Psychiatry is a branch of medicine that examines the functions of the brain related to emotions, thoughts, and behaviors, and deals with the diagnosis and treatment process of diseases that affect these functions. Psychiatric diseases may occur due to bodily structure and functioning disorders or due to experiences that are out of the ordinary and that may affect them deeply. Psychiatry covers the diagnosis and treatment of depression, bipolar disorder, obsessive-compulsive disorder, anxiety disorders, schizophrenia, attention deficit and hyperactivity disorder, social phobia, post-traumatic stress disorder, and many more. Specialists in this field can use different treatment options such as drug treatments and psychotherapy methods in the treatment of diseases according to the needs of the patient.
Depression (Major Depressive Disorder)
Depression is a mood disorder in which a person feels constantly sad, hopeless, helpless, and pessimistic. The causes of depression are known as genetic factors, hormonal changes, and some personality traits. Individuals with depression apply to the clinic with complaints such as hopelessness, agitation, slow thinking, slow decision-making, self-blame, loss of appetite, fatigue, and disappointment. These complaints negatively affect the daily life activities and social life of the person. The state of unhappiness felt in daily life should be differentiated from depression. There are differences between depression and daily demoralization, such as physical findings such as sleep and appetite disorders, introversion, isolation, and suicidal ideation, in addition to the psychological ones.
The diagnosis of depression is made after a clinical examination and, if necessary, laboratory tests followed by a psychiatric evaluation. In the psychiatric evaluation, the patient is asked questions about his life, feelings, thoughts, and health problems. Depression has many different symptoms. Catatonia, which means aimless movements, is one of these symptoms. Findings such as hallucinations are among the psychotic symptoms of depression. Diagnostic criteria for depression include a significant decrease in interest in all activities for most of the day, significant weight loss or gain when not dieting, fatigue that is felt almost every day, worthlessness, self-blame, lack of concentration, indecision, and repeated suicidal ideation. For a definitive diagnosis of depression to be made, these symptoms must significantly limit the person’s functionality.
Medical therapy is often used in the treatment of depression. Antidepressant group drugs are beneficial in the treatment of depression. Tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, selective serotonin reuptake inhibitors, monoamine oxidase inhibitors, and antipsychotic drugs are used by choosing an appropriate drug or drug combinations for each patient. Since abrupt discontinuation of the drugs used will lead to withdrawal symptoms, they should be discontinued gradually, or the dose should be changed. Drug use should always be under the supervision of a doctor. The other method used in the treatment of depression, apart from medical treatment, is psychotherapy. The features that psychotherapy treatment brings to the person can be counted as adapting to a difficulty, being satisfied with life, replacing negative attitudes with positive attitudes, and staying away from behaviors that increase depressive state. Hospitalization is recommended in cases where the depressive disorder cannot be cured by medical treatment and psychotherapy treatment.
Anxiety disorder is defined as the feeling of worry that prevents the realization of daily activities, unlike the anxiety and panic experienced in daily life. Anxiety disorder is seen at higher rates in women, socially suppressed individuals, and those with a history of childhood trauma. Anxiety disorder; consists of several subgroups such as a panic attack, social anxiety disorder, agoraphobia, and generalized anxiety disorder. A panic attack is an anxiety disorder with symptoms such as panic and accompanying chest pain, dyspnea, and sweating that occur without a specific factor. Social anxiety disorder is defined as feeling anxious about being judged about events in daily life. It is diagnostic if the individual’s complaints last at least six months. Agoraphobia is an anxiety disorder experienced away from home or in closed and crowded spaces. Generalized anxiety disorder is defined as excessive worrying for no apparent reason.
Anxiety disorder can be seen due to factors such as genetic predisposition, abnormal nerve pathways, cardiovascular diseases, diabetes, hormonal disorders, stress, childhood traumas, and drug side effects. Risk factors for anxiety disorder are lack of self-confidence, substance abuse, depression, trauma disorder, etc. can be listed as the disease may also develop due to other mood disorders. An anxiety disorder may accompany the symptoms in individuals diagnosed with post-traumatic stress disorder and obsessive-compulsive disorder. Patients with anxiety disorders often apply to the clinic with complaints such as restlessness, panic, dyspnea (shortness of breath), tachycardia, concentration problems, tremor, and sleep disorders.
The diagnosis of anxiety disorder is made by clinical examination. The duration and intensity of the patient’s complaints are also evaluated. Medical therapy and psychotherapy are the most used methods in the treatment of the disease. Antidepressant types, antisiolytic drugs, and green prescription benzodiazepine drugs are among the drugs used for anxiety disorders. The use of medication continues until the symptoms regress, and after all, symptoms have resolved, drug use and follow-up are often recommended for one more year. Psychotherapy is a treatment method that progresses with expert and patient interviews and aims to manage the anxiety experienced by the person. Techniques such as relaxation exercises, meditation, physical activity, lifestyle and behavior changes, and stress management can also help treatment in patients with mild symptoms of anxiety disorder.
Attention Deficit Hyperactivity Disorder
Attention deficit hyperactivity disorder (ADHD) is one of the neurobehavioral and neurodevelopmental psychiatric disorders. Individuals with attention deficit and hyperactivity disorder exhibit impulsive behaviors, are usually constantly on the go and have problems concentrating. These problems can negatively affect the social skills of individuals. Patients may exhibit irritable, anxious, or unhappy attitudes.
Individuals with attention deficit and hyperactivity disorder often apply to the clinic with complaints such as concentration problems and hyperactivity. Symptoms of attention deficit and hyperactivity disorder are grouped under three main headings; impulsivity, hyperactivity, and attention deficit symptoms. Of these, impulsivity means that the patient has difficulty controlling himself/herself and acts by his/her impulses. Symptoms that occur with impulsivity are symptoms such as impatience, haste, uncontrolled reactions, and inability to control or postpone their requests. Hyperactivity means excessive activity. It is the fact that the patient is more active than normal according to his/her peers and his/her level of development, at a level that will cause problems for himself/herself and those around him/hers. Symptoms that occur with hyperactivity are such as moving quickly, speaking quickly, talking a lot, wanting to move constantly, and not being able to sit for a long time. Attention deficit is the situation in which the patient’s attention span and intensity of a focus are insufficient compared to his/her peers and his/her level of development. Patients with attention deficit do not have a problem paying attention to every subject. The main problem here is that they cannot concentrate their attention on the focused subject and cannot maintain this attention for a long time. Attention can vary depending on the person’s interests. Sometimes, patients can pay attention for a long time while they are doing a favorite activity, but attention deficit symptoms may reappear during another activity. Symptoms that occur in a patient with attention deficit disorder are inability to make eye contact, forgetfulness, making mistakes very often, not being able to deal with the same task for more than 10 minutes, being easily distracted by external factors, and forgetfulness. It has been determined that some of the patients with attention deficit and hyperactivity disorder have similar problems in their families. Although this shows that genetic factors may be among the causes of attention deficit and hyperactivity disorder, it is not sufficient to fully understand the formation of the disease. It is thought that factors such as alcohol, smoking, chemicals exposed in the womb, problems exposed during birth or chemicals exposed after birth, and infections such as infections may cause attention deficit and hyperactivity disorder. The teamwork of family, school, and experts is very important in the treatment of the disease. Interviews can be made with the family and the patient for treatment purposes. In addition, drugs used in the treatment process and allowed to control the patient’s symptoms are an important part of the treatment.