Tele-medicine is the provision of health care remotely through the use of technology. Telehealth psychiatry is a method to provide a range of services including:

• Evaluation
• Therapies
• Individual
• Group
• Family
• Education
• Medication management

​Although it uses video-based electronics, telehealth psychiatry involves direct care between the psychiatrist and patient. Telehealth is a live interactive method for a doctor to provide needed mental health service to remote patients. It can also be used to transmit medical information to other consultants.

• Brings accessibility to rural areas
• The care is brought directly to the patient
• Incorporates mental health care along with primary medical services
• Allows for continual follow-up services
• Reduces barriers like transportation, child care, etc.
• Provides a confidential and convenient service

Telehealth psychiatry provides a needed service in what might otherwise be an underserved area due to access  or safety concerns. It is a cost effective method to offer aid to patients in privacy. The psychiatrist must be licensed in the states they are working, and can only provide care for patients in those states.
It is used in a number of different settings:

• Military
• Nursing homes
• Correctional facilities
• Schools
• Nursing Homes
• Clinics and hospitals

Experts estimate that 1/8 emergency room visits require a psychiatric intervention. Electronic Psychiatry visits can help evaluate the patient and offer treatment options. Nursing homes and long-term care facilities use telehealth psychiatry appointments to provide mental health treatment without compromising accessibility. Those in jail and prison can now also receive valuable psychiatric treatments for ongoing mental issues.

For the ordinary individual, they will schedule an appointment for a video appointment. However, it is suggested that, if at all possible, the patient should be prepared for an in-person appointment. The individual should have all relevant information, medical records, medications, and other materials readily accessible.  
Research is showing that telehealth psychiatry visits are equivalent to in-person appointments. Diagnoses are just as accurate, treatments are as effective, and patients show a high degree of satisfaction. Privacy and confidentiality are still maintained to standards or greater.

For people with severe anxiety disorders or those with mobility issues, remote treatments have proven highly beneficial. 
 
When considering a telehealth psychiatry appointment, it is important to find a secure place for your appointment. The psychiatric team will be responsible for their location. Be sure to verify the software works and you have a working internet connection. While many devices and operating systems offer secure software, not all do.

How often has mom told us “eat a little something and you will feel better”?  Think about it...your brain never stops working.  All day and all night, your brain keeps your bodily functions operating.  Using all that energy requires constant fuel.  What you eat directly affects your bodily functions, including the brain.  So the better you eat, the better your brain will work.  Conversely, when you overeat, or consume junk food, or otherwise skimp on nutrition, you are prone to sadness and anxiety.


This is the basic principle of nutritional psychiatry.


Today's research is showing a correlation between good nutrition and the reduction of free radicals, inflammatory cells, the kinds of bacteria that live in the intestinal tract, as well as how you feel, and behave.  Eating highly refined sugars is now linked to impaired brain function and the aggravation of mood disorders like depression.  Nutritious foods with vitamins, minerals, and antioxidants protects the brain from oxidative stress or free radicals produced as the body oxygenates.


Serotonin is a substance, a neurotransmitter, that regulates sleep, appetite, evens out moods, and reduces pain.  The vast majority of serotonin is produced in the gastrointestinal organs.  So there is a direct connection between the transmitters in the gut and the serotonin that keeps our lives on track.  As proper nutrition is processed by the body, it helps regulate our moods as well.


Studies have found that the risk of depression is lowered by 25% to 35% in persons who follow a Mediterranean or Japanese diet.  These eating plans are high in vegetables, fruits, unprocessed grains, and fish and low in meats and dairy.  They also shun processed and refined sugars and other foods.


A food diary is an easy way to see if it works.  Try one of these diet plans and after about a week start keeping a record of what you ate through the day and then how you felt the next day.  Continue this for another week and see if there is a change in your mental attitude.  This is also a way that you can find trigger foods by reintroducing them into your eating plan and then tracking how your emotions are affected.  Also note if you have increased or decreased energy and sleep patterns.


Nutritional psychiatry is applying these studies to patients who suffer from various forms of mental illness especially anxiety and depression.  It appears to be an effective method to reduce or eliminate medications that can have other side effects that adversely affect some people. 


Combining healthy eating with approved psychiatric counseling sessions is one of the non-invasive techniques that can greatly improve lives. 


A 2020 study has revealed that anti-inflammatory fats like Omega-3 are connected to a lower risk of depression.  This study found that women who consumed fish twice per week had a 25% lower risk of depression as compared to those women who ate fish less than twice per week.


Higher risk of depression was found in people who failed to get enough magnesium (beans, lentils, peas, avocado, nuts, whole grains, and dark chocolate).  The same was found in those who were deficient in zinc (oysters, pumpkin seeds, cashews).

Stress is an emotional strain that comes as a result of difficult or adverse circumstances.  It is an emotional response to external factors but can have physical symptoms as well.  Some of the physical issues are:

• Digestive problems
• Reproductive issues
• Muscle tension
• Headaches
• Fatigue
• High blood pressure
• Chest Pain

 
Mental health issues include:

• Anxiety
• Irritability
• Depression
• Anger
• Feeling overwhelmed
• Racing thoughts
• Worry
• Making bad decisions

 
Situations that cause us concern are called stressors.  Stressors can be negative like relationship issues or financial problems.  Stressors are also internal like pessimism about life, worrying about something that may or may not happen or self perception.
 
Stress is basically our perception of something difficult to deal with.  Stressors are somewhat individualized in that what may bother one person has no affect on another.  Strict deadlines may have you in a tizzy but  your coworker thrives in that atmosphere.  Common external stressors are:

• Major life changes (good or bad)
• Work or school
• Relationships
• Finances
• Overworked
• Commitments including family

 
Internal issues include:

• Lack of flexibility
• Pessimism
• Negative self image
• Unrealistic expectations

 
There are some indicators to show that you are having difficulty dealing with stress:

• Work or school performance drop
• “Self medicating” with alcohol, drugs, or tobacco or an increased use of any of them
• Difficulty dealing with daily situations
• Withdrawal from friends, family, or social situations
• Sudden irrational outbursts
• Taking dangerous chances
• Thinking of hurting yourself or others

 
There are definitely some ways you can learn to adapt or handle the stress in your life:

• Activity – Regular exercise can make you feel better.  Rhythmic pursuits like walking, dancing, and swimming are some of the best choices, especially if you try to focus on the sensations around you.  Park further from the entrance and enjoy a brisk walk into the building.  Turn on your favorite tunes and dance around the home.  Greet people you see along the way.  When you go out for a smoke break, just once per day, walk around the building instead.
• Interactions – Instead of texting, look up and speak to someone.  If your friends make you more anxious or worried, spend less time with them.  If you are trying to build some friendships, there are many free activities.  Try your local library movie night and join in the discussions afterward.
• Healthy eating – A diet of processed and convenience food, sugary snacks, and refined carbohydrates will only worsen the situation.  Eating good, lean protein, fruits, vegetables, reducing caffeine and sugar and drinking enough water every day will help you feel physically better and then more capable of handling the challenges that come your way.

 

In the clinical world of mental health, a sociopath and a psychopath are each classified as someone with antisocial personality disorder (ASPD).  These are individuals who cannot understand others' feelings.  In general, they have no guilt for doing harm.  They may be charming.  The terms sociopath and psychopath are often debated in academic circles, and many consider them to be the same thing.  Others apply small differences to the conditions.  
 
Shared behavior between sociopaths and psychopaths are:

• Disregard for laws
• Disregard for social rules or patterns
• Disregard for the rights of others
• No remorse
• No guilt
• Aggressive or even violent behaviors

 
Being selfish, acting out, or acting rebelliously are not, in themselves, cause for a diagnosis of ASPD.  However, if the symptoms are ongoing and are not altered by punishment or changes in lifestyle, the outcome is often different.  People with ASPD rarely if ever feel bad about what they are doing or how they are treating others. 
 
Sociopaths are generally nervous and can burst into anger easily.  They have few acquaintances and probably few to no friendships because they have difficulty maintaining relationships.  As a rule, they are less educated and frequently live on the fringes of society.  Crimes they commit are generally spontaneous. 
 
Psychopaths are very charming people and find it easy to manipulate others.  Because they are so charismatic, they seem disarming.  They are usually well educated and hold steady jobs.  While they do not form relationships, they learn how to imitate emotions.  They appear normal.  For this reason it can be difficult for a victim to realize they have been targeted.  Their crimes are very well planned and executed and plan for contingencies.
 
Psychiatric diagnoses usually center on the “nature versus nurture” theory.  Psychopaths are genetically predisposed to their behavior, while sociopaths are developed from childhood trauma or abuse.
 
To be diagnosed with ASPD, an individual over 18 must clearly demonstrate at least three of the following behaviors. 

• Clear disrespect for social norms and laws.
• Lies, uses false identities, and uses others for personal gain.
• Avoids long-term plans; ignores consequences.
• Aggressive behavior like frequent fights.
• Ignores personal safety or that of others.
• Ignores personal responsibilities like work habits or paying bills
• Has no guilt or remorse for actions.

 
Other indicators can be:

• Not learning from mistakes
• Threats and intimidation
• Frequent crimes
• Unwarranted risks
• Substance addiction
• Inability to maintain relationships
• For individuals younger than 15, animal abuse or cruelty

 
Both psychopaths and sociopaths are a risk to society and a danger to others in many cases.  Violence is not a required element for a diagnosis of ASPD but it is often found as a trait in those who have been so diagnosed.  Because of their ability to dissociate from others and lack of remorse, psychopaths are typically the more dangerous of the two.  Many convicted serial killers have been diagnosed as psychopaths.
 
Not everyone who has an antisocial personality disorder is a psychopath or a sociopath.  It is estimated that as much as 3% of the population has ASPD.  It is more common in males, those with substance abuse, and in prisons.