect on and inspire you.
The Internet's largest and oldest independent mental health social network created and run by mental health
professionals to guarantee reliable, trusted information and support communities to you, for over 16 years.
PsychDirectory is a global directory of various psych-related services and resources.
Peter R. Breggin, MD, has been called "The Conscience of Psychiatry" for his many decades of successful efforts to reform the mental health field. His scientific and educational work has provided the foundation for modern criticism of psychiatric drugs and ECT, and leads the way in promoting more caring and effective therapies.
We continually strive to be major mental health, mental health care, psychology and psychiatry resource portal containing links to relevant information, articles on mental illness, fact sheets, forums, software downloads and research sources. Our site objective is to address the needs of professional mental health workers, students and the layperson.
Psychology Information Online provides information about psychological diagnosis, disorders and problems, psychotherapy and counseling.
Our site has been designed to cut through these problems by providing easily accessible, well written and timely health information that can be viewed from the privacy of your home and office.
Depression and mental health resource.
The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities.
Screening for Mental Health Inc. is the non-profit organization that first introduced the concept of large-scale mental health screenings with its flagship program National Depression Screening Day in 1991.
Log and track seizure activity, appointments, and medication schedules through a simple calendar interface from your computer or mobile phone.
A blog by Psychiatrists for Psychiatrists. A place to talk; no one has to listen. All patient vignettes are confabulated; the psychiatrists, however, are mostly real.
The purpose of this website is to provide information about effective treatments for psychological disorders. The website is meant for a wide audience, including the general public, practitioners, researchers, and students. Basic descriptions are provided for each psychological disorder and treatment. In addition, for each treatment, the website lists key references, clinical resources, and training opportunities.
I said that my illnesses would not define me; yet, as I type my thoughts I realize that I have let them shape my life. How do I separate myself from something that is a part of me? Do I even need to?
Affordable, private therapy sessions with professional, licensed therapists who are waiting right now to help you make a real difference in your life.
Anytime and anyplace, on your mobile device or on the web, your therapy sessions are always 100% confidential and secure in your private chat room with your therapist.
The Health Psychology Network is designed to provide through, user friendly information that can help people learn ways to improve their physical and emotional health. Each area of The Health Psychology Network has been written by experts in their respective fields.
We face disability, disease and mental illness together.
The Sandtray Network is a non-profit organization, founded to promote learning, healing, and creativity through the use of the sandtray.
Lisa Brookes Kift, MFT is a psychotherapist and author of Therapy-At-Home Workbooks®, a cost effective, do-it-yourself, therapist-guided counseling alternative for individuals and couples. She is the creator of The Toolbox at LisaKiftTherapy.com with tools for marriage, relationship and emotional health and has a private practice working with individuals and couples in Marin County, CA.
Over 15,000 marriage and family therapists are listed in TherapistLocator.net. The therapists are Members of the AAMFT, and as such must meet stringent training and education requirements established by the AAMFT.
A unique therapist directory.
TIPS - an early intervention program for psychosis and other mental conditons...Norway.
Treatment Online (TOL) is the internet destination for the very best psychological support and evaluation. The informational therapy and social network of Treatment Online provides users of the service with a real benefit that grows incrementally with the level of participation and trust you invest in the service.
The purpose of Wired for Happy is to increase the frequency of positive moods so you experience healthier relationships. The most important relationship is with yourself.