By Roberto Hugo González
Dr. José E. Igoa, a prominent figure in the field of psychiatry, has a rich and diverse background that reinforces his expertise. Born in Tampico, Tamaulipas, Dr. Igoa’s medical journey began at the Autonomous University of Guadalajara. His pursuit of knowledge led him to Canada, where he completed his psychiatry residency at the University of Ottawa.
Despite the cold Canadian winters, Dr. Igoa found his way to McAllen, drawn by its warm climate, welcoming community, and the familiar comforts of Mexican culture. His decision to stay was partly influenced by the region’s charm, a sentiment humorously expressed through the local saying about drinking the water from the Rio Grande.
Dr. Jose E. Igoa, FRPC (C), MRC Psych, is the medical director at DHR Health Behavioral Hospital; he also has a private practice in McAllen and recently opened another practice in Harlingen, Texas.
Dr. Igoa’s career in the Rio Grande Valley isn’t just marked by longevity but also by his dedication to addressing complex psychiatric conditions. His approach to treating anxiety, for instance, involves understanding it as an adaptive response that, when excessive, leads to disorders like panic attacks. He emphasizes the importance of recognizing when symptoms escalate to a level where they disrupt daily functioning and biological cycles, urging individuals to seek psychiatric help.
The landscape of psychiatric treatments has evolved considerably over the years, as Dr. Igoa notes. His residency training forms the foundation of his practice, but continual advancements in the field have introduced new and effective treatment options. For depression, Dr. Igoa highlights the efficacy of psychological treatments, particularly cognitive therapies, in addressing the condition.
Dr. Igoa’s journey from a student in Mexico to a respected psychiatrist in the U.S. is proof of his commitment to his profession and his ability to blend cultural understanding with medical expertise. His approach to psychiatric care not only addresses the clinical aspects of mental health conditions but also considers the holistic well-being of his patients.
Advanced Treatments and Approaches in Psychiatry
“Cognitive Behavioral Therapy (CBT) and Interpersonal Psychotherapy are vital tools in treating mild to moderate depression,” Dr. Igoa said. They emphasize the role of thinking patterns and interpersonal relationships in mental health, providing patients with strategies to manage and improve their symptoms.
For severe depression, psychopharmacological treatments are often the first line of defense. These include various medications, each with unique effectiveness and side effect profiles. While older medications like tricyclic antidepressants and monoamine oxidase inhibitors were effective, they also posed significant risks, including potentially fatal overdoses. Dr. Igoa pointed out that modern medications are safer, with fewer side effects, and are as effective as their predecessors.
Besides medications, procedure-based interventions like transcranial magnetic stimulation and Electroshock Therapy are still used. Electroshock Therapy, in particular, has a high effectiveness rate of 90-95%, compared to 75-80% for medications.
He said that common side effects of psychiatric medications, particularly serotonin re-uptake inhibitors used for depression, include nausea, vomiting, and sexual side effects like decreased libido and anorgasmia. These side effects vary in intensity and frequency among individuals.
Treatment of Bipolar Disorder
Bipolar disorder, a condition marked by alternating periods of depression and mania, is highly genetic and requires specialized treatment. Mood stabilizers, such as lithium and certain antiepileptics like Depakote (valproic acid) and Tegretol (carbamazepine), are commonly used. Atypical antipsychotics are also employed to manage both depressive and manic episodes and to stabilize mood.
The Role of Psychotherapy Versus Medication
In treating conditions like depression, the combination of psychotherapy and medication is often most effective. While medication can alleviate symptoms like loss of energy or appetite, psychotherapy addresses the underlying issues, such as problems at work or in relationships, providing long-term coping strategies.
Continuous Improvement of Medications
The field of psychopharmacology is continually evolving, with new and improved medications being developed regularly. These medications aim to control symptoms effectively, much like treatments for chronic physical conditions like diabetes or hypertension.
Schizophrenia: A Persistent Challenge in Psychiatry
Schizophrenia, an enduring psychiatric condition, has been part of human history since its dawn. Characterized by a disconnection from reality, it manifests through hallucinations (often auditory) and delusions (false beliefs, sometimes persecutory).
“Schizophrenia affects approximately 1% of the population globally, regardless of region. The condition is progressive; with each relapse, individuals often lose some of their societal functioning capabilities. Family genetic factors play a significant role, with the risk substantially increasing if one or both parents have schizophrenia. However, environmental factors also contribute to its development.” Dr. Igoa stated.
Anxiety Disorders: Varied Forms and Diagnosis
He explains that anxiety disorders, which encompass a range of conditions, each diagnosed based on clinical observation of patient symptoms. Generalized anxiety disorder involves persistent worry accompanied by various physical symptoms. Panic disorder presents as acute episodes resembling heart attacks. Post-traumatic stress disorder (PTSD) results from traumatic experiences and includes symptoms like constant vigilance, flashbacks, and nightmares. Adjustment disorders arise in response to stressful life events, such as job loss or relationship issues, leading to anxiety. Dr. Igoa said that these disorders illustrate the diverse manifestations of anxiety in mental health.
Psychotic Episodes: Understanding the Break from Reality
Psychotic episodes are considered when individuals exhibit a significant loss of contact with reality, primarily through delusions and hallucinations. Psychosis can be a component of several conditions, including schizophrenia, depression, and bipolar disorder. Additionally, drug use can induce psychotic symptoms, necessitating a thorough differential diagnosis to identify the underlying cause, whether it be a primary psychiatric condition, substance-induced, or secondary to other factors.
The Pervasive Influence of Genetics in Mental Health
Dr. Igoa says that genetics play a crucial role in the development and persistence of mental disorders. Many psychiatric conditions are familial and chronic, impacting individuals throughout their lives. The respect for psychiatry has grown as the field acknowledges the disabling nature of these conditions. Disorders like depression, schizophrenia, and bipolar disorder are not only recurrent but also start from a young age, significantly impacting life trajectories. The risk of mortality, often through suicide, is a critical concern in these conditions, underscoring the severity and enduring nature of mental health disorders.
Building Resilience through a Balanced Approach
Dr. Igoa emphasizes the importance of resilience in mental health, likening it to a chair with four stable legs. These legs represent the physical, psychological, social, and spiritual aspects that contribute to overall mental well-being.
- Physical Needs: Good nutrition, rest, and exercise is crucial. Meeting these physical needs helps maintain mental health.
- Psychological Needs: Self-esteem, derived from fulfilling roles in personal and professional life, is essential for mental stability.
- Social Needs: Being part of a community and maintaining social connections are vital. Humans are inherently social beings, and isolation can adversely affect mental health.
- Spiritual Needs: Having a sense of purpose or belonging, whether through organized religion or personal interests, provides a meaningful direction in life.
Advising on Mental Health Problems
Understanding and acceptance are key when addressing mental health issues. Dr. Igoa stresses that mental health disorders, like physical ailments, have their roots in brain function and are not moral or personal failures. They require appropriate treatments, either through therapy or medication, depending on their severity.
Just as lifestyle changes may manage mild conditions, severe cases like deep depression with suicidal thoughts or psychotic symptoms need immediate medical intervention. The analogy of managing high blood pressure with lifestyle changes versus medication for severe cases parallels the approach to mental health treatment.
The Role of Conferences in Mental Health Education
Dr. Igoa highlights the importance of medical conferences in disseminating current knowledge in psychiatry. These events are carefully planned, often taking an entire year, and are based on feedback and current trends in mental health. As a speaker and participant in various conferences, including those sponsored by pharmaceutical companies, Dr. Igoa emphasizes the significance of bringing in experts and leaders in specific fields to share their insights and advancements.
The Growing Concern of Mental Health in the Region
Dr. Igoa discusses the increasing awareness of mental health issues in areas like the Rio Grande Valley. He notes that while certain disorders might be more prevalent due to regional factors, mental health concerns are a widespread challenge affecting various demographics.
During this interesting conversation, Dr. Igoa also spoke about the Prevalence of Disorders. He has been in south Texas for many years and understands that the region faces an array of mental health challenges. He said that higher rates of diabetes lead to secondary complications like strokes and subsequent depressive disorders. Attention deficit disorders among youth and the effects of drug use are also significant concerns.
He spoke briefly about the impact of Immigration. “Immigrants, especially, face unique mental health challenges. Many of them experience severe trauma, including sexual assault, and forced participation in brutal acts, leading to lasting psychological scars akin to those left by physical injuries,” he said.
Mental Health and Domestic Violence
The intersection of mental health and domestic violence is a critical area of concern. Dr. Igoa highlights the complexity of these situations, particularly for women who may feel trapped due to financial dependence or fear of retribution. These circumstances can lead to unspoken suffering and a cycle of abuse.
Domestic Violence and Mental Health: Mental health issues can both contribute to and result from domestic violence. Factors like alcoholism and drug addiction play significant roles, affecting not just the direct victims but also children and future generations.
The Prevalence and Treatment of Depression
Depression is a major concern, with a lifetime risk of nearly 20% in the population. This statistic underscores that mental health issues are common and not isolated cases. Dr. Igoa urges individuals not to suffer in silence but to seek the widely available treatments.
The Impact of Substance Abuse
Substance abuse, affecting approximately 17% of the population, is closely linked to domestic violence and broader mental health issues. Addressing these problems requires a multifaceted approach, focusing on both the substance abuse itself and its wider implications on families and communities.
In this final phase, Dr. Igoa’s insights reveal the complex tapestry of mental health challenges faced by communities, particularly in regions like the Rio Grande Valley. His emphasis on awareness, accessible treatment, and the critical role of community support highlights the importance of a holistic approach in addressing these pervasive issues.