Neurology or Psychiatry? What’s the Difference? The brain is a multifaceted organ. When it gets sick we can become confused about what factors are at play. Not all mental maladies are lumped together as “psychiatric.” It’s important to remember because treatments and referrals depend on the correct diagnosis. A neurological disease is characterized as having more to do with the nervous system; examples include Alzheimer’s disease and Tourette syndrome. A mental disorder typically centers around behavior and emotion: depression, anxiety, etc.

So what are clear, distinguishable examples of neurological symptoms versus psychiatric ones? Let’s take a look at the neurological disorder of Tourette’s and compare symptoms to those of depression – one of the most prevalent psychiatric disorders in the world.

Tourette sufferers present with involuntary “tics,” or repetitive actions. These include but are not limited to facial movements, shrugs, or vocalizations. Tics can range from simple (a single action or muscle movement) to complex – for example jumping or doing two separate actions. These tics do not necessarily affect one’s general behavior, and symptoms appear linked with the nervous system.

Depression sufferers are afflicted by negative moods and emotions. Someone with depression may withdraw from social functions, have a consistent feeling of sadness or “emptiness,” exhibit irrational outbursts, and suffer from a disrupted appetite and sleep schedule. These symptoms reflect behavior and disposition rather than the nervous system.

This doesn’t mean neurological and psychiatric disorders are mutually exclusive. For example 86% of Tourette sufferers are also diagnosed with a psychiatric disease like OCD or ADHD. In fact the repetitive behaviors seen in disorders like OCD can blur and complicate a Tourette’s diagnosis.

Debates have arisen among experts about whether to combine the two categories of illness. The argument is that they both focus on the brain. But the brain is one of the most complex organs we have, with myriad parts that function in various ways… most of which are interrelated.

Doctors find that neurological illness, put simply, involves basic functions of the brain like walking and talking. Psychiatric illnesses involve complicated functions of the brain that deal more with emotional regulation and identity. A recent study compared the two types of illness by observing the anatomy of sufferers’ brains:

The basal ganglia, located deep inside the brain, controls speech and movements. This is where neurological diseases saw the most dysfunction.

The prefrontal cortex, at the front of the brain, is responsible for personality and social expression. Psychiatric disorders presented more in this part of the brain.

The study didn’t end there. A number of ambiguities arose somewhat blurring the line between neurological and psychiatric issues, but the authors concluded it made more sense to keep the two disciplines separate.

Some researchers posit more philosophical theories. For example one study was published indicating a difference between “brain” and “mind.” According to the author the brain is the physical organ with its chemicals and parts, while our “mind” is an experiential interface manufactured by several working parts of the brain. Therefore, according to this study, neurological illness stems from brain dysfunction while psychiatric illness resides in the mind.

When it comes to anatomical, semantic, and even philosophical discernments there is some convolution – but doctors find it practically useful to distinguish between “neurological” and “psychiatric.” To quote a famous movie character, both neurologists and psychiatrists have a “very particular set of skills” unique to their practices. It’s pertinent to receive neurological care for a neurological disease, and psychiatric care for a psychiatric one.

References:

Bakhle, Shrirang. (2016, May) Identifying Conceptual Differences Between Psychiatric Disorders and Neurological Disorders Although Both Are Disorders of Brain. Psychology Research. 6(5), 259-269.

David, A., Nicholson, T. (2015, November) Are neurological and psychiatric disorders different? The British Journal of Psychiatry. Retrieved on June 16, 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4629069/

Farley, Pete. (2015, March) Mood, Anxiety Disorders Common in Tourette Patients. University of California San Francisco. Retrieved on June 14, 2019 from https://www.ucsf.edu/news/2015/03/123666/mood-anxiety-disorders-common-tourette-patients

Rettew, David. (2015, December) Psychiatric Vs. Neurological: Can the Brain Tell? Psychology Today. Retrieved on June 17, 2019 from https://www.psychologytoday.com/us/blog/abcs-child-psychiatry/201512/psychiatric-vs-neurological-can-the-brain-tell

Neurology or Psychiatry? What’s the Difference?

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