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When should one see a psychiatrist?

September 26, 2006

Bollywood (and Hollywood) lore suggests that people seeking psychiatric help are either so violent that they need strait-jacketing, or they are blathering idiots unable to take care of themselves. It’s the simplistic black and white world of the movies where people are divided into two kinds, the normal and the barmy. While most of us know that this isn’t quite true, we might still be surprised to know of the broad spectrum of behavior requiring psychiatric treatment. It’s not just illnesses like schizophrenia and obsessive-compulsive disorders that need treatment but also depression, anxiety, panic attacks, addictions, eating and sleeping disorders, and borderline personality disorders.

Not all sufferers seek help, either because they feel they can cope, or because they think that going to a psychiatrist is a sign of weakness or…madness. This is far from the truth. ‘Most people who visit a psychiatrist these days work, get married, and function as respectable citizens in society,’ says Dr. Bhupesh Velaskar, psychiatrist. The important thing is to recognise the symptoms and seek treatment before there are unpleasant consequences.

It’s possible to recognise the tell-tale signs. For example if a person feels low and disinterested in life, isolates himself from people and has thoughts of death, he needs help. At times a person maybe consumed with powerful emotions like violent rage, racking guilt, or intense jealousy, and the inability to control these emotions results in conduct unacceptable in society, like aggression, hostility and even violence. At times it’s an acute lack of self-esteem and feelings of rejection which cause self-destructive behavior. All this emotional distress can result in a lack of concentration and judgment. ‘When relationships and work is affected because awareness of oneself and surroundings is defective, behavior is bizarre or uncontrollable, judgment in social situations is off the mark, and you perceive things which others don’t, you need help,’ says Dr. Velaskar.

Psychological problems can manifest themselves in physical symptoms as well. ‘Aches, pains and severe exhaustion can be a symptom of depression,’ says Dr. Harish Shetty, social psychiatrist. Palpitations, sweating, tightness of chest can be caused in a panic attack. Sufferers do not hesitate to rush to their GP with such symptoms because it’s alright to admit to a migraine or constipation, but not to depression. And when treatment fails, it’s the family doctor who has to gently tell the patient to see a mental health professional.

People who have never had a psychological illness are the last to realise that they need help, specially if the distress they suffer is triggered by an external event like loss or trauma, or is caused by another person’s behavior. ‘Some psychological problems are caused by loss of a loved one through death, separation, divorce, loss of expectation (cannot have a baby), loss of job or because of physical incapacity due to illness or accident,’ says Ameeta Sanghavi Shah, psychotherapist. When people resist recognising that they need help they can make their situation worse ‘with use of escape measures like addictions or somatize their feelings with body aches, fatigue, head-aches or project their problems on others,’ says Shah.

As a first step a sufferer can seek treatment from a therapist. A therapist helps identify the internal and external factors that contribute to the problem and also such internal and external factors that can help relieve the problem. At times however she has to direct the patient to a psychiatrist. ‘If the person is not responding to counselling, and symptoms endanger the well-being of oneself or others, if the person has suicidal thoughts, is unable to eat, rest or work, then he might need medication. In this case he has to see a psychiatrist,’ says Shah. Psychiatrists not only provide psychotherapy, they carry out diagnostic evaluations, assess physical problems, and if needed prescribe medications and arrange hospitalization.

Serious mental illnesses like schizophrenia where there are clear biological components, can only be treated by psychiatrists. Ofcourse to some extent, every psychiatric problem is influenced by the genes. ‘A mental illness is always an interplay of the genes, environment, age, type of stress and the support system available,’ points out Dr. Shetty.

Once one recognises that a psychiatrist’s office is not a place where the weak or crazy go for shock treatment or sedation, that it’s a place of refuge, a place where one can unburden one’s soul, then it becomes easy to go there. Even normal people like you and me might need to do that, at some point in our lives. No one is immune. Not celebrities. Or successful professionals. And well, if you can run to the doc at the hint of a sniffle, why not when your mind is under strain? It’s only when you get the help you need that you can lead the life you deserve, and live it to the fullest.

(Published in The Times of India in 2005)

Related Reading: Coping with depression and grief, Not eating the right foods affects mood.
More Reading on Mental Illness

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12 Comments leave one →
  1. vishal permalink
    May 4, 2007 12:41 pm

    hello can any1 here find me the contact details of dr.harish shetty.

  2. Pranali permalink
    May 23, 2007 11:47 am

    Hey,
    Can anyone give me the contact details of Dr. Namrata Bijur?

  3. Wayne M permalink
    October 1, 2007 4:19 am

    Who should see a psychiatrist?
    I saw a new doctor last week and was asking him about signing some forms for protein supplements as I am on disability and can’t put on weight easily. I attend public meetings often and make a size-able contributions and have sharp analytical skills. It turns out the past doctor who I gave upon on, one and two years ago because of misdiagnosis is a friend of his as they are both from South Africa and have slight German accents. Why do i mention this, just for a description of them
    After five minutes, tops, he puts the abovre question to me. In response I ask him why he never attends city hall meetings or any other public meetings. He says I am accusing him. My social worker, a few days later laughed at his behavior as ridiculous.
    Next, should publicly elected politicians consider seeing a psychiatrist in an effort to be the most grounded and valuable to their constituents. I feel that their, all of them, attitude and misinformaton and lack of research related to the lack of affordable housing is a mental state that caused millions of dollars of pain, mysery and crime to communities everywhere. Thank You in advance for an answer.

  4. October 1, 2007 2:11 pm

    Wayne, thanks for visiting. I hope my post answered some of your doubts, but about your individual situation its very difficult for me to give answers. Also, I do not think a person’s profession should preclude him from seeing a psychiatrist.

  5. October 1, 2007 2:34 pm

    Nita;

    I only came across this post because of your latest comments section. Very interesting.

    I had written on the Indian Economy blog sometime ago about mental health issues in India. All hell broke loose and I was amazed to see how the anonymity of the web can bring sad experiences out in the open to be shared and how help can be sought…

    My rakhi-brother is a psychiatrist and a Professor at Harvard Med School. In a discussion he said to me that most of the times, diagnosis is so hard and ‘patients’ so resistant to seeking help that everyone usually waits for an ‘episode’ to happen before psychiatrists can intervene.

    While an episode may reduce a patient’s reluctance to seek help, it does not necessarily increase compliance with the drug regime which means that recurrence is a finite possibility.

    What really drew my attention was his view that diagnosis can be difficult. Many ‘disorders’ can have similar symptoms. It can be argued how many ‘disorders’ are outcomes of a social constructivist framing of the world, and how many real. Not all disorders yet have brain scanning based evidence to help. New disorders are constantly being created too.

    Another thing is that fine line between inability to cope and a full blown mental illness. The former can be helped by behavioural psychologists, the latter needs a psychiatrist and a drug regime. I think we have the former professional in greatly short supply in India; the latter are also relatively rare. In fact recent research in the US shows that a sympathetic friend can be as useful as ‘talk therapy’ with a psychologist. In the cases I have seen closely, psychiatrists do NOT provide talk therapy. Those are two different kinds of trainings and professional preferences, linked but different.

    Clinical practices in India re mental health can also be suspect. I know a lady who has been taking the same 1st gen medication for paranoia for 11 years, which were given to her by the family GP who is not a psychiatrist at all. This is cause for a malpractice lawsuit elsewhere but India! Her parents did not take her to a professional psychiatrist due to her resistance and their fear of stigma. Now things are worse and her parents worry who will look after her after they are gone… Her resistance is greater and despite her education and professional career, her family does not know what to do next.

    Alas I think in the juggernaut of growth, many support systems in India are breaking down. If there is stigma and poor awareness afflicting mental health, we will soon need more psychiatrists that we do now; meanwhile paid friendships in psychotherapy may help. But first step, awareness I think.

  6. October 1, 2007 3:41 pm

    Thanks Shefaly for that very informative comment! Actually there is a huge shortage of personnel in India in this field. Many hospitals hire unqualified people and so do schools! Plus the resistance to go to a psychiatrist. But this is changing gradually. Its a slow process to break down people’s resistance but its happening from what I know after talking to some psychiatrists. In fact it is the duty of the family doctor or the counselor to persuade.

  7. Rick permalink
    November 26, 2009 2:11 pm

    Hi, I am suffering from depression which happens every few years and lasts for many months. I have been able to get through and eventually over it in the past, but this time the period is too disturbing and difficult to handle. I have read on many websites, blogs and posts that the sooner I see a professional, the better it would be for me. I am however reluctant to see a psychiatrist and would rather want to see a therapist or counsellor who might be able to diagnose and guide appropriately. Can anyone please share the contact details of any such therapists in Pune?

    Help would be greatly appreciated.

    Thanks

  8. Czarina permalink
    June 19, 2010 5:15 pm

    i need help for my nephew who is not studying at all. he is 8 years old.

  9. yogitha maile permalink
    August 10, 2010 7:23 pm

    hello…

    myself yogitha frm mumbai. 23 yrs of age i m student studying in tybom. i got a personal problem due to where i cant concentrate on my studies when i am alone but i do concentrate at my classes. i cant discuss my problem to another. i can have dr. harish shetty’s clinic contact number so that i can b open and discuss.dr. shetty came to our college for seminar. it was long back around 3 years back.i had problem at time too. but consequences were not that higher at that time but its at a higher level. i lost myself. i dont know what is my aim. what is my career. which profession i should choose. i am very depressed and frastrated. do help!!!!!!!!!

    PLEASE…….
    waiting for ur reply…..

  10. NARAYANJOSHI permalink
    June 3, 2011 3:22 pm

    Dear Sir/Respected madam,

    It would be very kind of you, if your goodself, can help us with Contact details of Mr.Dr.Harish Shetty – Psychiatrist.

    AWAITING YOUR KIND REPLY.

    With Regards,

    N.Joshi

  11. November 12, 2012 11:43 am

    Dr. Harish Shetty: 9820032178

  12. Chin Janecka permalink
    February 4, 2013 7:23 pm

    Aside from being mega-rich and famous, what do David Beckham and Leonardo di Caprio have in common? Both suffer from Obsessive-Compulsive Disorder (OCD), Obsessive-Compulsive Disorder is an anxiety disorder that is characterized by an obsessive or distressing thought. It may also involve compulsions or “rituals.” It is such a serious concern that event the World Health Organization has labeled OCD as among the top 10 most disabling illnesses faced by society today. In the United States alone, it is estimated that 3.3 million people are suffering from OCD.,

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