Psychiatry

Anxiety is one of the most common psychiatric disorders and can manifest itself as generalized anxiety, social anxiety, anxiety attacks, or panic attacks. This condition is characterized by persistent fear, excessive worry, muscle tension, palpitations, shortness of breath, and a feeling of loss of control. 

Depression encompasses several types, including major depression, resistant depression, perinatal depression, and seasonal depression. This condition causes persistent sadness, loss of interest, intense fatigue, sleep disturbances, and negative thoughts, and is one of the most debilitating psychiatric disorders. 

Burnout is a syndrome related to prolonged work or emotional stress. This condition causes physical and mental exhaustion, loss of motivation, irritability, difficulty concentrating, and feelings of incapacity. 

Bipolar disorder involves intense mood swings, alternating between episodes of mania/euphoria and deep depression. Bipolar disorder affects energy, behavior, sleep, and thinking, and can significantly interfere with daily life. 

Personality disorders, such as Borderline and Narcissistic personality disorder, are characterized by emotional instability, impulsivity, unstable interpersonal relationships, fear of abandonment, or egocentric and manipulative behaviors. 

OCD involves intrusive thoughts (obsessions) and repetitive behaviors (compulsions) used to relieve anxiety. This condition can limit daily activities and cause significant psychological distress. 

Eating disorders, such as Anorexia, Bulimia, and Binge Eating, are characterized by dysfunctional eating behaviors, an intense fear of gaining weight, cycles of compulsion and purging, extreme food restriction, or a distorted body image.

It includes psychoses and schizophrenia, which can cause changes in the perception of reality. The most common symptoms include delusions, hallucinations, disorganized speech, and social isolation. 

Mental health is strongly linked to sleep quality. The most common disorders include insomnia, sleep apnea, and sleep paralysis. These can cause constant fatigue, difficulty concentrating, irritability, and impact emotional well-being. 

These disorders include various types of dementia such as Alzheimer's, Parkinson's, vascular dementia, and Lewy body dementia, and cause progressive memory loss, behavioral changes, language difficulties, and cognitive decline. 

ADHD affects children and adults, and is associated with difficulty concentrating, impulsivity, and motor restlessness.  

This includes dependence on alcohol, drugs, and other psychoactive substances. This abuse causes behavioral, physical, and emotional changes, requiring medical supervision and, often, complementary therapies. 

A general psychiatric consultation is the basis of mental health assessment. Its purpose is to diagnose and treat psychiatric disorders in adults, including anxiety, depression, bipolar disorder, schizophrenia, psychosis, obsessive-compulsive disorder (OCD), eating disorders, and cognitive changes associated with aging, such as dementia. 

During the consultation, the psychiatrist performs:

1. Complete clinical assessment – personal history, significant events, relationships, routines, habits, substance use, and stress factors.
2. Identification of symptoms – persistent sadness, lack of energy, irritability, anxiety, difficulty concentrating, memory problems, or behavioral changes.
   
   
3. Lifestyle analysis – sleep, diet, physical activity, social interaction, and patterns that may aggravate or alleviate symptoms.
   
   
4. Diagnosis and personalized treatment plan, which may include psychotropic drugs, psychotherapy, cognitive behavioral therapy (CBT), transcranial magnetic stimulation (TMS), or, in specific cases, electroconvulsive therapy (ECT).

The focus is on restoring emotional balance, reducing symptoms, and promoting well-being and functionality in daily life. 

These consultations aim to provide an assessment by a psychiatrist and psychologist simultaneously. This simplifies the usual assessment process, which involves first seeing a psychiatrist and then being referred to a psychologist, thus avoiding the need to repeat the entire medical history. The clinical assessment combines the perspectives of psychiatry and psychology to create an individual treatment plan.  

The result is faster and more effective treatment, which may include medication adjustments, psychotherapy, neuromodulation interventions, or lifestyle changes tailored to each person's specific needs.

Resistant depression, persistent anxiety, and burnout require detailed assessment, as approximately 30% of depression cases continue to show symptoms even after multiple treatments. These conditions are often characterized by extreme fatigue, irritability, difficulty experiencing pleasure, negative thoughts, constant tension, and an inability to manage everyday tasks. 

During this consultation, a complete review of previous treatments and factors that may be preventing recovery is conducted. The intervention combines psychopharmacological strategies—such as adjustments to antidepressants, anxiolytics, or mood stabilizers—with advanced neuromodulation techniques, such as TMS or ECT, when indicated.  

The psychological component is also essential, integrating CBT, stress management, increased resilience, and modification of harmful habits and lifestyles. The goal is to achieve significant improvement, even in more complex cases. 

OCD is a disorder that is often experienced in silence, due to the suffering associated with intrusive thoughts and compulsive behaviors. The consultation allows for a simultaneous assessment of the psychiatric dimension—including medication in effective doses, laboratory monitoring, and possible alternatives such as TMS—and the psychological dimension, analyzing the degree of dysfunctionality, thought patterns, and impact on daily life. The integration of drug treatment and specialized psychotherapy, such as CBT with Exposure and Response Prevention, significantly increases therapeutic effectiveness. 

The onset of psychotic symptoms, such as delusions, hallucinations, or exaggerated suspicion, is a source of suffering for both the patient and their family. Therefore, this consultation includes a detailed medical evaluation, using laboratory tests and imaging exams to rule out other possible causes. The treatment plan is tailored to each situation and includes modern antipsychotics, psychoeducation, cognitive and functional rehabilitation strategies, psychotherapy, and, when necessary, neuromodulation techniques.

The family plays a key role at this stage, being involved in the process of understanding and managing the illness. 

Perinatal psychiatry supports women during pregnancy and postpartum, assessing symptoms such as postpartum depression, anxiety, mood swings, or risk of relapse into pre-existing disorders. Treatment balances the safety of the mother and baby, combining appropriate medication, psychotherapy, and emotional and family support strategies. This consultation is essential to ensure psychological well-being at a particularly sensitive stage of life. 

ADHD in adults often remains undiagnosed, as its symptoms can be confused with anxiety, depression, or exhaustion. The consultation seeks to identify patterns of inattention, impulsivity, disorganization, procrastination, and difficulty managing time, from childhood to adulthood. Mood swings, consumption habits, and impact on professional, family, and social life are also assessed. 

Treatment combines medication appropriate for ADHD in adults, psychotherapy focused on organization, self-control, and daily management, as well as practical strategies that promote functioning and quality of life. 

Child psychiatry treats children and adolescents with emotional, behavioral, or neurodevelopmental difficulties. Problems such as anxiety, depression, ADHD, excessive fears, school difficulties, or family conflicts are assessed from a perspective that integrates the child, the family, and the school environment. The goal is to promote healthy development and prevent the perpetuation of symptoms into adulthood. 

Psychogeriatrics is the field that assesses and treats mental health problems in older adults, such as late-onset depression, anxiety, memory changes, dementia, and difficulties adapting to chronic illnesses or significant losses. This consultation involves a detailed analysis of cognitive status, associated physical illnesses, and emotional factors involved. Treatment includes medication, psychological intervention, cognitive stimulation strategies, and family support, ensuring a better quality of life and autonomy. 

Psychopharmacology is a central area of drug therapy in psychiatry, using drugs such as antidepressants, anxiolytics, mood stabilizers, and antipsychotics to treat various mental disorders. When properly adjusted to each person's pathology and needs, these drugs are safe, effective, and generally well tolerated, with few side effects. 

When used correctly, they do not cause excessive sedation, habituation, or dependence. In some clinical situations, as with other chronic medical conditions (such as diabetes), they may be necessary for prolonged periods to maintain stability and prevent relapses. 

At Joaquim Chaves Saúde, in addition to our clinical experience in prescribing and monitoring psychotropic drugs, we offer a wide range of laboratory tests to monitor blood concentrations of these medications. This approach improves dosage accuracy and increases the effectiveness and safety of treatment. 

Transcranial Magnetic Stimulation (TMS) is a non-invasive technique that uses magnetic pulses to stimulate specific areas of the brain associated with mental disorders. When applied repeatedly, it improves neuronal activity and can be especially effective in cases that do not respond to conventional treatments, such as medication or psychotherapy. 

TMS is recommended mainly for resistant depression, severe depression, obsessive-compulsive disorder (OCD), and migraines, and may also help in situations of tobacco addiction.  

At Joaquim Chaves Saúde, we use advanced TMS technology with BrainsWay equipment, recognized for its precision and clinical effectiveness. As it is a non-surgical treatment, without anesthesia and with rapid recovery, patients can resume their activities immediately after each session, making TMS a safe, well-tolerated, and comfortable option. 

Electroconvulsive therapy (ECT) is a highly effective therapeutic technique that has been used for several decades in the treatment of severe depression and other resistant psychiatric disorders. Despite its longstanding reputation, today it is a safe procedure, rigorously controlled and adjusted to each person using modern equipment and personalized parameters. 

ECT consists of applying an electrical stimulus that synchronizes neural networks and promotes the release of neurotransmitters, neural growth factors, and hormones. The treatment is quick, performed under general anesthesia and with muscle relaxation, making it painless and well tolerated. 

It is particularly effective in resistant depression, reducing delusions, hallucinations, and medication load, significantly improving mood, functionality, and quality of life. Usually, the initial cycle involves 6 to 12 sessions, with the possibility of maintenance treatment when indicated. 

At Joaquim Chaves Saúde, we have an experienced team and SIGMASTIM equipment, ensuring the utmost safety and precision in each ECT session. 

Esketamine therapy is an innovative approach for adults with resistant depression, especially when other antidepressants or psychopharmacology methods have not produced significant improvement. With rapid action and an innovative mechanism on the glutamatergic system, esketamine can begin to reduce depressive symptoms within a few hours. 

At Joaquim Chaves Saúde, it is administered via a nasal spray, always under direct medical supervision, ensuring safety and adequate monitoring.  

Cognitive Behavioral Therapy (CBT) is a structured, evidence-based psychotherapeutic approach recommended for various mental health conditions, such as depression, anxiety, phobias, obsessive-compulsive disorder, burnout, and emotional regulation difficulties. Focusing on the relationship between thoughts, emotions, and behaviors, it helps identify dysfunctional patterns and develop practical strategies to change them. 

CBT also includes specialized protocols, such as CBT-I (Cognitive Behavioral Therapy for Insomnia), considered the most effective non-pharmacological treatment for persistent sleep disorders. This intervention acts on sleep habits, thoughts associated with insomnia, and behaviors that perpetuate the problem, allowing for lasting improvement in sleep quality and continuity. 

At Joaquim Chaves Saúde, CBT is conducted by psychologists and psychiatrists with advanced training, integrated into a personalized therapeutic plan, often combined with other approaches, such as supportive psychotherapy or drug therapy, always according to each person's needs.