A little glossary of mental health

One thing that sometimes tends to cause confusion is the question of who is a psychiatrist, who is a psychologist, and how to figure out who to go to. It is certainly made more confusing by the fact that there are also clinical psychologists and the word "clinical" refers to disease, hospital and treatment. 

A psychiatrist is a doctor (that is, a graduate of medical school) who specializes in the field of psychiatry, i.e., they have the ability and right to diagnose and treat mental and behavioural disorders. As a doctor, they have the right to diagnose and prescribe medication. The so-called milder mental disorders (mild depression, anxiety, stress disorders) can be diagnosed and also treated by a family doctor. Since there are too few psychiatrists in Estonia, you should first talk about your concerns with your family doctor or make an appointment with the mental health nurse. It is possible that the problem can be solved with their help. If it is a more complex disorder, the family doctor can then refer you to a psychiatrist. You can also go directly to a psychiatrist, but when doing this you have to consider the long waiting time, which can be difficult when dealing with mental health concerns. 

Mental health nurse is a specially trained nurse who work to improve or support the mental and physical well-being of people with mental health or behavioural conditions. They may also support the people close to a person with these conditions, such as family members. They assess mental health needs and develop a nursing plan of care. 

A psychologist must have a degree in psychology from a higher education institute and have in-depth knowledge of human behaviour. A psychologist deals with the assessment, mitigation and prevention of psychological problems. If a psychologist has also studied psychotherapy, they can also work as a therapist. If they don't have this training, it is not ethical or correct to call themselves a therapist.

A clinical psychologist, in addition to a higher education in psychology, must also have a professional certificate as a clinical psychologist as well as an in-depth knowledge of mental and behavioural disorders. A clinical psychologist can perform various tests that can be used to assess the presence of, for example, the autism spectrum, attention deficit disorder, and other mental health disorders. Clinical psychologists often also have training as therapists. It is important to remember that the final diagnosis (i.e., whether it is a mental disorder according to the classification of diseases) is still made by a doctor. A clinical psychologist works with those dealing with a disease, those in a hospital setting, and those who require ongoing treatment, but they are not a doctor.

Psychotherapy is not just counselling, but a relationship between a person in need of help and a therapist with a specific method and purpose. Various therapies are used for mental health concerns and mental disorders, such as cognitive-behavioural therapy, schema therapy, trauma therapy, creative therapy, family therapy, etc. For milder psychological problems, therapy is not always necessary. For more severe disorders, however, there are specific forms of therapy, the effectiveness of which has been proven by scientific studies (more severe conditions often require medication, at least for a while). Unfortunately, there is no universal form of therapy that can help with all disorders. However, many good psychotherapists have studied many different therapies and know how to use and combine them based on the needs of the person they are working with.

​Psychiatric medication come in different forms and for many different purposes. Finding the right medication can be quite a time-consuming process. Our brains all work differently to some extent, so for the same problem, the same drug will not always work in the same way for different people.

Antidepressants are used for many mood disorders, including depression. Their effects appear gradually, usually not before 2-4 weeks. During the first few weeks, rather unpleasant side effects may occur (headache, anxiety, restlessness, nausea, the feeling of being "in cotton wool"), but in most people they subside. Before saying that the medicine is not suitable, it is worth having a little patience and you should discuss with the doctor whether you should try another medicine. It is very important to distinguish between antidepressants and sedatives. 

Tranquillisers and sleeping pills are used only for specific indications and for a short time. Long-term use of tranquillisers is very dangerous: serious side effects occur (memory problems, balance disorders, depression) and there is a high risk of addiction. Sedative addiction can be treated, but it is a long and difficult process. Antidepressants do not cause such dependence.

Antipsychotics are used to treat psychotic disorders (the best known of which is schizophrenia). Medication must be used for a long time to ensure good health and to prevent recurrence of psychosis: two years after the first episode of psychosis, five years in case of recurrent psychosis, and in case of chronic schizophrenia, the treatment can last a lifetime.

Recovery from a mental health disorder has its own specific stages. Especially in the case of more severe mental illnesses, recovery is a long process and can sometimes take years. In this case, in addition to psychotherapy and medication, rehabilitation also plays an important role. Research has repeatedly confirmed that the coping and health of those who participate in mental health rehabilitation programs are better than those who do not.

The word rehabilitation may sound a bit complicated, but there are quite simple and human things behind it. Rehabilitation means that if your daily practical coping or emotional balance has suffered due to mental health problems, it is possible to restore and repair these parts of your life. There are many ways to do this, depending on what areas of your life you need support in - whether it's studying, working, family relationships, economic coping, communication skills, time planning, finding free time activities, self-development, etc. So, during rehabilitation, you can deal with everything that the doctor and psychologist do not have enough time for.

Translated by Kellen Olivia Kiisler

If you have any questions on this topic, please reach out to us!