Ask a Psychiatrist:
An APA expert answers common questions about mental health

This month’s expert: Michelle B. Riba, M.D., M.S., president of the American Psychiatric Association

What exactly is “mental health”? And what’s a mental illness?

Mental health is a critical ingredient of overall health. As a psychiatrist, I look at how people are functioning at home, at work, at school, in relationships, and in the community. If you’re functioning well in those spheres, that’s mental health. If you are having problems, that’s a mental health concern – possibly a mental illness – and psychiatrists can help assess the situation and suggest treatment, if appropriate. Many people don’t know that psychiatrists also help with alcohol and drug use problems.

Aren’t all mental illnesses serious?

Just like in the rest of medicine, there are severe and not so severe illnesses. Some people may have heart disease, while others have allergies. But all people deserve a thorough evaluation and care and treatment. The same is true with mental health concerns. The good news is that there are safe, effective treatments for these concerns – you just need to seek help.

I’ve felt very tired lately, but I can’t tell if I should see my primary care doctor or a psychiatrist? Who should I see?

Either can help. Because of psychiatrists’ specialized training – they’re the only mental health practitioners who have earned medical degrees – many people feel that psychiatrists can best tell the difference between what’s emotionally based and what may have a physical basis. But other people already have a physician they’re comfortable with and feel like it’s easier to schedule an appointment with their primary care doctor.

I would say the most important thing is to get help. Whether it’s a vitamin deficiency or mild depression, either a psychiatrist or your family doctor should be able to help get you a proper diagnosis and an individualized, effective course of treatment. Your family doctor may talk to you about referring you to a psychiatrist.

Mental illnesses are rare, right?

No. Each year about one in five adults has a diagnosable mental health concern of some degree or another. This means few American families are untouched by mental illness. The key is to not put off seeking help. Problems like these usually only get worse and therefore more difficult to treat, so getting a diagnosis and care early on is very important. Mental illnesses are highly treatable. Indeed, most people who seek help will experience a full recovery or a significant reduction in symptoms.

What causes mental health problems?

Again, like in the rest of medicine, there are biological and genetic factors, as well as environmental factors. Stress or poverty, for example, can play a role in depression. But stress or poverty can also play a role in ulcers or heart disease. The distinction between “physical” and “mental” can be somewhat misleading. Mental illnesses have a biological nature, just as many physical illnesses have a strong emotional component. It’s why a healthy mind is a critical ingredient to leading a healthy life.

What about treatments? Is drug therapy the only option? I hear so much about medication.

I think the real question is one of appropriateness – that is, getting the right treatments for the right people. We know that treatment works. But any one person’s specific course of treatment may include medications, talk therapy, or a combination of both. The key is a comprehensive, individualized treatment plan – one that you feel comfortable with and will follow through on. If it’s a child who’s being treated, it’s critical that the treatment plan be tailored to the needs of the child and family, and what the parent or guardian is comfortable with. Psychiatrists look forward to discussing all the options and working cooperatively with you so you can make the best decision.

How do I find a psychiatrist?

Right on this Web site. Just follow this link.