Mental illnesses are defined as prolonged or recurring significant deviations in thoughts, feelings, or behavior. These disturbances must cause personal distress or burden the environment to be considered an illness.
Mental illnesses are increasingly diagnosed and are among the most common health conditions. Nearly half of all people experience a significant mental disorder at least once. In recent years, mental health issues have caused more sick days and early retirements, with depression and anxiety being the most common diagnoses.
Mental illnesses usually have multiple causes, including genetics, physical illness, life events, and emotional conflicts. Brain metabolism disturbances and brain tissue changes often contribute to their development.
What Are the Symptoms of Mental Illness?
The symptoms of mental illness can vary depending on the specific condition a person is experiencing. However, there are some common signs to look out for. These may include noticeable changes in personality or behavior, especially when there is no clear reason for them. Some people may become confused or express very dark or disturbing thoughts.
A person might show unusual or disorganized thinking for example, they may frequently jump from one topic to another or give long, complicated answers to simple questions. Sometimes, their actions may be inappropriate for the situation, such as taking off their clothes in public. Access to early mental health treatment in India can help manage these challenges effectively.
Other symptoms can include seeing or hearing things that are not actually there, known as hallucinations, or strongly believing things that are clearly not true, known as delusions. Sudden or extreme changes in mood can also be a sign of a mental health problem. In such cases, treatment for psychiatric illnesses in India is crucial to ensure proper diagnosis and care. Patients may also benefit from professional psychiatric treatment in India, which combines therapy and medical support to improve wellbeing.
How to Recognize a Mental Illness?
Mental illnesses are usually diagnosed by talking with the person affected. In some cases, caregivers or family members may also be asked for information.
Sometimes it’s clear that someone is suffering from a mental disorder. For example, a person might claim to be the president or believe that their thoughts are being controlled by a radio implanted in their brain.
However, in many cases it can be difficult to tell the difference between a mental illness and a normal emotional reaction. For instance, after the death of a spouse or child, it’s normal to feel deep sadness, so it may not be easy to distinguish between grief and depression. Similarly, someone who likes things very tidy may simply be neat, or they could have obsessive-compulsive disorder.
The difference usually depends on three main factors: how severe the symptoms are, how long they last, and how much they affect the person’s ability to function in daily life.
Who Treats Mental Illness?
Mental health care can involve different types of professionals, and often a team works together to support the patient. This may include psychiatrists (medical doctors who can prescribe medication), psychologists (who focus on therapy), social workers, and general practitioners (family doctors who can also prescribe medication).
The Psychiatrist
A psychiatrist undergoes five years of specialized training after medical school and passing the state exam. Four years focus on clinical psychiatry and psychotherapy, and one year on neurology. This training qualifies them to practice both psychiatry and psychotherapy.
The Psychologist
Only individuals with a psychology degree can use the title “psychologist.” Psychology is an empirical science, while psychiatry is a branch of medicine. Psychology studies human behavior, experiences, and development, considering both internal and external influences. Psychologists can further train as psychotherapists or psychoanalysts, gaining state certification to practice as “psychological psychotherapists.”
Psychiatrist. Overview of Tasks
A psychiatrist diagnoses and treats disorders in thinking, mood, emotions, memory, behavior, and motivation. People often see psychiatrists for prolonged psychological crises, emotional exhaustion, or persistent anxiety.
Unlike psychologists, who mainly conduct therapy sessions, psychiatrists can prescribe medication. After diagnosing the physical or medical causes of mental illness, they treat it with medication or therapy. Psychotherapists, however, focus on therapeutic exercises and treatments.
A psychiatrist’s work involves medical diagnosis, treatment, and research of mental disorders. They use both medication and psychotherapy to manage symptoms.
Psychiatry. Description of the Field
The term “psychiatry” comes from Greek, „psyche“ (soul) und „iatrós“ (physisian), and put together means “healing of the soul.” The medical field of psychiatry involves diagnosing, treating, preventing, and rehabilitating mental health disorders. It also considers the social dimension, as people exist within a social context. Psychiatry’s understanding of mental illness includes psychological, physical, and social factors. Over time, psychiatry has developed specializations like child and adolescent psychiatry, psychosomatics, geriatric psychiatry, and forensic psychiatry.
Treatment of Mental Illness
Over the years, there have been major advances in treating mental illnesses. Today, many psychiatric conditions can be managed almost as successfully as physical illnesses. In general, treatment methods fall into two main categories: physical treatment and psychotherapeutic approaches.
Physical Treatment Methods
Physical treatments include medication, electroconvulsive therapy (ECT), and brain stimulation techniques such as transcranial magnetic stimulation (TMS). These methods aim to directly affect brain activity to relieve symptoms.
Psychotherapeutic Methods
Psychotherapeutic treatments involve talk therapy, either one-on-one, in groups, with couples, or families. Techniques such as behavior therapy, relaxation training, exposure therapy, and even hypnotherapy are commonly used depending on the situation.
Studies show that combining medication with psychotherapy is often more effective than using just one of these methods, especially in severe mental health disorders.
Medications Used for Treatment of Mental Illness
Doctors use a variety of medications to treat mental health conditions. Some of the most common types include antidepressants—especially SSRIs (selective serotonin reuptake inhibitors), anti-anxiety medications, antipsychotics, and mood stabilizers.
There are many effective psychiatric medications, and they are often categorized by the condition they are primarily used to treat. However, many of them work across different disorders. For example, drugs used to treat schizophrenia may also help in bipolar disorder, and antidepressants are used for both depression and anxiety.
Antidepressants for Treatment of Mental Helth Disorders
The most commonly used antidepressants are SSRIs (selective serotonin reuptake inhibitors), and SNRIs(serotonin-norepinephrine reuptake inhibitors.
The most common SSRIs are: fluoxetine, sertraline, paroxetine, fluvoxamine, vortioxetine, vilazodone, escitalopram, and citalopram.
Other antidepressants include:
- SNRIs (serotonin-norepinephrine reuptake inhibitors) such as venlafaxine, duloxetine, levomilnacipran, and desvenlafaxine
- NDRIs (norepinephrine-dopamine reuptake inhibitors), such as bupropion
- Tricyclic antidepressants like amitriptyline and nortriptyline, which are used less often now due to side effects but can still be helpful for chronic pain
- MAOIs (monoamine oxidase inhibitors), like phenelzine and tranylcypromine, are used only when other treatments fail because they require strict dietary restrictions
Neuroleptic Used for Treatment of Mental Health Illnessess
For psychotic disorders like schizophrenia, older antipsychotic drugs such as chlorpromazine and haloperidol are still used, but newer medications—called atypical or second-generation antipsychotics—are usually preferred. These include aripiprazole, olanzapine, risperidone, quetiapine, ziprasidone, and others. If these do not work, clozapine may be used.
Anxiety Releasing Medication
Anti-anxiety medications like clonazepam, lorazepam, and diazepam, as well as antidepressants, are prescribed for anxiety disorders such as panic attacks and phobias.
Mood Stabilizing Medication
Mood stabilizers such as lithium, carbamazepine, valproic acid, and lamotrigine are used for bipolar disorder. Some antipsychotic medications are also effective in treating bipolar symptoms.
Treating Mental Health Illnessess with Psychotherapy
Psychotherapy involves talking with a doctor, psychologist, or counselor about people thoughts, emotions, and behaviors. Psychotherapy has made big progress in recent years. Therapists create a safe and supportive space to help people understand the causes of their emotional difficulties and explore healthier ways of dealing with them. As people gain more insight into their thoughts and emotions, they often change the way they act and feel, leading to a better quality of life.
In individual therapy, patients work one-on-one with a therapist. Other forms include group therapy, family therapy, or couples therapy.
Psychotherapy is helpful not only for mental illnesses but also for coping with life challenges like job stress, loss of a loved one, or the illness of a family member. Therapy can be done individually, in groups, as couples, or with families.
Depending on the specific issue mental health professionals can use one or more of the following types of psychotherapy:
Behavioral Therapy
This method helps people unlearn harmful behaviors and adopt healthier ones. A typical technique is exposure therapy, used for phobias. It gradually helps people face what they fear in a controlled and safe way. The goal is to reduce fear and avoidant behavior. Behavioral therapy is based on the idea that behavior can be learned or unlearned through experience.
Cognitive Therapy
Cognitive therapy focuses on changing negative thinking patterns. For example, someone might think, “If I’m not perfect, I’m a failure.” This kind of thinking can cause distress. Cognitive therapy helps people recognize and challenge such thoughts, leading to more balanced thinking and improved emotional well-being.
Interpersonal Therapy
Originally developed to treat depression, this therapy focuses on improving personal relationships. It helps people deal with unresolved grief, role changes (like adjusting to retirement or a new family dynamic), and difficulties in communication. The therapist helps patients understand and improve how they relate to others.
Psychoanalysis
This is one of the oldest forms of therapy, developed by Sigmund Freud. It involves lying on a couch and freely talking about whatever comes to mind. The focus is on understanding how past relationship patterns repeat in the present. The bond between therapist and patient is central, and through exploring the past, the patient can change how they deal with relationships today.
Psychodynamic Therapy
Similar to psychoanalysis, this approach looks at how unconscious patterns affect thoughts and behavior. It usually involves fewer sessions per week and does not require the patient to lie on a couch. The focus is a bit more on present-day issues than on deep analysis of the past.
Supportive Therapy
This is the most common form of therapy. The therapist offers emotional support and guidance to help the patient manage day-to-day challenges. A common type is problem-focused therapy, which can even be provided by a family doctor.
Brain Stimulation Treatments
For people who don’t respond to medication or psychotherapy, treatments with brain stimulation can help. These methods stimulate the brain using distinct technic which may stabilize mood and thinking process by triggering the brain to release chemicals that regulate emotions.
Electroconvulsive Therapy (ECT)
ECT involves placing electrodes on the scalp and sending a small electric current to the brain while the patient is under anesthesia. This causes a brief seizure and is especially effective in treating severe depression. Though memory loss may occur temporarily, ECT is generally safe and modern techniques have made the procedure much safer than in the past.
Transcranial Magnetic Stimulation (TMS)
TMS for short, is a non-invasive procedure in which specific areas of the brain are stimulated or inhibited using magnetic fields applied through the skull (transcranially). TMS is used both in basic research and in the diagnosis and treatment of various neurological and psychiatric disorders.
Psychiatric Diagnostic Systems
Psychiatric diagnoses are made based on international agreements, without addressing the causes. These systems categorize mental illnesses by their symptoms, describing the appearance but not the cause. The content is a collection of symptoms agreed upon by experts, making diagnoses reproducible and treatment easier.
The International Classification of Diseases (ICD) is the most widely recognized diagnostic system globally. In Germany, doctors must use ICD-10 codes for diagnoses.
The Diagnostic and Statistical Manual of Mental Disorders (DSM), created by the American Psychiatric Association, complements or replaces parts of ICD-10. With the release of ICD-11 and DSM-5, changes in classification of mental illnesses are expected.
Treatment of Mental Health Illnesses. Summary
Due to the complex causes of mental illnesses, therapy and rehabilitation are multidimensional. This includes a network of outpatient, inpatient, and partial care services. Optimal care requires coordination with fields like psychiatry, clinical psychology, neurology, psychosomatic medicine, and general medicine. Current neurobiological, psychological, and social science knowledge is also essential.
Psychiatrists are specially trained to treat mental illnesses and are usually the ones who prescribe medication. However, psychologists, and social workers also play a key role in treatment, mostly through therapy.
The main treatments include medication and psychotherapy, also known as talk therapy or counseling. In addition, there are other treatment options such as electroconvulsive therapy (ECT), where a controlled electrical impulse is given to the brain under anesthesia, and transcranial magnetic stimulation (TMS), which uses magnets placed on the head to stimulate certain brain areas. Get inspired with CHMC care stories on Instagram.
The specific treatment depends on the illness and patient preferences. For moderate to severe conditions, medication and psychotherapy are usually combined. Lighter cases often rely on psychotherapy alone.