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James Reed
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Looks like my work Z10 is finally getting the big upgrade to 10.3. Will be interesting to see how the Amazon app store works out

I'm a forensic psychiatrist.

Not a forensic psychologist (ie Cracker)

Not a psychotherapist

Not a forensic pathologist (ie CSI)

So what does it mean?

The psychiatrist bit means that I am a doctor (so I've been through the same University training etc as any other doctor, be they a surgeon, GP, anaethetist or whatever). I've also worked in general hospitals in medicine and surgery like any other doctor, so in my time I've done quite a bit of medicine. However, now I specialise in diagnosis and treating mental illness - and that's what makes me a psychiatrist.

There's a lot of misunderstanding about what mental illness is and isn't. Doctors are actually particularly bad at knowing about mental illnes, which is rather unfortunate. I remember when I worked in general hospitals consultants would make disparaging remarks about patients coming in who were said to have "mental health problems". They would often remark on how they shouldn't have to deal with such people, how their problems were "supratentorial" (ie 'all in the mind') and they were always very keen to get rid of them from the wards as quickly as possible. They also perpetuated the view that there was in some form a difference between physical and mental illness - when in my view there is no difference at all.

This may seem like a strange statement, but let me try to convince you why I think it's true. The first difficulty comes in trying to define what illness is. I'd be interested to hear your views on this. I've spent a lot of time thinking about this, but in brief it comes down to something in the body not working properly. This must obviously include the brain, which in turn must affect behaviour and thinking.

Secondly, our bodies as a whole are a physical entity, and things going wrong in one bit can affect other bits. A serious infection of the tissue around the brain is clearly a 'physical' illness - but it can have a signficant effect upon behaviour. People with encephalitis can become confused and aggressive - is this mental or physical illness?

Likewise, mental illnesses can have identifiable 'physical' causes. Mental illnesses such as schizophrenia have a lot of research evidence supporting the view that they are caused by underlying disturbances in neurotransmitters (that is chemicals) in the brain. Just like diabetes is caused by disturbances in hormone levels in the pancreas.

The other compelling argument is that many 'mental' illnesses can be treated, just as 'physical' illnesses can. Someone who is profoundly depressed, feeling very down, unhappy, agitated, unable to sleep or eat and possibly contemplating suicide can be transformed back to normal again with a few weeks course of antidepressants. If an illness responds to a chemical treatment, it must have in some form a chemical origin.

This is only the essence of my argument, but I hope it makes some sense. I've found it quite upsetting how people with 'mental' illnesses are treated so badly in some cases, because of misunderstandings about what their illness is.

My job as a psychiatrist is to assess and treat people with these sorts of illnesses. It can take place at home or in hospital (just like any other sort of illness). One of the perks is that patients may become very ill, but rarely die as a result of their illness (although this happens sometimes through suicide or other disturbed behaviour). You generally get the chance to follow patients through good time and bad, and see them come through difficult times and improve again. This contrasts with many of those dealing with 'physical' illness who only meet patients when they are in a crisis, from which many will not recover.

As a career, psychiatry remains an extremely good option and one which is frequently overlooked
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