Domain 2.14Anatomy and Physiology

Psychiatry And Common Psychiatric Conditions

Last updated June 16, 2026

Overview

Welcome to the comprehensive study guide for Psychiatry and Psychology. This guide merges critical concepts from Domain 1.5 (Psychology) and Domain 2.14 (Psychiatry) to provide a holistic view of mental health in a medical setting.

As a Medical Assistant (MA), you are often the first clinical point of contact. While you do not perform psychological evaluations, diagnose conditions, or provide therapy, your role is vital. Understanding these principles allows you to:

  • Improve Communication: Build trust and provide empathetic care by understanding developmental stages and psychological needs.
  • Ensure Patient Safety: Recognize signs of suicidal ideation, aggressive behavior, or crisis and alert the provider immediately.
  • Support Holistic Care: Understand the connection between physical health (e.g., chronic pain) and mental health (e.g., depression).
  • Facilitate Treatment: Understand medication protocols (especially for controlled substances) and recognize side effects.

This guide covers developmental theories, defense mechanisms, common psychiatric conditions, and the specific role of the MA in mental healthcare.

1. Theories of Development and Motivation

The exam frequently tests your knowledge of key theorists who described how humans develop and what motivates them.

Erik Erikson: Psychosocial Development

Erikson's theory proposes eight stages, each with a unique psychosocial conflict. Successfully resolving the conflict leads to a healthy personality.

Stage (Age) Conflict Successful Resolution Clinical Relevance for MAs
Infancy (0-1.5) Trust vs. Mistrust Infant develops a sense of security and trust when caregivers are reliable. A calm, gentle approach helps build trust with infant patients and their parents.
Toddler (1.5-3) Autonomy vs. Shame/Doubt Child develops a sense of independence and personal control. Allow toddlers to make simple choices (e.g., "Which arm for the blood pressure cuff?").
Preschool (3-5) Initiative vs. Guilt Child begins to assert power and control over their environment. Engage children with play-based explanations for procedures to encourage cooperation.
School Age (5-12) Industry vs. Inferiority Child copes with new social and academic demands; develops a sense of competence. Praise a child's bravery during a procedure to build their sense of accomplishment.
Adolescence (12-18) Identity vs. Role Confusion Teenager develops a sense of self and personal identity. Respect their need for privacy and communicate directly with them, not just their parents.
Young Adult (18-40) Intimacy vs. Isolation Forms intimate, loving relationships with other people. Be mindful of discussions around relationships and family planning.
Middle Adult (40-65) Generativity vs. Stagnation Creates or nurtures things that will outlast them (e.g., children, positive change). Patients may be balancing their own health with caregiving for children and aging parents.
Older Adult (65+) Ego Integrity vs. Despair Reflects on life with a sense of fulfillment or regret. Listen patiently to their stories; treat them with respect and dignity.

Abraham Maslow: Hierarchy of Needs

Maslow's theory suggests people are motivated to fulfill basic needs before moving on to advanced needs.

Exam Tip: You must satisfy the needs at the bottom of the pyramid before you can address the needs higher up. Think: you can't worry about your career (Esteem) if you don't have food and water (Physiologic).

  1. Physiologic Needs (Base): Air, food, water, shelter, warmth, sleep. Essential for survival.
  2. Safety Needs: Security, order, law, stability, freedom from fear.
  3. Love and Belongingness Needs: Friendship, intimacy, family, connection.
  4. Esteem Needs: Achievement, mastery, status, self-respect.
  5. Self-Actualization (Peak): Realizing personal potential, self-fulfillment.

Carl Rogers: Humanistic Theory

Humanistic theory emphasizes the drive toward self-actualization. A key concept for MAs is Unconditional Positive Regard—accepting and respecting others as they are without judgment. This builds trust in the provider-patient relationship.

Sigmund Freud: Psychosexual Stages

Freud posits that personality develops through childhood stages focused on pleasure-seeking zones.

  • Oral Stage (0-18 mo): Mouth (sucking, biting).
  • Anal Stage (18-36 mo): Bowel and bladder control.
  • Phallic Stage (3-6 yr): Genitals.
  • Latency Stage (6-Puberty): Dormant sexual feelings.
  • Genital Stage (Puberty on): Maturation of sexual interests.

2. Stress, Coping, and Defense Mechanisms

Hans Selye: General Adaptation Syndrome (GAS)

Selye described the body's three-stage response to stress:

  1. Alarm: The initial "fight or flight" response. Cortisol and adrenaline spike.
  2. Resistance: The body tries to adapt to the stressor but remains on high alert.
  3. Exhaustion: Resources are depleted, leading to burnout, illness, or collapse.

Types of Stressors and Coping

When a patient faces stress or a diagnosis, their ability to cope is influenced by:

  • Internal Characteristics: Age, personality, resilience, spiritual beliefs.
  • External Characteristics: Family support, friends, community, financial status.

Categories of Stressors:

  • Background Stressors: Daily hassles (traffic, waiting in line).
  • Personal Stressors: Major life events (death, marriage, job loss).
  • Cataclysmic Event Stressors: Sudden, large-scale events (natural disasters, wars).
  • Burnout: Physical, emotional, and mental exhaustion from prolonged workplace stress.

Psychological Defense Mechanisms

These are unconscious strategies used to cope with anxiety. The exam heavily tests identifying these in patient scenarios.

Mechanism Description "In the Clinic" Example Memory Aid
Denial Refusing to accept a painful reality. A diabetic patient insists, "The lab results are wrong. I feel fine." The patient denies the truth.
Projection Attributing your own unacceptable feelings to someone else. An irritable MA thinks, "This patient is so demanding and angry today." You project your feelings like a movie projector.
Displacement Redirecting strong emotions to a less threatening target. A patient angry at their boss is rude to the front desk staff. You dis-place your anger to a safer place.
Rationalization Creating a logical but false excuse to justify behavior. "I didn't take my pill because I felt good and didn't want side effects." Making irrational behavior sound rational.
Regression Reverting to immature, childlike behaviors. An adult anxious about a blood draw begins to whine and suck their thumb. To regress means to go backward.
Sublimation Channeling unacceptable impulses into constructive activities. An aggressive person becomes a successful surgeon or boxer. Making a negative impulse sublime (noble).
Reaction Formation Behaving the exact opposite of how you truly feel. A patient terrified of surgery acts overly cheerful and jokes about it. You form a reaction opposite to the feeling.
Compensation Overemphasizing a trait to make up for a weakness. A patient anxious about poor health talks constantly about their career. You compensate for weakness with strength.

3. Foundations of Psychiatry

Mental health disorders are medical conditions rooted in the Nervous System involving brain chemistry imbalances.

Key Neurotransmitters

The brain relies on chemical messengers called neurotransmitters.

Neurotransmitter Function Clinical Connection
Serotonin Regulates mood, sleep, appetite. Low levels linked to Depression.
Dopamine Controls pleasure, reward, motivation. Excess linked to Schizophrenia; low to Parkinson's.
Norepinephrine Fight-or-flight (energy/focus). Imbalances linked to Anxiety and ADHD.
GABA The brain's "calming" chemical. Low levels linked to Anxiety.

Exam Tip: Most psychiatric medications work by adjusting these chemicals. SSRIs (Selective Serotonin Reuptake Inhibitors) increase available Serotonin.

The DSM-5

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) is the standard classification system used to diagnose mental disorders. MAs do not diagnose, but you will see "DSM-5 criteria" in charts.

4. Common Psychiatric and Mental Health Conditions

Neurodevelopmental Disorders

  • Autism Spectrum Disorder (ASD): Affects communication and behavior. Symptoms include difficulty with social interaction, repetitive behaviors, and sensory sensitivity.
    • MA Role: May require a quiet room; use clear, direct instructions (avoid idioms).
  • Attention-Deficit/Hyperactivity Disorder (ADHD): Involves inattention, hyperactivity, and impulsivity.
    • Treatment: Stimulants (e.g., Methylphenidate).
    • Clinical Note: These are Controlled Substances (Schedule II) requiring strict prescription monitoring.

Anxiety and Trauma-Related Disorders

  • Generalized Anxiety Disorder (GAD): Persistent, excessive worry about various things. Signs include restlessness, fatigue, and muscle tension.
  • Panic Disorder: Recurrent, unexpected panic attacks.
    • Symptoms: Sudden intense fear, palpitations, sweating, shortness of breath, chest pain.
    • MA Role (Differential Diagnosis): Symptoms mimic a Myocardial Infarction (Heart Attack). Never assume it is "just anxiety"; the provider must rule out cardiac issues first.
  • Phobias: Intense, irrational fear of a specific object or situation.
    • Agoraphobia: Fear of open or crowded places.
    • "White-Coat Syndrome": Anxiety in a medical setting causing abnormally high blood pressure readings.
  • Social Anxiety Disorder: Intense fear of social situations due to fear of judgment.
  • Obsessive-Compulsive Disorder (OCD):
    • Obsessions: Intrusive thoughts (e.g., fear of germs).
    • Compulsions: Repetitive behaviors (e.g., washing hands) performed to reduce anxiety.
  • Post-Traumatic Stress Disorder (PTSD): Develops after exposure to a traumatic event (war, assault). Diagnosis requires this exposure.
    • Symptoms: Flashbacks, nightmares, avoidance, hyperarousal.
    • MA Role: Use "Trauma-Informed Care." Ask permission before touching the patient.

Mood Disorders (Affective Disorders)

  • Major Depressive Disorder (MDD): Persistent sadness and loss of interest.
    • Symptoms: Anhedonia (diminished interest/pleasure), weight changes, fatigue, suicidal ideation.
    • Pathophysiology: Low Serotonin/Norepinephrine. Treated with Antidepressants (SSRIs).
  • Bipolar Disorder: Extreme mood swings between two poles:
    1. Mania: High energy, risky behavior, grandiosity.
    2. Depression: Sadness, hopelessness.
    • Treatment: Mood stabilizers like Lithium (requires frequent blood draws to monitor toxicity).

Psychotic Disorders

  • Schizophrenia: A severe disorder involving a break from reality (psychosis). Linked to excess Dopamine.
    • Hallucinations: Sensory experiences (hearing voices/seeing things).
    • Delusions: False beliefs (e.g., paranoia/conspiracies).
    • Disorganized Speech: "Word salad."
    • Flat Affect: Lack of emotional expression.

Behavioral, Somatic, and Other Disorders

  • Eating Disorders:
    • Anorexia Nervosa: Self-starvation, fear of weight gain, low BMI. Risks: Amenorrhea, heart failure.
    • Bulimia Nervosa: Cycle of binge eating and purging. Risks: Dental erosion, Electrolyte Imbalance (Hypokalemia) leading to cardiac arrhythmias.
  • Substance Use Disorders (SUD): Uncontrolled use despite harm.
    • Tolerance: Needing more for the same effect.
    • Withdrawal: Symptoms after stopping.
    • Addiction: Compulsive drug seeking.
    • Risks: Alcohol (Liver cirrhosis), Opioids (Respiratory depression/overdose), Stimulants (Heart attack).
  • Conversion Disorder: A psychological stressor is "converted" into a real physical symptom (e.g., sudden blindness or paralysis) with no medical cause.

5. End-of-Life: Kübler-Ross Stages of Grief

Dr. Elisabeth Kübler-Ross proposed a model for the emotional states of terminally ill patients.

High-Yield Mnemonic: DABDA

  1. D - Denial: "This can't be happening to me."
  2. A - Anger: "Why me? It's not fair!"
  3. B - Bargaining: "If you let me live, I promise I will..."
  4. D - Depression: Profound sadness, withdrawal.
  5. A - Acceptance: Coming to terms with mortality; sense of peace.

6. Key Psychological Concepts

  • Cognitive Dissonance: Mental discomfort when holding two conflicting beliefs (e.g., a smoker knowing smoking is unhealthy).
  • Motivation: Factors that direct and energize behavior.
  • Sympathy: Feeling compassion for someone.
  • Empathy: Understanding and sharing the feelings of another.
  • Behavior Modification: Techniques to change behavior through reinforcement.

7. The Medical Assistant's Role

1. Screening Tools

You will administer questionnaires to screen for conditions:

  • PHQ-9: Depression.
  • GAD-7: Anxiety.
  • CAGE: Alcohol abuse.

2. Observation and Documentation

Document objective findings accurately.

  • Subjective: "I feel like everyone is watching me."
  • Objective: "Patient is pacing, avoiding eye contact, wringing hands."

3. Safety and Crisis

If a patient expresses Suicidal Ideation:

  • NEVER leave the patient alone.
  • Alert the provider immediately.
  • Remove dangerous objects.

4. Therapeutic Communication

  • Empathy vs. Stigma: Use non-judgmental language (e.g., "Substance use disorder" instead of "Addict").
  • Adaptability: Adjust style for age (play for kids, respect for elders) and condition (calm for anxiety, direct for ASD).

8. Final Key Takeaways

  • Memorize the Theorists: Erikson (psychosocial stages), Maslow (needs pyramid), Rogers (unconditional positive regard), Selye (GAS), and Kübler-Ross (DABDA).
  • Master Defense Mechanisms: Be able to identify Denial, Projection, Displacement, Rationalization, and Regression from scenarios.
  • Neurotransmitters: Serotonin (Mood/Depression), Dopamine (Reward/Schizophrenia).
  • Anxiety vs. Cardiac: Panic attack symptoms mimic heart attacks. Always rule out physical causes first.
  • Eating Disorders: Anorexia = low weight/restriction. Bulimia = binge/purge. Both risk electrolyte imbalances and cardiac arrest.
  • Hallucination vs. Delusion: Hallucinations are sensed (voices); Delusions are believed (conspiracies).
  • Medication Safety: ADHD meds are controlled substances. Lithium (Bipolar) requires blood monitoring.
  • Safety First: A patient mentioning suicide is an emergency. Do not leave them unattended.
  • Role: Observe, listen, document, and communicate. Do not diagnose.