Psychiatrist Prof. Dr. Nevzat Tarhan noted that medication and psychotherapy are usually used together in the initial stage of psychiatric disorders, stating, 'The brain's role in treatment is critically important. Since psychiatric diseases cause disruptions in the brain's electrical and chemical communication, medication is the gold standard.'
Prof. Dr. Tarhan stated that personalized psychiatric treatments will play an important role in achieving more effective and safer results, adding, 'Genetic treatments provide personalized therapy. Especially in cases where improvement cannot be achieved, genetic evaluations may be important.'
Üsküdar University Founding Rector, Psychiatrist Prof. Dr. Nevzat Tarhan, evaluated current approaches in psychiatric diagnosis and treatment methods.
Psychiatric illnesses are often referred to as 'disorders'...
Prof. Dr. Tarhan reminded that in psychiatric diagnosis and treatment methods, especially in diagnosis, classical diagnostic methods were previously used, noting that in these methods, individuals were examined and diagnosed based on symptoms and checklists. He added that the reason psychiatric illnesses are often referred to as 'disorders' is that biological evidence and their equivalents in the brain have not been fully substantiated.
Prof. Dr. Tarhan stated that even if there is a pathology in the brain, this pathology could not be fully defined as a disease, and therefore the term 'disorder' was used, expressing the following:
'For example, terms like depressive disorder, schizophrenic disorder, and bipolar disorder are used this way. Neuropathological evidence was required to define a condition as a disease. However, in recent years, laboratory evidence has increased. Thanks to neuroimaging, neurobiological, and neurophysiological studies, brain functions are measured, and the causal link between diseases has been established. Addiction is called 'reward deficiency syndrome,' which stems from the insufficient functioning of the brain's reward area. Depression, on the other hand, can be defined as the asymmetric functioning of the brain's frontal region and the incongruent functioning of pleasure and depression areas. In the future, diagnoses based on connectivity disorders of specific brain regions may be made. However, currently, the gold standard diagnostic method is clinical examination, and this examination is supported by laboratory tests and brain imaging.' he explained.
Medication and psychotherapy are fundamental treatment methods
Prof. Dr. Tarhan noted that in the treatment plan, medication and psychotherapy are generally used together in the initial stage of psychiatric disorders. He explained that psychiatric disorders are divided into two main groups: neurotic and psychotic. Patients in the neurotic group are aware of their illness and seek treatment voluntarily; they can usually be cured with outpatient treatment as long as they do not carry serious risks like suicidal thoughts. Medication and psychotherapy are the fundamental treatment methods for these patients.
Medication aims to regulate signal and energy flow
Prof. Dr. Tarhan explained that patients in the psychotic group are individuals who do not accept their illness and are unaware of being ill, and the treatment plan for patients in this condition, called psychosis, is different. He said, 'In treatment, the brain's role is critically important. Since psychiatric diseases cause disruptions in the brain's electrical and chemical communication, medication is the gold standard. In psychiatric disorders, disturbances occur in the energy flow between certain regions of the brain. Detecting these disturbances and planning treatment accordingly is important. Medication aims to regulate this signal and energy flow. Psychotherapy also has a biochemical equivalent in the brain and is therefore used as an effective treatment method alongside medication.'
Increase in illnesses!
Pointing out that low serotonin levels in the brain are associated with psychiatric disorders such as depression and suicide, Prof. Dr. Tarhan stated, 'Currently, medications that increase serotonin are widely used in the treatment of depression and other psychiatric diseases.'
Prof. Dr. Tarhan added that while diagnoses and treatments have become easier, there is also an increase in illnesses. He said, 'We are now getting results in a few months for diseases we used to struggle with for one or two years.'
Brain functions are examined with brain imaging techniques
Prof. Dr. Tarhan stated, 'By examining brain functions with brain imaging techniques, differences in a person's brain activity and chemical communication disorders can be identified. This provides significant progress in understanding the biological origins of psychiatric diseases.' He explained that such findings indicate that the illness occurs beyond a person's will or control and arises due to disorders in specific brain regions.
Tarhan said, 'Telling a person with depression or other psychiatric disorders to 'cheer up' or 'don't dwell on it' would be ignoring the disorders in their brain chemistry or function.' He emphasized that such conditions can be too complex to overcome by willpower or control alone, and therefore, in the treatment of psychiatric disorders, it is important to understand the individual's biological and chemical state to create appropriate treatment plans.
Being misunderstood further increases the pain…
Prof. Dr. Tarhan noted that individuals with psychiatric disorders suffer, and being misunderstood further increases this pain. He explained, 'There are patients who cry profusely when they understand the reason. They blame themselves. They say, 'Why am I like this?' Yet, the serotonin stores in their brain are depleted, the person is exhausted. That is, involuntarily.'
Repairing damaged networks in the brain becomes possible with newly developing technologies
Prof. Dr. Tarhan stated, 'With newly developing technologies, it is becoming possible to repair and correct damaged networks in the brain through methods like brain modulation therapies. For example, magnetic stimulation therapy can correct receptors and open ion channels by delivering magnetic stimuli to specific regions of the brain. This can enable medications to reach the brain more effectively and support the treatment process.'
Prof. Dr. Tarhan also noted that pharmacogenetic studies examine individuals' genetic makeup to determine which medications might be more effective. He added, 'Genetic information can help tailor treatment plans to individuals and achieve more effective results. In this way, medication dosages and treatment durations can be determined based on individuals' personal genetic profiles, thereby increasing treatment response and tolerance.'
Personalized treatment yields more effective and safer results…
Prof. Dr. Tarhan also stated that personalized psychiatric treatments will play an important role in achieving more effective and safer results, adding, 'Genetic treatments provide personalized therapy. Especially in cases where improvement cannot be achieved, genetic evaluations may be important. In both the elderly and children, when treatment response is not obtained or medications are ineffective, evaluating genetic factors can help identify new treatment options.'
Prof. Dr. Tarhan also explained that recent developments in psychiatry and the increase in treatment options have increased the likelihood of improvement for long-term disorders like schizophrenia. Therefore, he stressed the importance of patients not losing hope and continuing treatment, and also stated that psychiatric illnesses affect not only individuals but also their families.
Both individual and family support and hope are important…
Prof. Dr. Tarhan also stated that in some cases, examining genetic predisposition and evaluating genetic factors in the family can guide the treatment plan and help discover new treatment options, adding, 'In the fight against psychiatric illnesses, the support and hope of both individuals and families are important.'
Prof. Dr. Tarhan reminded that studies on applying genetic treatment from a person's own stem cells are also needed, stating that something needs to be done regarding autism, and that genetic treatments offer hope for the coming period.
Tarhan emphasized that the relationship between neuroscience and psychiatry is steadily strengthening, and that psychiatric residents pursuing doctoral degrees in neuroscience allows them to better understand brain processes and the biological foundations of psychiatric illnesses. In light of this information, he noted that methods called neuro-navigation are being developed, aiming to target and treat specific regions in the brain.
Prof. Dr. Tarhan also stated that in some treatments, the goal is to activate nerve cells by stimulating the energy molecule called adenosine diphosphate within them, and that the use of some treatments for health and well-being is increasingly growing.