Why Doesn’t Psychiatry Have Specializations

We have medical doctors that specialize in hearts, intestines and stomach, feet, joints, eyes, mouth, skin, just about every part of the body has a distinct specialization.

Thus my title question begins. Why the hell isn’t there specialization like that in psychiatry.

The only thing there really is right now? Psychiatrists and psychologists. One talks to you, one gives you meds. I do realize that there is a little more nuance there than that, but there’s no sectionalized specialization like there is with medical doctors.

Why in the world could it be important?

Well, first off… Have you seen the DSM?


That is a big book, and it has over 300 different disorders. Some of them have lots of different cross-overs, but they still are their own things.


1.) Say you have a bipolar patient who is in a depressive episode. You do not know they are bipolar, and thus you treat them as you would depression, with the same medications. Congratulations, you have probably just sent that individual into a full blown mania.

2.) You have a patient come in that is having a very hard time. They are depressed, and they are hearing voices. They’re up front about it, and they are somewhat aware that the voices shouldn’t be there. That’s obviously schizophrenia right? Well… No. Again you could be describing bipolar disorder. I know, because it happens to me.

Those are just two examples of overlap but the need to know the differences, and how to dig as well. There should definitely be general psychologists, as there are now, and I would not advocate taking that away. What I am advocating for is the ability to talk to someone who really knows my illness inside and out. Someone who’s entire study is the effects and possible causes of bipolar. Perhaps that’s not the only illness they focus on, but you know, only the one specific group type.

I think that specialization would go a long way in more effectively handling and managing mental illness.


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