How Psychiatry Has Evolved As A Medical Specialty, And Where It Stands Today

The fight to end the demonization and negative stigma associated with individuals who suffer from mental illness is spreading fast. But what many people may not realize is that a debilitating stigma plagues the very professionals who diagnose and treat these mental illnesses as well.

Although psychiatrists are doctors who have completed medical school, they are often not taken as seriously, both by fellow doctors of other specialties as well as patients in general.

In fact, a study presented to the Royal College of Psychiatrists in the UK reported that 54 percent of surveyed patients did not even know that psychiatrists have a medical degree. Likewise, a 2012 Gallup poll showed that only 41 percent of Americans perceived psychiatrists to have “high” or “very high” standards of honesty and ethics, compared to 70 percent who attributed those traits to medical doctors in general.

Nathaniel P. Morris, a resident physician in psychiatry at the Stanford University School of Medicine, explains that the specialty is perceived as a sort of pseudoscience, “somewhere between neuroscience and voodoo.” Others write off psychiatrists as “pill-pushers” who prescribe medication as a quick fix for any of their patients’ mental problems. Still more people discredit the field as not having evolved enough over the past several decades to truly be considered a legitimate medical specialty.

This, however, is simply not the case. While psychiatry has its faults (what field or industry doesn’t?), the field is essential for understanding and treating mental health, a vital component of every individual’s overall health and well-being. Serious issues, from eating disorders, to depression, even the U.S.’s current opioid epidemic, require psychiatric research and treatment in order to be properly addressed.

Mark Rubinstein, M.D., psychiatrist and author of “Bedlam’s Door: True Tales of Madness and Hope”, also points out that more advances have been made in understanding and treating mental illness in the past sixty years than in “all the centuries during which human beings have populated the earth.”

Where typical treatments for mental illness used to consist of horrific practices like lobotomies, high-leveled electroshock therapy without anesthesia, or simply throwing a patient into a mental institution, the development of psychiatry as a science was the first attempt to seriously (not to mention humanely) study mental health.

Developments in the field have been exponential, to the point that psychiatric research has led to the potential use of gene therapy, and has also entered the realm of neuroscience. Neuroimaging is now used to detect structural abnormalities of the brain and monitor psychiatric diseases. Neurobiological markers for schizophrenia, bipolar disorder, and other major psychiatric conditions have also been discovered, which is crucial for pathopathology.

The ability to detect drug-related biomarkers is in development as well which will allow doctors to determine what medications will be most effective for each individual patient, essentially eliminating the trial-and-error process of administering treatments and even preventing the onset of mental illnesses.

And despite the aforementioned “pill-pusher” stereotype, psychiatric medications have been a game-changer for effectively treating mental illnesses since they were first developed in the late 1980s. In fact some conditions such as bipolar disorder, PTSD, phobias and severe depression can be all but untreatable without some sort of medication implemented with therapy. The development of anti-anxiety medications, potent antipsychotic remedies, effective antidepressants, and mood stabilizers has resulted in monumental improvements in the qualities of many people’s lives.

Still, it is important to remember that pharmaceutical drugs are not the miracle solution to all medical problems, even though they may be the easy option to fall back on.

Morris explains, “Psychiatrists must be able to maintain their clinical skills and to recognize the varied medical causes of psychiatric symptoms. We need to work at the interface of mind and body in order to provide the best care for our patients.”

He says that psychiatry can be “among the most inspiring medical specialties.” He urges fellow psychiatrists to actively engage in their jobs and the medical community as a whole in in a manner that allows them to break the stigma stifling the psychiatric field.

This includes taking the time to truly work with patients, helping them find ways to deal with their illnesses other than simply relying on medication. Psychiatrists should also not exclude themselves from performing the medical duties they were trained in medical school to do, such as performing physical exams on patients as opposed to sending them off to another specialist.

Psychiatry has come a long way, and shows promising developments in the future as well. It has made exceptional contributions to patients lives as well as medical science. Despite the negative perception that looms over psychiatry compared to the rest of the medical community, this branch of medicine centers around one of the most important aspects of the way we as human beings function day to day: our minds.

Mental state is not as tangible as the brain, nerve tissue, or our DNA, but it is directly related to all of the three. And, as stated above, it is much more closely connected to our physical health than many people realize.