Psychopharmacology (medication)
Analytical Talk Therapy (ALT)
Cognitive Behavioral Therapy (CBT)
Interpersonal Therapy (IPT)
FAQ

Psychopharmacology (medication) – Medications have shown to be helpful in managing most psychiatric disorders. Generally, the combination of medications and talk treatment is more effective than either alone. The effects of talk therapy are often longer lasting, and can, in some, be transformative. Medications may act more quickly. The benefits of medication generally go away once the medication is stopped. There are typically more risks associated with medications than with therapy.

Analytical Talk Therapy (ALT) – the attempt to define and clarify the nature of your problem in terms of your life memories, assumptions, and expectations about the world so that we can ‘unwind’ the knots that hold you captive. This can be an intellectual, spiritual, and emotional journey.

Cognitive Behavioral Therapy (CBT) – a more ‘action-oriented’ therapy useful when you already have a clear idea about the nature of your problem. For instance, if you have frequent panic attacks and want these to stop, CBT has been shown to be an effective treatment.

Interpersonal Therapy (IPT) – a form of talk therapy focused upon the nature or absence of your relationships with other people. For instance, IPT can be very helpful for depression and grief after the loss of a loved one.

FAQ:

What is a psychiatric illness like depression?

No one knows what psychiatric illness is. Although commonly referred to as disorders, until we learn more, psychiatric illnesses are probably best considered symptoms like pain. Pain is something that nobody can feel but you and greatly impairs your ability to function. Likewise, your depression can only be felt by you and impairs your day-to-day living, although it can certainly affect the people in your life. Other people may notice your depression just like they notice when you are in pain, or you may hide depression like you hide pain.

What causes psychiatric illness?

Medical causes are those things we can change, like removing a tumor, to fix a problem. In some people with psychiatric disorders a specific cause can be found such as a toxin or tumor or infection, but for the vast majority, no single cause is ever found. It is a fact that every psychiatric disorder identified thus far has been associated with multiple causative sources and multiple genetic patterns and is influenced by a broad array of life experiences and biological processes. While research has uncovered numerous biological, psychological, and situational factors that are correlated with psychiatric illness, it is important to know that correlation does not imply causation.

Do medications cure psychiatric illness?

No. Psychiatric medications may decrease the burden, frequency, and severity of symptoms; but they do not cure the illness, just like blood pressure medications do not cure hypertension. Some people taking medications have a so-called ‘full response’ for a period of time when they do not notice the illness, although symptoms may return. In general, even without treatment, psychiatric symptoms change over time and may resolve spontaneously, or may come and go.

Is it okay to be prescribed three or more psychiatric medications at the same time?

There are no randomized, scientific studies that have analyzed the safety or effectiveness of prescribing 3 or more psychiatric medications simultaneously. Few studies have examined the safety and efficacy of prescribing 2 psychiatric medications for a single psychiatric condition, although this practice is common and accepted for bipolar disorder and major depression. In general, taking multiple medications increases the risk of medication-related adverse events and unforeseen drug interactions.

Can a brain-scan tell me what disorder I have?

Magnetic resonance imaging (MRI), Positron emissions tomography (PET), single photon emissions computed tomography (SPECT), Electroencephalography (EEG) and other imaging techniques have been used to generate pictures of brains of people with and without psychiatric disorders, and in people as they undergo treatment. These pictures represent different biological features of the brain (e.g., size, blood flow, diffusion of water, electrical potential, molecular concentrations…). In research settings, they have found statistical differences between people with and without disorders. Although the brains of the two groups differ, these differences alone have not yet proven to be cost-effective diagnostic tools in a general clinical setting, nor do we know how to treat a person according to a brain scan—although progress is being made in this area. For instance, PET scans are accepted as useful adjuncts in dementia diagnoses. A careful psychiatrist is still the ‘gold standard’ for diagnosis.

Can a genetic test tell me about my diagnosis and treatment?

Most psychiatric disorders are thought to be ‘polygenic’, meaning multiple genes contribute to the potential to developing the disorder. Environmental factors play a key role as well. In some families, a rare mutation in a single gene may increase susceptibility (the chance of getting a disorder). In general, while susceptibility genes have been suggested, genetic testing is not yet diagnostic, although research progresses. Genetic tests may help direct treatment, but these tests are not considered the standard of care.

What is the risk my child will have the same disorder I have?

Below are the estimated chances of having several psychiatric disorders. General lifetime risk is the chance that a randomly chosen person will get the disorder. If you already have the disorder, the first-degree relative risk is the chance that your first-degree relative (child, parent, or sibling) will have the disorder as well.

Adapted from: Finn, Christine T. and Smoller, Jordan W. (2006). Genetic Counseling in Psychiatry. Harvard Review of Psychiatry, 14:2,109-121.

My attention is poor and I procrastinate and can’t get things done. Do I have adult ADHD?

Many of the symptoms of adult attention-deficit/hyperactivity disorder (ADHD)—such as poor concentration, memory problems, procrastination, irritability, and restlessness—are also common in mood and anxiety disorders. For example, most people with significant anxiety disorders will have a terribly difficult time concentrating and completing projects because they are worrying about imagined failures or busy avoiding day-to-day problems. As well, poor concentration is a diagnostic criterion for major depressive disorder.