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DECISION-MAKING PROCESS FOR PSYCHIATRIC ILLNESSES

How is Treatment For Psychiatric Illnesses Decided? And When to Start Medicines?

As a psychiatrist, I often get asked, “Can’t this be treated with counseling?” Patients come to me convinced that counseling is the only way to go. Maybe they heard it from friends or read it online, but they’re set on it. As we’ve discussed in previous posts, there’s a lot of Western influence on counseling, and they want to follow the same process here, especially for the therapist.

 

Let me tell you how we decide if treatment is needed. For example, let’s say someone comes to us with Major Depressive Disorder (MDD). We’ll start by asking them about their symptoms and seeing if they fit the criteria for clinical Major Depressive Disorder (MDD).

Here Are The Main Things We Look For

  • The symptoms must meet the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM).
  • The symptoms must have lasted for at least 15 days.
  • The symptoms must be severe enough to put the person’s life at risk (like suicidal thoughts or intentions).
  • The symptoms must significantly impact the person’s personal, professional, and social life.
  • If the symptoms meet all these criteria, we’ll start looking into treatment options.

Counseling or Talk Therapy Can Be Helpful When​

  • The symptoms are mild and don’t interfere with daily life.
  • There’s an external factor, like social or personal problems, that’s causing the symptoms.
  • But counseling is only effective if the person is willing to apply the techniques learned in therapy in real life, not just on the couch.

If your symptoms are severe and there’s no external factor causing them, counseling probably won’t be helpful.

 

These symptoms are caused by a lack of certain brain chemicals like serotonin, dopamine, and nor-epinephrine. These chemicals need to be given from the outside, either in pills or injections, and can’t be gotten from food or other vitamins. Doctors decide which medicines to give based on the person’s symptoms and other things about them.

 

Everyone is different, so each person gets treated differently.

Summary

Please note the following key considerations:
  • Seek professional evaluation for Major Depressive Disorder (MDD).
  • Understand the severity of your condition.
  • Consult with your psychiatrist regarding available psychiatric treatments.
  • Investigate whether external factors contribute to your Major Depressive Disorder (MDD).
  • Medication is typically prescribed for moderate to severe Major Depressive Disorder (MDD).
  • Counseling, akin to lifestyle modifications, serves as an additional treatment option, not the sole intervention.
  • Counseling is not effective for psychotic illnesses.