Psychiatry is the branch of medicine focused on the diagnosis, treatment and prevention of mental, emotional and behavioural disorders. 

A psychiatrist is a medical doctor who specializes in mental health, including substance use disorders. Psychiatrists are qualified to assess both the mental and physical aspects of psychological problems. 

People seek psychiatric help for many reasons. The problems can be sudden, such as a panic attack, frightening hallucinations, thoughts of suicide, or hearing “voices.” Or they may be more long-term, such as feelings of sadness, hopelessness, or anxiousness that never seem to lift or problems functioning, causing everyday life to feel distorted or out of control.

Because they are qualified doctors, psychiatrists can order or perform a full range of medical laboratory and psychological tests which, combined with discussions with patients, help provide a picture of a patient’s physical and mental state. Their education and clinical training equip them to understand the complex relationship between emotional and other medical illnesses and the relationships with genetics and family history. 

Psychiatrists use a variety of treatments – including various forms of psychotherapy, medications, psycho social interventions and other treatments (such as electroconvulsive therapy or ECT), depending on the needs of each patient. 

Most medications prescribed by a psychiatrist are used in much the same way that medications are used to treat high blood pressure or diabetes. After completing thorough evaluations, psychiatrists can prescribe medications to help treat mental disorders. Psychiatric medications can help correct imbalances in brain chemistry that are thought to be involved in some mental disorders.

Patients on long-term medication treatment typically meet with their psychiatrist periodically to monitor the effectiveness of their medication and any potential side effects.

 To practice as a Psychiatrist, you need to have a Bachelor of Medicine and Bachelor of Surgery degree (MBChB), followed by a Masters in Medicine, specialising in Psychiatry. Prospective students also need to be registered with the HPCSA.

Some psychiatrists also complete additional specialised training after their four years of general psychiatry training. They may become certified in:

• Child and adolescent psychiatry
• Geriatric psychiatry
• Forensic (legal) psychiatry
• Addiction psychiatry
• Pain medicine
• Psychosomatic (mind and body) medicine

Antisocial personality disorder (ASPD) is a condition characterized by a lack of empathy and regard for other people. People who have antisocial personality disorder have little or no regard for right or wrong. They antagonize others and often act insensitively or in an unfeeling manner. 

It is not unusual for symptoms to be present during childhood; such behaviours may include fire setting, cruelty to animals, and difficulty with authority. Individuals with this disorder may lie, engage in aggressive or violent behaviour and participate in criminal activity from an early age. 

These characteristics often lead to major difficulties in many life areas. At its core, the inability to consider the thoughts, feelings, and motivations of other people can lead to harmful disregard for others. As adults, the disorder can be destructive to both the person living with it and those who come into contact with them. 

People with antisocial personality disorder are more likely to engage in risk-taking behaviours and dangerous activities. Those with the disorder are often described as having no conscience and feel no regret or remorse for their harmful actions. 

While the condition may begin in childhood, it cannot be officially diagnosed before the age of 18. Children who display these symptoms are diagnosed with conduct disorder. In order to be diagnosed with ASPD, a person must display a disregard and violation of the rights of others before the age of 15. 

The exact causes of antisocial personality disorder are not known. Personality is shaped by a variety of forces including nature and nurture. Upbringing can also have an important influence. Childhood abuse, neglect, and trauma have also been linked to the onset of ASPD. A number of factors have been found to increase the risk of the disorder including smoking during pregnancy and abnormal brain function.

Research suggests that people with ASPD have differences in the frontal lobe, the area of the brain that plays a role in planning and judgment. People with the disorder also tend to require greater stimulation and may seek out dangerous or even illegal activities to raise their arousal to an optimal level. 

As this is a complex personality disorder, it is recommended that you work with your psychiatrist or mental health team in the event that you or a loved one are experiencing a range of these symptoms.  

A complex personality disorder where a person experiences instability in their relationships, moods, thinking, behaviour — even in their identity.

A person with a borderline personality disorder (BPD), most probably feels like they are on a rollercoaster — and not just because of their unstable emotions or relationships, but also because of their wavering sense of who they are.

Their self-image, goals, and even their likes and dislikes may change frequently in ways that feel confusing and unclear.

People with BPD tend to be extremely sensitive. Some describe it as like they are having an exposed nerve ending. Small things can trigger intense reactions. And once upset, have trouble calming down. It’s easy to understand how this emotional volatility and inability to self-soothe leads to relationship turmoil and impulsive — even reckless — behaviour.

When a person with BPD is in the throws of overwhelming emotions, they are unable to think straight or stay grounded. They may say hurtful things or act out in dangerous or inappropriate ways that then make them feel guilty or ashamed afterwards.

It’s a painful cycle that can feel impossible to escape. But it’s not. There are effective BPD treatments and coping skills that can help people with BPD feel better and back in control of their thoughts, feelings, and actions.

There are many complex things happening in the BPD brain, and researchers are still untangling what it all means. But in essence, if you have BPD, your brain is on high alert. Things feel scarier and more stressful to you than they do to other people. Your fight-or-flight switch is easily tripped, and once it’s on, it hijacks your rational brain, triggering primitive survival instincts that aren’t always appropriate to the situation at hand.

This may make it sound as if there’s nothing that can be done. After all, what can you do if your brain is different? But the truth is that you can change your brain. Every time you practice a new coping response or self-soothing technique you are creating new neural pathways. Some treatments, such as mindfulness meditation, can even grow your brain matter. And the more you practice, the stronger and more automatic these pathways will become. So, don’t give up! With time and dedication, it is possible to change the way we think, feel, and act.