When someone says, “psychiatrist,” the word “shrink” likely comes to mind. It’s not a particularly flattering name for a medical specialty; the equivalent of “pimple-popper” for dermatologists or “gas-passer” for anesthesiologists. Curiously, the appellation is unique to the U.S. — there are no equivalents in other languages and the term is not commonly used in other English-speaking countries.
So where did the term “shrink” come from? It’s said to have originated in late 1940s Hollywood, when adventure films featured indigenous tribes of the Amazon who brandished the shrunken heads of their enemies as totems of power. As the story goes, on the set of one such film, a studio executive complained about the production being over budget and behind schedule due to a temperamental actress. He supposedly remarked, “We should send her to a psychiatrist to have her head shrunk.” The name stuck.
Hollywood didn’t just give psychiatry its sardonic name, but has also contributed to its unflattering public image. Movies have portrayed psychiatrists as quirky, weird or depraved — think Gregory Peck in “Spellbound,” Lauren Bacall in “Shock Treatment,” Michael Caine in “Dressed to Kill” and Kevin Spacey in “Shrink,” to name a few.
Yet despite our society’s tendency to poke fun at the profession, psychiatry is the medical specialty that deals with the parts of the brain that control most mental functions, including thoughts, feelings and perceptions. In fact, a full 25 percent of the global population will develop a mental disorder before they die, the World Health Organization estimates. Even if you are not one of them, traumatic events and the vicissitudes of life often cause mental states and symptoms that require temporary professional help. Thus, most people will need psychiatric help at some point in their lives, whether it’s for themselves or their family.
[See: 11 Simple, Proven Ways to Optimize Your Mental Health.]
However, while an upset stomach or joint pain might prompt you to call your primary care doctor or consult an orthopedist, would you know what to do if you or a loved one became too fearful, moody, intoxicated (once again) or otherwise started acting strange? The first question to ask yourself is whether this behavior is “normal” and inconsistent with the individual’s circumstances. If not, with whom should you consult — a psychiatrist, psychologist, therapist (of any discipline), clergyman or self-help guru? In most instances, people can’t readily answer those questions and thus, don’t seek help. As a result, nothing is done until the problem becomes so severe that it can no longer be avoided or until something bad happens, which often is too late.
At social events, people I meet invariably ask what I do for a living. When I reply that I am a psychiatrist, they either clam up and awkwardly change the subject, or begin to reveal intimate and personal problems that are usually reserved for long-trusted friends and family members, if anyone at all. Even if they don’t disclose their troubles on the spot, the odds are good that they will contact me in the ensuing days or weeks, asking for personal or family advice.
The fact that so many people end up soliciting my clinical guidance for their psychiatric concerns through chance social meetings — instead of seeking treatment through the usual medical channels — attests to two important facts: the frequency of mental illness in the population and the grave discomfort that people feel toward psychiatry.
At the same time, who can blame them? There’s no question that psychiatry has done its share to create this disquiet and wariness. Only a few generations ago, psychiatrists possessed ossified theories of and lacked effective treatments for mental illness. But progress in science and technology over the past 50 years has dramatically changed the scientific basis and therapeutic capability of psychiatry. Today, the greatest hindrance to effective care is not a gap in medical knowledge or a shortcoming in effective treatments, but the enduring social stigma of mental illness and the understandable — but no longer warranted — lack of confidence in the competence of psychiatrists.
[See: Apps to Mind Your Mental Health.]
So when should you see a shrink? The answer relates to how severe your symptoms are, how long they’ve lasted and how much they interfere with your ability to go about everyday life. We all may experience a very wide range of emotions and mental dislocations over the course of our lives or even day to day, but our built-in resilience should enable us to adapt and regain emotional stability and mental functionality soon enough. In the wake of extreme events, such as the death of a loved one, a natural disaster or the loss of a job, this process can take longer. However, if such psychic disruptions occur for no reason, are blown out of proportion compared to their cause, persist for months or interfere with your ability to work or perform ordinary activities, it’s probably time to seek professional consultation.
Although not everyone needs a psychiatrist to treat his or her problem, psychiatrists are highly-trained health professionals. They are also the most expensive. That’s why it’s helpful to know that in cases where medication and medical management aren’t necessary, psychologists, social workers, nurse practitioners or lay therapists may do just as well providing your treatment. However, it’s a good idea to visit a psychiatrist first for what physicians call your “chief complaint” in order to cover all bases. That consultation should provide a diagnosis and recommended treatment plan. You may simply hear, “It’s nothing serious” and receive a recommendation to wait to see if symptoms subside. Or, you may get a more formal diagnosis and a recommendation for treatment. If the psychiatrist doesn’t find hospitalization, medication or any procedure necessary, he or she may recommend that you see another mental health professional who can deliver psychotherapy or other forms of psychosocial treatment depending on convenience, preference and cost.
If you don’t know how to find a referral, start with your primary care doctor. If he or she can’t help, try contacting the psychiatry department of the local medical school or the district branch of the American Psychiatric Association. It’s imperative to find a well-trained and competent psychiatrist, which may require some shopping around.
[See: How to Find the Best Mental Health Professional for You.]
The main thing to remember is to be vigilant and aware of mental disturbances that may occur in you, your family or friends, and not deny or overlook them. If you have any concern about yourself or others, it’s better to err on the side of caution rather than procrastinate or avoid. The only downside to seeking an appointment for evaluation — even if it turns out to be nothing — is the time and money spent. But that’s negligible if the visit leads to a life-changing intervention or staves off an illness that could cause unnecessary distress, disruption, disability or even death.
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When Should You See a Shrink? originally appeared on usnews.com
