Psychiatric Disorders

Psychiatric disorders are medically recognised health conditions that cause marked changes in a person’s thoughts, feelings and behaviour and seriously affect daily functioning, relationships and overall quality of life. Often misunderstood as a lack of willpower, a flaw of character or self-indulgence, they are in fact no different from other medical conditions such as diabetes, heart disease or asthma. The only thing that sets them apart is the organ they affect: the brain, and its function, the mind. The complexity of the mind adds to the mystery and stigma surrounding psychiatric disorders. Modern science, however, shows clearly that they arise from a complex interaction of biological, genetic, psychological and social factors. Approaching the subject free of prejudice, with a scientific and above all humane perspective, is the first and most important step for patients and their families alike. On this page we look more closely at this broad and important field of psychiatry: what the term psychiatric disorder means, the most common types, and how they are diagnosed and treated. Remember that mental health is an inseparable part of overall health, and seeking help is one of the greatest forms of care you can show yourself.

What are psychiatric disorders?

Psychiatric disorders describe a wide range of health problems that result from changes in brain function and affect a person’s mood, thinking and behaviour. For a condition to be defined as a “disorder”, it must meet the diagnostic criteria set out in internationally recognised manuals such as the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), published by the American Psychiatric Association. The common idea behind these criteria is that the symptoms cause clinically significant distress or loss of functioning in social, occupational or other important areas of life. Modern psychiatry works within the biopsychosocial model, which holds that these disorders cannot be reduced to a single cause.

The biopsychosocial model

This model highlights the interaction of three main groups of factors in understanding psychiatric disorders and their symptoms. Biological factors form the foundation. Genetic predisposition is one of the most important biological risk factors: a family history of depression, bipolar disorder or schizophrenia can increase a person’s risk. Genetics alone is not decisive, however; it only creates a predisposition. Imbalances in brain chemistry, particularly in the levels of neurotransmitters such as serotonin, dopamine and noradrenaline, underlie many disorders, and differences in brain structure or dysfunction in brain circuits are further parts of the biological picture. Psychological factors include a person’s experiences, ways of thinking and coping mechanisms.

Trauma, neglect or abuse in childhood are serious risk factors for psychiatric disorders later in life. Insecure attachment styles formed early on can lead to difficulties in later relationships and in coping with stress. Negative, unhelpful thought patterns known as cognitive distortions (for example “I will always fail” or “Nobody loves me”) can be both a cause and a consequence of depression and anxiety. Personality structure and limited coping strategies also add to psychological vulnerability. Social factors cover the environment a person lives in. Chronic stress, poverty, unemployment, social isolation and discrimination put considerable pressure on mental health. Problems in family relationships and major life events such as divorce or bereavement can trigger a disorder in vulnerable people. Cultural expectations and social stigma can also delay or prevent help-seeking and worsen the course of illness. In short, psychiatric disorders are complex, many-layered conditions: genes may load the gun, a traumatic event may pull the trigger, and the social environment may shape the outcome. Treatment therefore needs to address all three areas.

The most common psychiatric disorders and their symptoms

Psychiatric disorders cover a wide spectrum, each characterised by its own cluster of symptoms. Below are some of the main categories seen most often, and what living with them can feel like. This classification is essential for making a diagnosis and planning the right treatment.

1. Mood disorders: conditions involving persistent and severe changes in emotional state.

• Major depressive disorder (depression): much more than feeling sad. It involves a low mood lasting at least two weeks, loss of pleasure (anhedonia), feelings of worthlessness and guilt, loss of energy, changes in sleep and appetite, difficulty concentrating and recurrent thoughts of death or suicide. The world can seem to have lost its colour.
• Bipolar disorder: mood swings between two extremes. Periods of depression alternate with periods of mania or hypomania, marked by elation and excessive energy. During mania a person may talk a great deal, need little sleep, take risks (overspending, reckless driving) and show inflated self-esteem (“I can do anything”). These cycles can turn a person’s life and relationships upside down.

2. Anxiety disorders: the core feature is excessive, persistent fear, worry and anxiety in the absence of real danger.

• Generalised anxiety disorder (GAD): constant, uncontrollable and disproportionate worry about health, work, money and other matters. A sense that “something bad is about to happen” dominates, accompanied by restlessness, muscle tension and fatigue.
• Panic disorder: sudden panic attacks of intense fear and terror, with palpitations, shortness of breath, trembling and a choking sensation; the person may feel they are having a heart attack or dying. Between attacks, people often live with the fear of having another one (anticipatory anxiety).
• Social anxiety disorder (social phobia): avoidance of social situations because of fear of being judged or evaluated negatively by others.

3. Obsessive-compulsive and related disorders:

• Obsessive-compulsive disorder (OCD): distressing, intrusive and repetitive thoughts, urges or images (obsessions), together with repetitive behaviours or mental acts the person feels driven to perform to reduce the distress (compulsions). Fear of contamination with cleaning compulsions is among the best-known examples. OCD can take up a large part of a person’s time and seriously restrict their life.

Although these psychiatric disorders take many forms, what they share is that they cause suffering and can leave a person feeling they have lost control of their life.

Diagnosis and the importance of psychiatric assessment

An accurate diagnosis is the cornerstone of effective treatment for psychiatric disorders, and it requires careful expertise. Because definitive biological markers such as blood tests or X-rays are not yet available for most psychiatric conditions, diagnosis relies largely on what the patient describes, observed behaviour and the clinician’s experience. It is not an act of labelling or stigmatising, but a scientific effort to make sense of a complex situation and offer the most appropriate help. Working with an experienced specialist such as psychiatrist and psychotherapist Prof. Dr. Ali Keyvan helps ensure the right steps are taken from the very start.

A psychiatric assessment usually has several stages. The first interview (clinical interview) is the most important. The psychiatrist listens in detail to the patient’s complaints: when and how they began, how severe they are and how they affect daily life. Beyond the current picture, a comprehensive history is taken, covering past medical and psychiatric history, any family history of similar conditions, childhood and adolescence, relationships, education and work. This holistic approach is essential for understanding the possible causes and triggers behind the symptoms.

Another step is a physical examination and laboratory tests, because some medical conditions can mimic psychiatric symptoms. An underactive thyroid (hypothyroidism) can cause symptoms of depression, while an overactive thyroid (hyperthyroidism) can cause anxiety or manic symptoms. Vitamin deficiencies, neurological conditions and some infections can also affect mental state, so ruling out an underlying physical illness is vital for differential diagnosis. The clinician may also use psychometric tests and rating scales. Standardised instruments such as the Beck Depression Inventory, the Hamilton Anxiety Rating Scale or the Minnesota Multiphasic Personality Inventory (MMPI) help measure symptom severity objectively, assess personality traits and monitor the effect of treatment.

In the light of all this information, the psychiatrist compares the patient’s situation with the criteria of international diagnostic systems such as the DSM-5. Reaching the right diagnosis reduces uncertainty and confusion and shows the patient that they have a known and treatable health condition. This is where hope begins, and it opens the way to an individual and effective treatment plan (medication, psychotherapy or both). Anyone who suspects a psychiatric disorder should be encouraged to see a specialist for this kind of thorough assessment.

Modern treatment and the hope of recovery

One of the most encouraging developments in the field of psychiatric disorders is the range of highly effective treatments now available. These conditions are no longer seen as a fate to be carried for life. With the right treatment and support, people can very often manage their symptoms, regain their functioning and lead fulfilling lives. Treatment in modern psychiatry usually rests on two main pillars: pharmacotherapy (medication) and psychotherapy. The best results are often achieved by combining the two in a personalised plan.

Pharmacotherapy targets the biological factors underlying psychiatric disorders, particularly imbalances in brain chemistry. Different groups of medication are available, including antidepressants, anxiolytics, antipsychotics and mood stabilisers. Antidepressants of the SSRI group (selective serotonin reuptake inhibitors), for example, ease the symptoms of depression and anxiety by increasing serotonin levels in the brain. Contrary to popular belief, these medicines are not addictive and do not change a person’s personality. Their aim is to restore a healthy balance in the brain’s chemistry so the person feels better, regains energy and benefits more from psychotherapy. Medication should always be started, adjusted and stopped under the supervision of a psychiatrist.

Psychotherapy, or “talking therapy”, focuses on the psychological and social roots of a disorder. It helps people understand and change unhelpful thought patterns, negative emotions and behaviours. There are many types of psychotherapy across different schools:

• Cognitive behavioural therapy (CBT): focuses on how negative thoughts (cognitions) and related behaviours affect our feelings. It teaches people to recognise and question these thoughts and replace them with more realistic ones. It is highly effective for OCD, anxiety and depression.
• Psychodynamic psychotherapy: seeks to understand the unconscious conflicts, early experiences and relational patterns at the root of symptoms, aiming for lasting change through insight.
• Dialectical behaviour therapy (DBT): developed especially for people who struggle with emotional regulation, such as those with borderline personality disorder. It teaches skills for coping with intense emotions, mindfulness and interpersonal effectiveness.

Alongside these main approaches, treatment can be enriched with lifestyle changes (regular exercise, healthy eating, good sleep habits), family therapy, group therapy and mindfulness. Recovery does not always mean that symptoms disappear completely. Sometimes it means learning to live with them, managing them and building a meaningful, productive life in spite of them. What matters is not to lose hope in the face of psychiatric disorders, and to take the first step towards help.