Psychiatrist Questions Mental Health

Difference in treatment between a psychiatrist and psychologist?

I have dealt with anxiety and depression for year. I need help and am wondering if i should see a psychologist or psychiatrist? how will they be different?

17 Answers

Psychiatristsare physicians who can and do prescribe medications for depression and anxiety. They also are trained to do psychotherapy with or without medications. Psychologists are trained to do psychotherapy but cannot prescribe medications. They often will refer patient to a psychiatrist when medication is indicated as primary treatment or as a supplement to psychotherapy.
The only difference is that psychiatrists can prescribe medication if needed since they are medical doctors.
Psychiatrists are MDs and can prescribe medications. Some also provide psychotherapy (talk therapy). Therapists, such as psychologists and social workers, provide talk therapy only of which there are many kinds. You can see either. If your therapist feels you need a psychiatrist, they will tell you
Psychiatrist evaluates a patient and diagnoses, recommends treatment. Psychologist performs tests needed and provide needed psychotherapy.
I would ask a doctor you know who is experienced in treating anxiety problems. The principal difference in a psychiatrist and psychologist is the psychiatrist can use medicine. Anxiety and depression usually come together. First, seeing a psychiatrist might be a good idea.
Both could be very effective. Psychologists are skilled n psychotherapy and may be able to do psychological testing to elicit possible etiologies of the depression. Psychiatrists are physicians and are highly skilled in the use of 'physical' treatments such as medications, ECT, rTMS and also skilled in psychotherapy. Both Psychiatrists and Psychologists are both often skilled in specialized psychotherapeutic techniques such as DBT and CBT
A psychiatrist is a physician. The approach to care would depend on the individual. A psychiatrist would likely also want to make sure there were not a medical cause of difficulty with mood. Some psychiatrists focus more on medication care while others mostly psychotherapy or some a mixture. A psychologist would likely approach treatment through psychotherapy.
Clinical psychologists have Ph.D.s (Doctorate) in clinical psychology and are trained to treat all the mental disorders. They are also trained in conducting extensive psychological or neuropsychological (brain damage) evaluation. Psychiatrists have a Medical Degree in medicine and are mainly trained in treating medical conditions. Psychiatrists have to spend many years on medicine and then they specialize in psychiatry. Psychiatrists mainly prescribe psychotropic medication while psychologist mainly conduct therapy. Most depressed individuals go to therapy first and they are referred to a psychiatric if the psychological believes that medication is warranted
Psychiatry and clinical psychology are two separate professions, with different training, knowledge, and skills. Both can diagnose and treat mental disorders, but in different ways. Psychiatrists are medical doctors (with an MD degree) who specialize in mental health and psychiatric disorders. Psychiatrists have broad medical training, so they can test for common medical causes of depression and anxiety, including endocrine disorders, brain diseases, medications, etc. They are licensed to prescribe medications and specialize in medication treatment of depression, anxiety, and many other mental disorders. They are also trained to do psychotherapy, although many do not do much psychotherapy in their practice settings. Clinical psychologists have Ph.D. or Psy.D. degrees in psychology, but are not medical doctors, don't have training in pharmacology, and cannot prescribe medication. However, they often have more training and experience in doing psychotherapy than many psychiatrists. They also have expertise in doing psychological testing and assessment.
First, let me explain what each can do for you. Both are experts at diagnosing and treating psychiatric illnesses. The primary difference lies in how each profession treats mental illnesses.

A Psychologist is a type of doctor--a PhD--who is an expert in psychotherapy or counseling, but does not prescribe medications.

A psychiatrist is a medical doctor--a D.O. or M.D.--who focuses on both the medical and psychiatric components of mental illness, and who treats these illnesses with medications when appropriate. Most psychiatrists do not provide therapy or counseling, but instead refer patients to other mental health professionals--like PhDs--for non-medical therapy.

When a patient's symptoms are mild and are not disabling or causing any significant distress, starting with a psychologist is often recommended. For patients whose symptoms are more severe, an evaluation by a psychiatrist should be considered.
Not all psychologists and psychiatrists are the same or alike. That said, psychologists are better prepared to deal with treatment approaches, while psychiatrists are trained to use pharmacological agents to help the problem. Typically, if the condition is severe, look for a combo team that works well with each (psychologist and psychiatrist).
A psychiatrist could determine if your anxiety and depression might have a biologic cause and could respond to medication.
Great question and glad you asked! This shows that you are invested in your healthcare. In medical school, there was an important lesson taught year after year which is the basis of a physician's thought process: there is no wrong question, so ask away until you understand something.

Your question is one that many ask and I can see why it would be easy to not clearly know who is who and what is what given the plethora of healthcare staff. Becoming educated about what the credentials and scope of each person involved in your is a step in becoming a true partner in your care. The more you know, the more empowered you are as a patient.

Here is the difference between the two:
1. Psychiatrists such as myself are physicians, meaning they are "Medical Doctors" as defined as either having an MD (Doctor of Medicine) or a DO (Doctor of Osteopathic Medicine--same as MD, just additional curriculum). We are licensed by the Medical Board of California and complete a four year medical residency, then take a two part exam to become diplomates or "specialty board certified" by the American Board of Psychiatry & Neurology. We practice medicine and are licensed as such. Our first year typically is in general medicine, pediatrics and neurology. We also learn the six main therapeutic modalities--i.e. CBT. But this is only part of our education. Our foundtion is in medicine and we use that knowledge along with our psychotherapeutic training to diagnose and treat patients across all psychiatric disorder spectrums.

Psychologists while referred to as "Doctor", are not physicians. They had either a PsyD or PhD in psychology, which is based on studying behavior and the therapeutic modalities also learned by psychiatrists. Psychologists spend more time learning talk therapy. They do a one year "internship" which is seeing patients while supervised by a licensed psychologists. There is no speciality board for psychology as it is not a medical specialty. They are licensed by the Psychology board.

From my experience, and what evidence shows is that treatment in talk therapy is more effective if the patient is also being treated with pharmacological interventions as there is no way to separate the neuroscience of the brain from the rest of medicine. Your brain is attached to the rest of you which is governed by multiple complex processes, genetic variabilities, etc.
The right medication can help patients reach a point where they are more open, forward-thinking and thus able to make better use of their time in therapy.

I hope that helps.
A psychiatrist is a medical doctor and can prescribe medications if needed. A psychiatrist completed four years of medical school, four years of psychiatry residency and possibly additional fellowship training. Some psychiatrists see patients for various forms of therapy as well as medication management, and some may instead focus on treatment with medication as needed.

Psychologists are not medical doctors, but some may have their doctorates in psychotherapy. Psychologists can have differing amounts of post-graduate education, but all had to complete an accredited training program. Psychologists do different forms of psychotherapy, but cannot prescribe medications.

Carly Snyder, M.D.
A psychiatrist can give medication because they are medical doctors, a psychologist is not a medical doctor but a doctor of psychology and can only offer therapy. If you have depression, then you might need antidepressants more than anything right now plus therapy. A nurse practitioner can also give medication and provide therapy. A psychologist is the best for any therapy, but because they cannot give out medication, that changes everything in a country that over medicates clients.
A psychiatrist is trained as a physician and is a medical doctor who can prescribe medication, and often is also trained in therapy. A psychiatrist will also consider medical causes of symptoms. A psychologist is trained in therapy, in doing research, and can do psychological testing. Some psychiatrists also do reach. Both groups can be in administration.
A psychiatrist is a fully trained physician who has studied and had experience practicing all medical fields and then chose to specialize in psychiatry. Psychiatry is the ONLY field that blends the physical and the mental...the mind AND body experience. Psychologists are trained in emotions and therapy, but not in medical issues. As time goes on, we are finding more and more mental concerns are actually medically or chemically mediated and therefore the psychiatrist is the unique professional with the expertise to evaluate and treat.

Gary M. Glass, M.D.