American Medical Association Family Medical Guide - American Medical Association [449]
Psychiatrist A physician who has completed medical school and residency training and specializes in diagnosing and treating mental problems (with medical and physical causes) and behavioral disorders. Psychiatrists employ treatments such as medication and psychotherapy.
Psychologist A professional who has completed graduate training in human psychology but not in medicine (and, therefore, cannot prescribe medication in most states). Many psychologists conduct psychological testing and statistical analysis. Clinical psychologists practice psychotherapy.
Psychotherapist A psychiatrist, psychologist, or social worker who looks for the cause of a person’s problems and helps the person develop coping strategies to deal with them.
Psychotherapy Also called talk therapy, a term that covers several types of treatment—including suggestion, analysis, and persuasion—for mental disorders. Frequently used forms of psychotherapy include:
• Cognitive-behavioral therapy, which teaches you how to change inappropriate or negative patterns of thought and behavior.
• Psychoeducation, which shows you how to recognize signs of relapse so you can get help early. Social rhythm therapy is a form of psychoeducation that teaches a person with a disorder such as bipolar disorder how to regulate his or her daily routine to help prevent manic episodes.
• Family therapy, which evaluates the interactions of family members to help lower the level of family stress that might be worsening your disorder or that might result from it.
• Interpersonal therapy, which helps you improve your relationships with other people.
Neurosis Now an outdated, nonmedical term for an emotional disorder that is not as severe as a psychosis. People with neuroses have symptoms, such as anxieties or fears, that they recognize as being irrational but cannot control.
Psychosis A mental disorder in which a person has difficulty distinguishing reality from fantasy. Hallucinations (abnormal perceptions not based on reality), delusions (false, irrational beliefs), and distorted speech patterns are hallmark symptoms.
Psychosomatic Physical symptoms thought to be caused by a mental or emotional problem. The symptoms can often be treated by addressing the associated psychological problem.
Structural abnormalities in the brain such as from a moderate to severe head injury can contribute to the development of depression. Biological factors, such as blockage of the arteries to the brain (stroke; see page 669) and age-related brain chemical or structural changes, can also trigger depression. Genes play a role, too; if you have a close relative who has had depression, you are more likely than other people to develop it. Stressful life events, such as the death of a family member, may trigger depression in susceptible people. This vulnerability to depression probably involves a combination of genetic, biological, psychological, and environmental factors.
Recreational or prescription drug abuse, alcohol use, or exposure to a poison or toxin can produce symptoms of depression. Depression can also be a symptom of a number of medical conditions, including Cushing’s disease (see page 898), stroke, hypothyroidism (see page 903), or cancer of the pancreas (see page 800). People who have a serious physical illness, such as heart disease, cancer, or diabetes, also are at risk of developing depression.
Depression can deter a person who has a serious medical condition from seeking or complying with treatment—for both the physical illness and the depression. Depression caused by a medical condition often goes unrecognized and, therefore, untreated. But early diagnosis of depression can improve overall health. About 70 to 80 percent of people with depression experience relief of their symptoms after receiving treatment.
Symptoms
Depression usually occurs in episodes that last at least 2 weeks. During this time, the primary symptoms are overriding melancholy, despair, and hopelessness.