How do psychiatrists tell if a mental health issue is psychological vs. neurological?

I’m not entirely sure if I should be weighing in on the pricing issue here.😬

In my view, the cost of seeing a psychiatrist isn't actually the core issue. Honestly, they're relatively low. Someone could make more in just a few months running a niche massage business. Training to become a therapist takes a long time and costs a fortune, so it makes sense that their rates stay lower than what you'd see elsewhere—it's not like they're ignoring the cost of living.

The real breakdown is in the healthcare system. For people who can't afford private care but desperately need it, it seems like the system can't offer much more than a quick visit with a GP.

I don't see an easy fix. It's capitalism; everything has a price tag, including our health. Unless we decide to go back to being a communist state,😍

Jerry Martinez5 said:Exactly. If you end up being admitted, it’s pretty much expected that they’ll rule out any organic causes first.

Best regards.
This is my first time posting here—regarding how, during hospitalization, psychiatrists tend to rush toward a diagnosis before they've actually ruled out physical, organic issues. In my own experience, there was this constant push to get me to accept their conclusion before we even looked at the facts. They kept pushing their narrative, while I kept insisting that there was clearly a physical cause behind everything, but they just wouldn't listen. Even after I had an ultrasound—which clearly showed a tangible, organic issue—and even after my psychiatrist finally agreed that my initial diagnosis was wrong and said it should be wiped from my medical records, that old hospital diagnosis still sits there as the primary entry in my file. So, when people try to tell me otherwise now... who's actually the one losing touch with reality? Seriously, WTF? 😵 😵

vividhound192 said:Best regards.
This is my first time posting here—regarding how, during hospitalization, psychiatrists tend to rush toward a diagnosis before they've actually ruled out physical, organic issues. In my own experience, there was this constant push to get me to accept their conclusion before we even looked at the facts. They kept pushing their narrative, while I kept insisting that there was clearly a physical cause behind everything, but they just wouldn't listen. Even after I had an ultrasound—which clearly showed a tangible, organic issue—and even after my psychiatrist finally agreed that my initial diagnosis was wrong and said it should be wiped from my medical records, that old hospital diagnosis still sits there as the primary entry in my file. So, when people try to tell me otherwise now... who's actually the one losing touch with reality? Seriously, WTF? 😵 😵

When I first experienced psychosis, they ran every single neurological test under the sun "just to be safe," even though it seemed pretty obvious it was a psychotic break (schizophrenia), especially since my mother has that diagnosis and it's partially hereditary. Why some children of schizophrenic parents develop it while others don't—well, according to official medical consensus, we just don't know for sure. It could be early childhood trauma, or maybe just bad luck; for instance, if one parent is ill but the other doesn't have any predisposition toward mental illness, the condition might never manifest. Bipolar disorder seems to have a much stronger genetic link than schizophrenia; for example, in identical twins, if one has schizophrenia, there's only about a 50% chance the other will develop it, whereas with bipolar disorder, that number jumps up to 80%.

Honestly, just let people do their jobs in peace. Maybe in a few hundred years, they’ll actually manage to learn something meaningful... but certainly not while being squeezed by this kind of constant pressure. I mean, who could possibly achieve anything worthwhile under these conditions? 🙂

There's no substitute for the grind of actual learning. 😬

Harold Anderson3 said:When I first experienced psychosis, they ran every single neurological test under the sun "just to be safe," even though it seemed pretty obvious it was a psychotic break (schizophrenia), especially since my mother has that diagnosis and it's partially hereditary. Why some children of schizophrenic parents develop it while others don't—well, according to official medical consensus, we just don't know for sure. It could be early childhood trauma, or maybe just bad luck; for instance, if one parent is ill but the other doesn't have any predisposition toward mental illness, the condition might never manifest. Bipolar disorder seems to have a much stronger genetic link than schizophrenia; for example, in identical twins, if one has schizophrenia, there's only about a 50% chance the other will develop it, whereas with bipolar disorder, that number jumps up to 80%.

That's an interesting point. Though, I don't think we can ever be 100% certain that a specific "gene" dictates one illness over another. Even identical twins end up with different personality traits and psychological profiles. A lot of it comes down to how an individual processes things—like whether they can overcome a traumatic event or if it eventually turns into a clinical diagnosis.

rapidgull3 said:It stands to reason that an initial psychiatric evaluation should include a brain CT scan to ensure the organ itself is functioning properly. Only once organic causes are ruled out should psychiatrists and psychologists proceed with psychotherapy. Otherwise, therapy risks being futile and medication intake becomes pointless if there is no effect.

Every single psychological issue has a neurological basis—otherwise, it wouldn't exist in the first place. It’s like asking whether digestive issues have a physiological cause, or if high blood pressure is linked to circulation...

The issue is that our psychiatric establishment mostly operates under some sort of psychodynamic logic—which is really just updated Freudianism—and they aren't particularly collaborative with neurologists, aside from the fact that a patient might have to wait six months for a scan when they need help immediately. Consequently, they mostly default to pharmacotherapy, which—thank God—usually has some measurable effect, given the realities of neurochemistry... but everything else seems to boil down to these clumsy conversations about parental relationships and a general assessment of whether a person is dangerous or not.

God, it’s their specialty... "doctors" and all that. You can't tell them they're doing it wrong; you can't really say anything to them at all. Any criticism you offer is simply treated as another symptom, which serves as further justification to keep you institutionalized for a while longer...

The problem is actually somewhat deeper... most branches of medicine deal directly with the organism, so their approaches and methods are more technical. Psychiatry, however, pretends to deal with the "person," yet they remain—quite ironically, since they should be the ones to understand this distinction—operationally under the delusion that an organism is synonymous with a person. They believe things can be resolved through conversation and by keeping someone confined in a closed space and so on... I suppose it works, in a way. Everything helps. Even leeches, for instance, truly assist with inflammations and hematomas—that is proven...

That’s a fair point. Perhaps we aren't looking at a neurological cause, but rather a neurophysiological one.
I don't subscribe to the whole mind-body duality thing either; it's all one single entity. It’s much like the particle-wave duality in physics. They are essentially the same thing. I suppose you could say there is no such thing as a psychosomatic illness—because, in reality, every illness is psychosomatic. There isn't really a "mind" that exists independently from the "body," or vice versa.
That being said, I suspect various ailments might have distinct organic indicators. It probably makes more sense to consult a different specialist first, rather than jumping straight to a psychiatrist, if they can identify specific markers that warrant further testing.

So, one of my doctors sent me off for an EEG and a brain CT scan.
Later on, I ended up getting an MRI for some other stuff.

I’ve got this super mild neurological thing—kind of like epilepsy—but that’s really it.
Everything else is just mental health stuff.

Luckily, I could get everything done at the hospital, because if I’d tried going to a private clinic, the bill would've been absolutely insane. ☕