Originally published in UMC Vim & Vigor, Fall 2012 issue
In March of this year, the University of Arizona College of Medicine was joined by Ole Thienhaus, MD, MBA, by way of Las Vegas, where he was a professor and chairman of the Department of Psychiatry and Behavioral Sciences at the University of Nevada School of Medicine. Dr. Thienhaus earned his medical degree from the Free University of Berlin, West Germany, in 1978. He completed a fellowship in geriatric psychiatry in 1984 and a residency in psychiatry in 1983 at the University of Cincinnati, as well as an internship in general surgery in Germany in 1979. He has published two books on psychiatry: The Manual of Hospital Psychiatry and Correctional Psychiatry Volume I, with a second volume in the works.
Q: So many people seem unsure how to differentiate psychiatry from psychology. Can you set the record straight?
A: This is a very common misunderstanding. Psychiatrists are MDs who got to the end of medical school and decided to specialize in the treatment of mental illness. A psychologist, on the other hand, usually attains a PhD through a traditional university setting. While the psychologist learns multiple testing techniques, psychotherapy, and psychometric testing, the psychiatrist actually prescribes medications, can put patients in a hospital setting if deemed necessary, and helps with forensic cases. These are two distinct skill sets, though there is some overlap.
Q: Why is it that so many mental illnesses go undiagnosed?
A: Many of the conditions we‚Äôre dealing with are less clearly documented than diseases in other branches of medicine. For example, say you have a cold; you can check to see if you have a temperature and document that. Then there‚Äôs a clear algorithm to follow to diagnose and treat. Mental illness, on the other hand, is largely defined by descriptive criteria, especially subjective symptoms such as: I feel sad. I feel suicidal. Such symptoms are dependent on the credibility of the person. There‚Äôs also the unfortunate tradition of ‚Äújust help yourself,‚Äù where someone may convince themselves they just need to get over it or tough it out.
Q: In your opinion, what is behind the taboo and mystery of mental illness that also contributes to problems going undiagnosed and unmanaged?
A: Historically there has been a definite stigma surrounding the field, but it continues to improve‚Äîthere‚Äôs even less so now than when I trained 30 years ago. It‚Äôs often viewed that if you seek treatment for mental illness there‚Äôs something wrong with you as a person. If you see a psychiatrist for depression, there‚Äôs some part of you that‚Äôs weak. This happened very publicly in 1972, when the vice presidential nominee on the George McGovern presidential ticket was forced to withdraw when it was discovered he had received electric convulsive therapy for depression.
In fact, of the five states I am licensed to practice in, I was asked first to disclose any history of mental health treatment. Not had I suffered a heart attack, nor any other health problem. They‚Äôve since stepped back from that, but only in the last 10‚Äì15 years. It‚Äôs the residual belief that the need for mental healthcare changes your value or competency, your adequacy as a whole person.
Q: What do you think contributed to the shift of increased public acceptance of mental illness such as depression?
A: People coming out and self-identifying has helped this progress, particularly public figures such as legendary journalist Mike Wallace. Powerful figures of authority or influence showing the world that they‚Äôre not only functioning but successful has made others feel more comfortable coming forward and admitting they also suffer from depression. But mental health is such a broad term, we need to be careful to define it. There‚Äôs a great difference between depression, and say, schizophrenia.
Q: Clearly we don‚Äôt want anyone to diagnose themselves or a loved one, but what are some of the warning signs that indicate someone should seek a professional opinion?
A: A sustained change, new pattern, or deviations in the emotional aspects of a person‚Äôs behavior. One day of errant behavior is not cause for concern. Sure, loss of sleep is normal once in a while, or feeling down about work or finances. But a dramatic or sustained change is when there's cause to worry. If someone you care about has such symptoms, often if you ask them directly about it, they are aware and ready, possibly even eager, to discuss.
Could Outpatient Therapy Help You?
If you or someone you know may need to seek professional help for depression or other mental illness, The University of Arizona Medical Center‚Äôs Outpatient Clinics, at both the University Campus and the South Campus, are a great place to turn. "An outpatient appointment is a great place to start. It's a noncommittal way to just see if your symptoms are cause for concern," explained Dr. Thienhaus. "In my experience, many patients only ever come in for one appointment and realize their problems are better addressed by a vocational counselor, marriage counselor, or medical professional. You don't have to be hearing voices or on the brink of suicide to seek help.
Get the Help You Need
For an appointment at one of our Outpatient Clinics, call 520-626-7664 (University Campus) or 520-874-7523 (South Campus).