psychiatry IS medicine

today’s topic is a bit of an opinion piece. In my opinion, psychiatry has always been a grab bag. Often referred to as part of the “soft sciences,” even though it’s a medical discipline. I don’t know if it will ever be the hard science that many medical disciplines are. We’re certainly a very long way off from blood tests, genetic testing, DNA testing or anything like that to diagnose or guide treatment for most psychiatric disorders. Those technologies are really in their infancy and are only of use and very specific cases if at all.

and in a discipline that is not so cut and dry, many mistakes have been made over the years. Off the top of my head, the pathologizing of homosexuality. Reliance on dream interpretation and psychotherapy. In fact, until the DSM-5 it was not kosher to diagnose a child with autism and ADHD. Of course, we now know, that if you have either of those conditions, you’re more likely to have the other than the general population.

personally, I think psychiatry has suffered from I need to overcompensate the fact that it’s not so cut and dry by trying to create very strict structures, guidelines, do’s and don’ts that are often two black and white and miss the gray of what psychiatry is at its heart.

but I think that we are now at a crossroads with psychiatry. What we refer to as psychiatric disorders we are finding more and more are neurobiological brain disorders. That means they’re physiological. Much like space, and the deep ocean, the brain is largely unexplored and under understood. But what we do know, is that there are biological underpinnings for ADHD, for schizophrenia, for bipolar, for depression.

whenever I take a new client through my ADD ucation session, I tell them, if you get nothing else out of this know that what you’re dealing with is real, medical, brain based, and not a psychological character flaw.

My Hope is that this understanding will lead to decreased stigmatization of mental health and mental disorder. It is also my hope, and I think I’m already seeing this, that psychopharmacology becomes yet more important in the overall toolkit of a psychiatrist. You have to address the physiological in order to address the psycho emotional, in my opinion.

sometimes it’s just a cigar. And most of the time, it doesn’t even matter if it’s a cigar if you’re not on the right meds.