Aura MD | Ashley Toutounchi, MD - Psychiatrist Houston

The economics of health care are often blamed on physician specialists. Many articles have been published in the media about the advantages of non-physician medical treatment. Many wonder if decades of specialized training could be compressed into a one-year training program. What are the potential benefits for my patients if they see a psychiatrist? The myth that psychiatrists only have to be trained in the administration of medication has been perpetuated by insurance companies. Many people may be surprised to learn that psychiatrists are trained and supervised in many types of psychotherapy during their three-year residency. The former president of American Psychoanalytic Society was my long-term supervisor during my residency. Can a non-specialist with limited training be able to replicate my skills as a psychiatrist? How can I advise my patients about new provider selections that are required by changes in their insurance reimbursements?

It is crucial for patients to first understand their diagnosis and what it means for their daily lives. Media and the herbal industry promote treatments that can treat depression, including massage and herbs. Advertisements don't distinguish between mild and serious depression. Mild depression may respond to distractions and other treatments might be available. Mild depression symptoms, by definition, are not disruptive to personal functioning. You may feel blue and depressed when you wake up. If you call a friend or go to work, the feeling will disappear. Sometimes, severe depression can cause a lack of energy, loss of appetite, difficulty focusing or concentration, and intrusive thoughts about suicide. It is easy to see the differences in severity and impact on daily functioning. The daily message is that regardless of the lack of scientific support or determination of severity, depression can be treated.

Vogue Magazine's May 2009 issue featured the article "Pregnant Pause", which was a touching description of the daily struggles faced by subspecialists in reproductive psychiatry. A pregnant woman was described in the article as having eating phobias and strange obsessive thoughts that impeded her daily functioning. She was diagnosed with mild depression, and her primary care doctor treated her. The article noted the negative effects of antidepressant treatment during pregnancy. The article emphasized that the patient had a mild illness and that she was given incorrect information. Patients with severe illnesses often get their mental health care from people who have not received psychiatric training. The stigma surrounding psychiatry is widespread.

Many magazines that have a reputation for being trustworthy do not consider the severity of illnesses and offer potential treatments that may not be scientifically sound. When counseling patients about their treatment options, I am a psychiatrist who is an expert in reproductive health. The Pregnancy Decision Handbook for Women With Depression, an award-winning book, was created to provide information that can be used in developing individualized treatment plans. There are many treatment options available for women depending on the severity of their illness.

I answer patients' questions about potential mental health providers by suggesting that they have an honest discussion about their illness. A psychiatrist should be consulted if you have a serious illness that can hinder your ability to function, or if you are taking SSRIs at a higher dose than the norm. The introduction of serotonin selective inhibitors (SSRIs), and Prozac were major advances in mental health treatment. However, if you've been suffering from depression for twenty years, stabilization will require the ability to deal with treatments that aren't usually easy for less-trained health professionals.

Individuals with strong family histories of mental illness or previous bouts that left them disabled should see a specialist at the very least for a consultation. After repeated medication failures, many patients are referred by psychiatrists. Misdiagnosis and inappropriate dosages of medication by less-trained health professionals can often lead to treatment resistance. My extensive training and experience allows me to distinguish between emotions that are due to a psychiatric or underlying condition. It is often not necessary to prescribe medication, as it may be a life event that causes the patient to feel bad but does not impair their ability to function. Instead of having a prescription given after a quick crisis assessment, the patient needs to be able to cope with the stressful event. My presence is seen as expensive in the current health care debate. But, is it really wasteful to see a psychiatrist? If the psychiatrist is able to diagnose and treat the illness, then it's not wasteful. Is it possible to replace a well-trained, respected psychiatrist with a primary care doctor and counselor?