A psychiatrist is a medical doctor who specializes in the mental health field. Psychiatry is the branch of medicine that focuses on the prevention, diagnosis, and treatment of mental, behavioral, and emotional disorders.
Psychiatrist vs. psychologist
Although their professions overlap in many ways, psychiatrists aren’t the same as psychologists. Psychiatrists get medical training that lets them prescribe medications and perform procedures. They normally treat more complicated mental health conditions. Psychologists mainly provide counseling and nonmedical support but do neuro-psych evaluations. Psychologists have a doctoral degree (PhD). They use talk therapy to help people but can't prescribe medication.
Psychiatrist vs. therapist
A therapist is a mental health professional who has a master's degree. Their studies might be in psychology, family therapy, or counseling. Therapists use talk therapy and other methods to help people. And while a psychiatrist can prescribe medication, a therapist can't.
What Does a Psychiatrist Do?
When you make an appointment with a psychiatrist, they’ll first ask about your mental and physical symptoms. This may involve a physical exam, lab tests, and/or a psychological evaluation. As part of the process, they’ll refer to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to determine what mental illness you may have. Published by the American Psychiatric Association, this manual is used by mental health professionals for diagnoses and by insurance companies for reimbursement purposes.
There are many classes of mental illness, including:
- Schizophrenia spectrum and other psychotic disorders
- Bipolar and related disorders
- Trauma- and stressor-related disorders
- Obsessive-compulsive and related disorders
- Depressive disorders
- Anxiety disorders
- Feeding and eating disorders
- Elimination disorders
- Sleep disorders
- Sexual dysfunctions
- Substance-related and addictive disorders
- Personality disorders
It may take more than one visit to get a proper diagnosis.
After making a diagnosis, the psychiatrist will tell you about your condition and work with you to develop a treatment plan. Treatment may involve any combination of the following:
- Psychotherapy, or talk therapy
- Light therapy, which mainly treats seasonal depression
- Brain stimulation therapies, such as deep brain stimulation (DBS), vagus nerve stimulation (VNS), and transcranial magnetic stimulation (TMS)
- Electroconvulsive therapy (ECT) and now ketamine therapy
Some common medications psychiatrists prescribe include:
- Antipsychotic medications
- Sedatives and anxiolytics
- Mood stabilizers
Where do psychiatrists work?
About half the psychiatrists in the U.S. are in private practice. In addition to that, many work in several different settings. Those can include:
- Hospitals, including emergency rooms
- Psychiatric hospitals
- Courts and prisons
- Rehabilitation programs
- For the government or military
- Private companies
- Skilled nursing care facilities or hospice programs
How to Become a Psychiatrist
Psychiatrists take the traditional steps to becoming a doctor. They complete a bachelor's degree as well as a 4-year medical school degree program. To earn a Doctor of Osteopathic Medicine (DO) or Doctor of Medicine (MD) degree, psychiatrists must have the same medical training as most other doctors.
Psychiatrists-in-training must then complete a psychiatric residency program, in which they get hands-on experience.
If a doctor wants to practice in a specific field of psychiatry, that can lead to more job opportunities.
A U.S. Bureau of Labor Statistics survey from 2022 showed that the estimated average yearly salary for a psychiatrist is $247,350.
Pay might be more or less, depending on where you work. For instance, psychiatrists who work in doctors' offices and outpatient care centers generally make more than psychiatrists who work in hospitals.
The area of the country where psychiatrists practice also often determines how much they get paid. In 2022, psychiatrists in North Dakota made close to $400,000. Psychiatrists in California averaged $311,950 a year, and doctors in Connecticut were paid an average of $308,690.
Types of Psychiatrists
Some psychiatrists take part in fellowships that can involve 1 to 2 years of research projects and training to learn to treat specific groups of people. Those can include:
This branch of psychiatry focuses on young children and teenagers and conditions that involve their behavior, well-being, and the way they think. These doctors may also talk with the families of their young patients.
This doctor deals with issues that touch mental health and the law. They may study mental conditions among people who are in prison. Some doctors may be called to a court to talk about the mental health of people accused of crimes, and even tell courts whether a person is able to stand trial. A forensic psychiatrist could also be asked to figure out whether a person might hurt other people.
Other specialties for psychiatrists
Doctors can go through training to practice in other areas, including:
- Geriatric psychiatry, which treats people who are 65 years old or older. These doctors have training in later-life conditions such as depression, dementia, and anxiety, among others.
- Addiction psychiatry, which treats people with substance abuse disorder
- Emergency psychiatry, to help people in emergency situations such as attempted suicide, psychosis (when people may lose a sense of reality and see or hear things that are not there), substance abuse, serious depression, or violence
- Consultation or liaison psychiatry, when they partner with doctors in a general medical setting
Reasons to See a Psychiatrist
There are a number of signs that you might benefit from visiting a psychiatrist, including:
- Problems adjusting to life changes
- Anxiety or worry
- Lasting depression
- Suicidal thoughts
- Hurting yourself
- Obsessive thinking
- Hallucinations or delusions
- Uncontrollable alcohol or drug use
- Body image problems
- Poor concentration
- Emotional outburst
- Sleep issues
Mental health exists on a spectrum. Not all mental health issues require medical treatment from a psychiatrist. Many people seek counselors or psychologists first and are then referred to a psychiatrist if necessary. Ask your doctor about the right mental health practitioner for you.
What's a Psychiatrist Appointment Like?
It can be a little scary when you go to see a psychiatrist, especially the first time. But remember that they're highly trained professionals who know all the latest treatments and medications that can help you.
It's a good idea to make some notes about things you want to talk about. They might include:
- Issues that have been on your mind, including why you made the appointment
- Your family's mental and physical health history
- Symptoms you have and how they're affecting your life
- Any changes in your physical health (Some of them could be caused by stress.)
Also, bring a list of all the medicines and supplements you take, including over-the-counter medicines. Or, if it's easier (and you take several medications), bring them with you in a bag.
You can make a list of questions you want to ask. You might consider these:
- Do you have a diagnosis yet? If not, when do you think you will?
- Where can I get more information about my condition?
- What are the treatment options?
- How much experience do you have treating people with this condition?
- How will I know I'm feeling better?
- When can I expect to start feeling better?
- Are there side effects to my medication?
- What should I do if I feel worse?
- What if I have an emergency?
How much does a psychiatrist appointment cost?
A session with a psychiatrist generally costs between $100 and $200. Some doctors cost more, some less based on a number of things, including location, the doctor's training and reputation, and whether they are a specialist. You should expect your first session, which is normally longer than usual sessions, to cost more.
The Affordable Care Act covers mental health care. Most insurance plans include it, but coverage can be different, depending on your plan and whether your doctor is in your insurance network.
Not all psychiatrists accept insurance, so it's a good idea to check beforehand. If your therapy is covered, you'll pay a copayment, which is a part of the fee for the session. If the doctor you want to see isn't in your insurance network, it's still possible the company will pay you back a portion of the cost. It won't be as much as they would pay for a doctor in their network, though.
If you don't have insurance, some doctors in private practice offer what's called a "sliding scale." That means the fee for a session can be lowered, based on what you can afford. Online directories can help you find practices that have that option. Some psychiatry practices offer payment plans, too.
Two other options if cost is an issue are community mental health centers or college and university clinics.
A psychiatrist is a specially trained doctor who treats your mental health.
- They can prescribe medicine if you have serious mental conditions.
- You might start off seeing another kind of counselor who might suggest you see a psychiatrist if your condition might need medication or more intense therapy.
- You can get help paying for your treatment with a psychiatrist through your insurance or other options, including a sliding scale for lower fees, payment plans, or going to a clinic.
What are the major psychiatric disorders?
A mental health disorder is one that negatively affects your emotions, the way you think, or the way you act.
The World Health Organization (WHO) identifies several major psychiatric or mental health disorders:
- Anxiety – High levels of worry or fear that can affect how you function every day
- Depression – Long-term feelings of sadness or emptiness, or not getting happiness from things that would normally make you happy
- Bipolar disorder – Alternating between feelings of depression and manic symptoms that may include intense happiness, high energy, or a need for less sleep, among other things
- Posttraumatic stress disorder (PTSD) – Having flashbacks or nightmares about extremely scary situations you lived through, avoiding things that remind you of what happened, and a feeling that you might be under threat right now
- Schizophrenia – Changes in your view of reality and your behavior that can cause you to see or hear things that are not there