Psychiatric Assessment

Much of psychiatric assessment is based on a very careful and methodical history-gathering process. The goal in the assessments of those with depression and bipolar is to have a clear sense of several things: how people's symptoms have changed over time, the transitional process from one mood state to another, how quickly those transitions take place, and if there were any patterns that can be recognized. Information regarding any influence treatment has had on the course of symptoms is also noted. This very careful and thoughtful analysis not only takes time, but also requires a fair amount of help from the patient.

Another part of the psychiatric evaluation is the mental status examination. This is a structured way of evaluating the important dimensions of mental functioning: mood, attention, memory, patterns of thinking, et cetera. The psychiatrist compares what he finds through the mental status examination with information that he has about typical patterns of thought and emotions found in different conditions. The psychiatrist may request psychological tests to more precisely define the nature of the psychological processes. The psychiatrist may well order some screening laboratory studies, and perhaps neuroimaging, electrocardiogram, or electroencephalogram (EEG).

All of this information is used to identify a diagnosis from which the psychiatrist is able to make suggestions for treatment. The recommendations are based on scientific literature which looks at how others with similar problems respond to treatment.

The focus leans toward symptoms and diagnosis, more so than functioning, although both are important. It's a frequent criticism of psychiatric assessment that psychiatrists focus more on problems than on creative adaptation. People are not just a sum of their problems, they also have come up with creative solutions to these problems. For instance, one person with a severe depression may be unable to leave their bed, whereas another person may have found a way to continue to function normally.

One thing that is important is to find a way of keeping track of mood states and transitions. This is especially true because of a phenomenon called State Dependent Learning. This phenomenon is based on how the brain stores memory. The hippocampus, which is part of the limbic or emotional part of the brain, is where memory is stored. The result is that memory is inevitably stored along with emotions surrounding that memory. In fact, emotions serve as kind of a way of classifying and finding memories. In other words, when you're in a certain mood, it may be very difficult to recall times when you were in a different mood, thus making it very important to keep track of mood changes over time. Otherwise, decisions may get made based on what your mood is at the moment, rather than a more comprehensive sense of how things have been over a period of time.

Contact our Personal Advocate to help you to find the right provider for your needs.