The mental health field is expanding at a rapid rate. According to the World Health Organization, one in four people will suffer at some point in their lives from a mental health or neurological condition. As of 2017, roughly 450 million people across the world were living with a mental health condition causing disability.
While that’s a rather shocking number, it speaks to the huge need for qualified people who are committed to the field of mental health. It also translates into opportunity if you are looking to make a difference in the lives of others and would like to embark on a reliable career that will be demand for years to come. Whether your interest lies with children, teenagers, adults, the elderly, or sociocultural groups with specific mental health challenges, there is much you can do to help.
What Is Psychiatry?
Psychiatry is the primary branch of mental health work that has its roots in medicine as a treatment option, rather than the application of non-medical therapies, typically referred to as “talk therapy”. Psychiatry is distinguished from other branches of psychology by its combined approach to the diagnosis and treatment of mental health disorders through both therapy and medication. A psychiatrist’s approach to social, emotional, and behavioral disorders is grounded in the best practices of psychology, but also seeks to identify and treat chemical imbalances that give rise to adverse behavioral and physical conditions.
To prescribe and/or dispense medication, psychiatrists need a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) to meet the legal guidelines to practice. Psychiatrists receive full medical training, including an intensive study of biological and life sciences, biochemistry, pharmacology, anatomy, physiology, and pathology, while also engaging in the comprehensive study of psychological concepts, principles, theory and practice.
The need for psychiatric treatment may develop over time in ways that are not obvious to the patient, or may be caused by dramatic events, such as a personal crisis or sudden life change. Congenital or developmental disorders, anxiety and depression, and more severe conditions such as schizophrenia, bipolar disorder or psychosis are also common reasons to seek out psychiatric help. In each case, the mental health challenge facing a patient make it difficult for them to live happy, fully-functioning lives, and it’s the role of the psychiatrist to help them find a solution.
What Does a Psychiatrist Do?
Psychiatrists act as specialized physicians. They can order and perform tests, and use a variety of other assessment techniques to identify the underlying issue affecting a patient. A few common psychological assessments include the classic Rorschach test or simple talk therapy. Common medical assessments include the ordering of blood tests or CT scans.
Psychiatrists may also review family medical and psychological history, past experiences or traumas in the patient’s life, and recent events- all of which may contribute to their current mental state. Once they have a comprehensive picture of the factors impacting a patient’s physical and mental health, they can construct a diagnosis and craft a treatment plan.
A psychiatrist’s duties may vary significantly depending on their patient population and work setting, but some of the most common include:
- Interviewing and evaluating patients
- Observing and examining behavior
- Reviewing medical and family histories
- Administering and interpreting psychological tests
- Communicating with family members or other members of the support team
- Developing treatment plans that combine therapy and medication
- Monitoring the effects of medications and adjusting as necessary
- Supervising staff
- Overseeing medical students and residents
- Maintaining written histories of patient interactions and progress
- Organizing and filing these and other documents
- Contributing to the medical field through contributions to journals or other industry-specific publications
The foundation of a psychiatrist’s practice is talk therapy. This is otherwise known as psychotherapy, a field popularized by Freud and his beliefs in the supremacy of the subconscious. Today, however, it applies to any of a wide range of talk therapies, including:
- Cognitive behavioral therapy, which the psychiatrist tries to help the patient find healthier links between thoughts and behavior
- Art therapy, in which the use of art helps patients make sense of mental difficulties
- Counseling and couples counseling
- Group therapy
- Hypnotherapy, in which a regressed state is induced to help the patient remember past events
- Bereavement counseling, for patients who have recently experienced a major loss
These are not the only types of therapy, of course, but they represent a few of the most common techniques in the psychotherapy toolkit. Psychiatrists may use these with patients, meeting them just a few times a month or, in more intensive settings, several times a week. They augment these approaches through prescribing and administering medications. These include:
- Antidepressants, used to treat anxiety, Post-Traumatic Stress Disorder (PTSD), panic disorder and depression
- Hypnotics, used to induce sleep
- Mood stabilizers, for help with bipolar disorder
- Stimulants, used to treat Attention Deficit Hyperactivity Disorder (ADHD) and other attention-related issues
- Sedatives, for anxiety and insomnia
- Antipsychotics, used to treat hallucinations, delusions, schizophrenia, severe bipolar disorder, and other conditions which represent a break from reality
Most frequently, psychiatrists prescribe medications in tandem with therapy, but may sometimes opt for only one or the other. In rare cases, psychiatrists may prescribe electroconvulsive therapy (ECT), a treatment performed under anesthesia that involves administering small amounts of current to the brain. This treatment is safe, and is credited with the reversal of many negative conditions through simple changes in brain chemistry.
Overall, the range and combination of psychiatric treatments is almost as varied as patients themselves, and a good psychiatrist will be able to determine what is best for any individual or group at the time of treatment.
Typical Work Environment & Occupational Challenges
While psychiatry can be a very rewarding profession, it can also be a challenging one. Psychiatrists often witness crippling human suffering, stemming from personal trauma. Psychiatrists also treat devastating mental disorders, which completely incapacitate a person or change them irreparably. These situations can become overwhelming if you’re not careful to maintain professional separation, and take steps to actively safeguard your own mental health and well-being.
However, psychiatrists also experience major triumphs. When they successfully work with a patient to restore cognitive function, cope with severe crisis, reduce anxiety, or find ways to manage congenital or genetic conditions, the satisfaction can be extremely rewarding (and validating of their career choice).
Psychiatrists work in a variety of settings, from their own private practice – in which they pay for their office or building – to hospitals, mental health clinics, psychiatric hospitals, military organizations, schools, nursing homes, and governmental institutions. Many psychiatrists work in multiple settings and travel to meet clients or consult with other medical professionals.
What Is the Difference Between a Psychiatrist and a Psychologist?
The main difference between psychiatry and psychology, as mentioned above, is medical training. Psychologists undergo significant training as well, earning a master’s before they are allowed to practice and often earning a doctoral degree to enhance their knowledge and specialize in certain fields.
However, while psychologists and psychiatrists may use nearly identical means of psychotherapy (talk therapy), psychologists are prohibited by law from dispensing medication. They also do not undergo medical training or residency, but instead complete their training through a practicum or apprenticeship with another practicing psychologist.
Psychiatrist Salary & Job Outlook
As of May 2019, the Bureau of Labor Statistics (BLS) reported that psychiatrists earned a median salary of $220,380 – higher than family practitioners, physicians, surgeons, internists, and pediatricians.
Overall employment of psychiatrists is projected to grow about 4% between 2019 and 2029.
Psychiatry Jobs & Job Description
The main job of a psychiatrist is to evaluate, treat and follow up with patients who are suffering from mental disorders. The role includes practicing psychotherapy and prescribing medication in tandem. A psychiatrist’s role requires that them to communicate effectively with other colleagues and medical professionals, and to explain complex medical issues in a plain, understandable manner when speaking to patients and their family members.
To do so effectively, you will need a thorough knowledge base and a wide variety of skills, including:
- A complete understanding of current and past psychological thought and best practices
- The ability to listen to patients and respond with respect, as well as exert a positive bedside manner
- Calm, rational and nonjudgmental skepticism of what you hear, and the willingness to challenge their patients’ views and beliefs gently
- Good organization and documentation skills
- Excellent decision making processes and good instincts about your patients
- Analytical skills
- Ethics that adhere to the highest code
- A thorough understanding of medications, dosages, side effects and interactions
- The ability to collaborate well with other physicians, specialists and family members
- A willingness to share findings and contribute to the overall richness of the psychological field
Many of these skills take time and practice to develop, and that’s okay. You will begin to gain these skills in school, then continue to hone them through residency and the life of your career.
Psychiatry Degrees, Education, and Training
To become a psychiatrist, you must first complete a bachelor’s program. This includes 4 years of study with a pre-medical focus, taking courses such as biology, chemistry, human anatomy and physiology, mathematics, physics, psychology and other social sciences. While you don’t have to earn your bachelor’s degree in pre-medicine, it helps to do so, because you will have already completed a long list of pre-requisites for medical school. Students also need to pass the Medical College Admission Test (MCAT) before applying.
Like the bachelor’s degree, med school typically takes 4 years. The first two years focus on academic work in the classroom while the latter two are mainly concentrated around clinical practice. During this period, students will complete rotations in different parts of a hospital or clinic, while psychiatry students usually receive extra training by clerking with practicing psychiatrists.
Afterwards, you must complete residency. During this time, you receive the designation of a practicing physician, but require the oversight of a professional. This often takes place in a hospital, inpatient program or outpatient center where you will assess, diagnose and treat patients as you would when practicing on your own. Residency may extend between 2 and 4 years, and you may be required to take a test to officially complete it. Either way, most psychiatrists choose to take a written and oral exam through the American Board of Psychiatry and Neurology, earning board certification. This must be retaken every 10 years.
If you wish to specialize further, you can complete addition coursework to focus on sleep medicine, children or adolescents, geriatric populations, pain management and more. Others choose to pursue Doctor of Philosophy degrees (PhDs), which will enable them to conduct in-depth research in their fields.
No matter which route you take, know that the path to psychiatry is long and sometimes difficult, but can be very rewarding. In addition to making a nice income, you will be helping people, which can have far reaching affects for the community you live in.