The Future of Psychiatry

Psychiatry has long relied on traveling to a book-lined doctor’s office and sitting for an hour on an uncomfortable or overstuffed couch while you talk. Based on these conversations, a psychiatrist determines the best treatment options for a patient. This technique often runs into resistance or outright dishonesty that can hinder or halt treatment. That stereotype may be a thing of the past, as new tools and techniques emerge to bring psychiatry into the 21^st century. What new and exciting changes are sweeping the field of psychiatry and how will they alter how we look at mental health and the treatment of mental illnesses? Genetic Roles Are Key Many mental illnesses have been considered genetic based on a patient’s family history, but new advances in human genome mapping and genetic targeting have allowed researchers to tie specific genes or gene errors to many mental illnesses common today, such as depression, bipolar disorder, schizophrenia and even substance abuse. A study published in the Lancet in 2013 found that two specific genes that help to regulate the flow of calcium into the brain’s neurons, CACNA1C and CACNB2, have been tied to a variety of mental illnesses. Having this knowledge can both aid psychiatrists in diagnoses and help them develop an effective treatment plan that will specifically treat the affected genes or areas of the brain that are related to these specific gene errors. Aiming for Neuroplasticity The brain is one of the few organs that does not bounce back after injury or illness, and studies both recent and not so recent have found that mental illnesses such as depression and mood disorders actually do have a physical impact on the brain. While this has opened new doorways and effectively gotten rid of the idea that mental illness is just a chemical imbalance, few methods can improve or reverse the structural atrophy that occurs during a prolonged or lifelong mental illness. Scientists are working on “brain repair” strategies, which will allow them to take steps to optimize the healing environment, including the use of products like nerve growth factors and other techniques. Many of the existing drugs that are used to treat these mental illnesses and mood disorders already have these effects. It’s Not Just in Your Head Since the diagnosis of mental illnesses began, they were considered just that — mental. No one considered the fact that these illnesses might have an effect on a patient’s physical well-being in addition to their mental health. Now many psychiatrists are all but abandoning traditional treatment techniques in favor of a whole-body treatment plan, since studies have demonstrated a distinct link between physical and mental health. Patients who suffer from chronic physical ailments are much more likely to suffer from mental illnesses as well, and vice versa. Skip the Office Visit One of the most common things preventing people from seeking out psychiatric help is fear of the stigma attached to mental illnesses, or simply a fear of doctors in general. Many people who suffer from extreme anxiety disorders are terrified of the idea of visiting a psychiatrist even if it enables them to live a more functional life. Telepsychiatry is a new technique that allows patients to speak with licensed psychiatrists from the comfort of their own home by means of videoconferencing. In addition to helping people with anxiety issues, this can enable psychiatrists to reach other patients in need, such as the elderly or the disabled who may not be able to travel to an office setting. The technique decreases travel time not only for the patients, but for doctors who may be on call and unable to reach a treatment facility. It could even be used to make sure people are able to continue their treatment plans in the event of a natural disaster or other occurrence that prevents travel. The Introduction of Pharmacogenomics Pharmacogenomics is a term used to describe how a person’s genetic predispositions affect how he or she metabolizes medications. While previously disregarded, these tendencies can drastically change how effective a patient’s treatment plan is. This approach disregards the traditional “one size fits all” drug treatment plans that currently exist and instead creates a customized treatment plan that prescribes medication based on how a person’s body absorbs and metabolizes different drugs. Pharmacogenomics is still a new field, and limited in its applications. It’s currently only being used regularly in a few academic settings around the United States, but it is one of the biggest breakthroughs in the field of psychiatry in the last couple of decades. Catch It Early Much like cancer and other debilitating physical ailments, one of the strongest tools in a psychiatrist’s arsenal is early diagnosis and intervention. With all of the genetic advances that allow researchers to determine if a person is at risk for mental illness, in some cases psychiatrists are able to begin to create a treatment plan before symptoms of these illnesses even manifest in the patient. While it’s important not to jump the gun, so to speak, early diagnosis and treatment can create a way for these illnesses to become manageable before they have a negative impact on the patient’s life. There are far too many cases of patients losing jobs, families or even their lives because of a mental illness that is diagnosed incorrectly or too late. With all of these amazing new advances in the field of psychiatry, there is no reason for us to be playing “catch up” with treatment plans anymore. Conclusions Many of these new and amazing techniques are still in their infancy but once they hit the mainstream, the way we treat mental illnesses will be changed forever and hopefully for the better. Every day we learn a little more about the human genome and how the human brain works — let’s use those breakthroughs to help improve life for every human being.