We often hear that counseling sessions in psychiatry are conducted by different people who can also prescribe drugs to mental health patients. Perhaps, a nurse or a social worker cannot prescribe psychotropic drugs, but it looks like a counselor, a psychologist, and a psychiatrist can all do that. Indeed, all of them can provide counseling, but only psychiatrists and nurse practitioners are licensed to prescribe psychotropic drugs.
The difference between a therapist, a psychologist, and a physician lays in their training and education. Psychiatrists have a Doctor of Medicine degree. They attend medical school than do a residency in psychiatry with the further training and licensing. Psychiatrists are often the only people authorized to prescribe medication and they deal with severe mental disorders. Psychiatric nurses do not have as deep education as a psychiatrist but they certainly are trained and licensed accordingly.
A psychologist has a doctorate degree in psychology. They can work as therapists or teach at universities and conduct a psychological research. In most states, psychologists cannot prescribe medication. Still, they work with mild-to-severe psychological conditions.
A counselor usually provides therapy to individuals and families. This is a Master’s degree psychotherapy professional who focuses on routine life issues. They do not deal with severe conditions and do not prescribe medication. Similar to them, marriage and family therapists work with couples.
Dissociative identity disorder (an old name – multiple personality disorder) is a disconnection between one’s thoughts, memories, and identity. A mild form of disconnection is common to most of us, like daydreaming in the middle of the project. Dissociative identity disorder, however, makes people permanently absent from their real-life environment. The patients deal with a memory loss and a blurred sense of identity as though they are being detached from their self. They also have difficulties coping with everyday stress and staying in relationships with others, however, these are not direct symptoms of any mental disorder.
A distinct feature of dissociative identity disorder is the presence of alternative identities. The patient can feel the presence of other people talking inside their head, influencing the patient’s action, and taking control of them. Unlike any imaginary friends, these alternative identities look quite realistic. A person can even describe their voice, manners, and small details of appearance. The patients change identities for days or hours if they feel that some of them have taken over.
Dissociative disorders develop in response to traumas. People with multiple identities recognize physical, sexual, or emotional abuse as well as a life-threatening disturbance that happened in their childhood. Most patients with personality disorders have developed them in the childhood and were unable to cope with them as adults.
Like with most psychiatric disorders, there is no other treatment for dissociative personality disorder than medication and psychotherapy. The effectiveness of talk therapy depends on the experience of a therapist, and the range of antidepressants and antipsychotic drugs is almost the same for all in mental care facilities.
Everyone’s favorites, pets give us a considerable boost of positive emotions. When friends are not there to lift our spirits and one’s sweetheart is engaged in their business, it is a perfect time to cuddle with pet cats and dogs. They are most likely to be cheerful and they can hardly accuse us of ignoring them the other day. Besides, pets are good therapists. Specially-trained therapy dogs help patients with such serious conditions as Alzheimer’s, dementia, autism, and post-traumatic stress disorder. A four-legged buddy is a steady cure for depression, not even to mention a Sunday-night melancholy.
There is no magic in pet therapy. Petting a furry little friend, we bring comfort to the animal and to ourselves. The softness of their fur and the warmth of the body boosts the release of oxytocin that fights stress by reducing cortisol. That is why we feel an instant relief holding a pet in our arms.
A small walk in the park is often the thing we need to take the weight of the world off ourselves. And we can easily arrange an unplanned fresh-air therapy session if we have a dog. Animals are most likely to make you play with them or go out. Use this time for reflecting, socialization with neighboring dog-owners, and breathing fresh air in the park. Walking out with a pet is a brilliant idea for a sedentary person, but even sitting in the house we can get the relief we need at this very moment. Living with a pet, we do not feel entirely isolated. When there are no other people to talk to, we can always confide our troubles in our furry friend. Perhaps, we do not need a therapist when we have a good pet always ready to cheer us up.
Neurofeedback is the form of monitoring the brain activity that can help the brain function more effectively. Real-time brain activity is displayed with the use of electroencephalography. Video or sound marks desirable and undesirable activity so that the patient can react and facilitate a positive change in their brain. Physicians claim that if we can measure brain activity, we can learn how to make it better. We do not need drugs if we can regulate our brain by ourselves.
As a form of self-regulation, neurofeedback is used to improve brain function. It is common for treating anxiety-depression spectrum disorders, attention deficit, behavior, and sleep disorders. To get a neurofeedback, one shall apply to their mental health provider. Psychologists and family therapists can do it as well. They apply electrodes to the scalp that further transmit the signal to the computer. The patient can see their brain dynamics and they attempt to change it. It looks like a graph of frequencies, some of them to be promoted, others to be suppressed. A patient sees it as a video game they play with own brain.
A neurofeedback is not a universal cure for mental health patients. However, it works well with organic brain disorders that are hard to cure. Neurofeedback works best for a dysregulation as it is not a disease. Using neural training, we can learn how to regulate brain activity and align brain processes. The technique is applied to relieve seizures, help with sleep problems, and cope with anxiety and depression.
Mental conditions do not necessarily make patients locked inside the hospital settings. There are partial hospitalization and intensive outpatient programs tailored for patients to attend their healthcare provider without an overnight stay. However, the type of care depends on the severity of symptoms and needs of the patient. The patient can get admitted to a mental hospital in two cases. They either sign themselves in if they feel overwhelmed by their conditions or they are admitted by a doctor or the police if they are considered dangerous for themselves or for the others.
There is no universal standard of how a mental health hospital shall work. Most of the establishments in the US adjust to the needs of their patients so that each of them may have a different experience from their stay in such institution. Patients together with their doctors make decisions on the psychiatric medication they take. In case of involuntary admission, medication can be given without the consent of the patient. Fear of a mental hospital for many is based on the fear to lose autonomy over one’s own body and mind.
A daily routine of most inpatients of a mental health hospital is similar. As a part of their treatment plan, group therapy is facilitated by a psychologist or social worker. It may include any specific therapy (cognitive behavioral or art therapy) or it can involve discussion of treatment issues. Group therapy is usually designed to suit most patients in the facility. Individual therapy looks more like a counseling. Dialectical behavior therapy and cognitive behavior therapy are common treatments for inpatients. Between therapy sessions, patients have a lot of time to relax, reflect, work, or study, if possible.
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