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By Dr Sucheta Tiwari, Editorial Staff Professionals Speak November 13, 2018 5 minute read

Understanding Psychiatry Part 1: Identifying the need for help

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This is the first of a five part series – Understanding Psychiatry, where we speak with Dr Sucheta Tiwari, a psychiatry resident and public health expert.

Mental illness is a difficult and stigmatized experience which can stop us from gathering information and seeking help. Additionally, searching for answers on the internet can feel like an overwhelming mountain of information and opinions that offer no certainty. One of the results of all of this is that we shun psychiatry and psychiatric medication without understanding it clearly.

Dr Tiwari breaks down this information for us to enable and empower us to make informed decisions about our mental health care. The interview has been both quoted directly as well as paraphrased in the interest of brevity and clarity.


From the perspective of modern medicine, we learn disorders of the mind arise from the brain and affect our thinking, feeling and behavior.

These are symptoms that we’re not as familiar with as say, a cough or a fever.

In this article, we’ll lay out the ways in which we can recognize the need to see a mental health professional, both in ourselves and others.


Identifying when we / someone needs help

Mental health concerns or even mental illness are not often easily identifiable. Just by the ways in which we know them, it takes us a long while to come to terms with an otherwise simple fact: something is not right and we need to seek help from a mental health professional.

A good way to identify the need for help is to think of the three domains in mental health – thinking, feeling, and behavior.

Maybe someone is behaving oddly different from their usual selves, or perhaps expressing thoughts that seem noticeably different from their usual expressions – perhaps the content has changed dramatically, or perhaps there is a palpable and sustained difference in moods.

Feeling different, or realizing or being told that we are behaving differently, or thinking in a manner unusual to ourselves are also changes that need attention.

Of course, in cases where there is a possible or perceived harm to self or others, it’s best to visit the emergency room or specifically visit a psychiatrist.

If the behavior, thoughts or feelings are significantly different from the usual behavior, thoughts and feelings, seek help.

There are some moments that make us more prone to these changes than others.

Major Life Changes: Any major life change in social, financial, marital or employment-related structural changes that causes a change in thinking, feeling, or behavior in a drastic manner also requires attention. Sometimes a major life event, including happy events such as a marriage or promotion, can be really stressful.

Anniversaries: These are particular days, marked by the calendar, where memories flood back as if no time has passed. Difficult anniversaries of loss or trauma can trigger our emotions, thoughts and behaviors as if we were reliving a moment in the past.

That said, not all major life events or anniversaries trigger significant changes in behaviors, thoughts and emotions. These are just times that are known to make us more prone to mental health concerns than others. Similarly, mental health concerns may present themselves even in the absence of any obvious trigger.

If we observe sustained or drastic changes in behaviors, thoughts or emotions, only then do we need to see a mental health professional.

An example of sustained change could be persistently feeling sad, with or without discernible reason, for several weeks. Or it could involve having constant anxiety provoking thoughts. It could be visible to the other as sadness, tremors, inability to leave the house, not want to meet friends, not want to speak to family over the phone, performing oddly poorly at work – or do things that we would normally do. It’s often that a few of these will present themselves together.

We can thus look for these changes in our personal, relational and professional lives.

Even if you’re uncertain, you can always visit a psychiatrist as a precaution and rule out or mitigate the future possibility of developing a mental disorder.

The next step involves us learning what a psychiatrist does, as opposed to a neurologist and clinical psychologist, so that we know exactly what kind of mental health professional we’re seeking help from.

Article 3 will explore more about some of the ways in which we can be prepared for our visit to a psychiatrist. The fourth segment discusses the ways in which this medication works and some of the issues we may encounter when taking these medications. We also talk about different psychotropic medications and things we should all know if we choose to use them. In the last segment, we examine the principles and shared process by which diagnosis are formed and psychotropic medication delivered. 


If you have particular questions or concerns and we’ll do our best to help you resolve them. writein@theshrinkingcouch.com
This article has information only. Please do not consider this to be a substitute for medical advice.

sucheta tiwari
Dr. Sucheta Tiwari is in the final year of her psychiatry residency. She has received her medical education from the University of Delhi and also has a masters degree in Global Health from the University of Oxford, UK. She hopes to work with mental health issues both with individuals as well as the communities they live in.
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5 Comments

  • Reply November 13, 2018

    Understanding Psychiatry Part 3: First visit to a psychiatrist & what to expect | The Shrinking Couch

    […] Understanding Psychiatry Part 1: Identifying the need for help […]

  • Reply November 13, 2018

    Understanding Psychiatry Part 4: Taking Psychotropic Medication | The Shrinking Couch

    […] articles in the series include a discussion of how to identify the need for help, the differences between a neurologist, psychiatrist and clinical psychologist, and what to expect […]

  • Reply November 13, 2018

    Understanding Psychiatry Part 2: Psychologist, Psychiatrist or Neurologist? | The Shrinking Couch

    […] Once we realize we need to seek help, we will likely encounter three primary types mental health professionals – a neurologist, a psychiatrist or a clinical psychologist. […]

  • Reply November 13, 2018

    Understanding Psychiatry Part 5: Principles of psychiatric prescription | The Shrinking Couch

    […] articles in the series on Understanding Psychiatry include a discussion of how to identify the need for help, the differences between a neurologist, psychiatrist and clinical psychologist, what to expect in […]

  • Reply March 14, 2019

    Erika Brady

    I like that you mention how you can visit a psychiatrist as a precaution to help prevent developing a mental disorder in the future. When choosing one, it would probably be a good idea to research the different professionals in your area to learn about their specialties and experience. This could help you find a psychiatrist that can prevent the mental disorders you’re worried about and want to avoid so that they can know how to help you and what signs to look for to help you understand your current condition.

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