If you have mental health concerns, you should seek help. But where do you go? How do you know what type of doctor you should talk to? Do you look for a psychiatrist or psychologist?
If you’re unsure what the difference is, you’re not alone. “We get that all the time,” says Tristan Gorrindo, MD, director of the American Psychiatric Association Division of Education. “There’s a lot of confusion out there."
There are similarities, but there are important differences, too. Here’s what you need to know to decide which is right for you.
How They’re Alike
Psychiatrists and psychologists are different types of doctors trained to help you deal with mental health issues. Both are there to talk you through problems. They aim to provide you with the means to manage the issues in your everyday life.
How They’re Different
Psychiatrists are medical doctors (MDs) who graduate from medical school, have a year of medical internship, and have 3 years of residency in the assessment and treatment of mental health disorders.
Psychologists have a doctoral degree in an area of psychology, the study of the mind and human behavior. They’re not medical doctors. A psychologist can have a PhD in philosophy or a PsyD in clinical or counseling psychology. Typically, they do 1-2 years of internship. Unlike psychiatrists, psychologists are also trained in giving psychological tests (like IQ tests or personality tests).
Because of their medical training, psychiatrists can prescribe medication -- probably the most commonly known distinction between the two fields. But a few states allow psychologists to prescribe a limited number of psychiatric medications if they’ve taken a course in psychopharmacology.
Both psychiatrists and psychologists are typically trained to practice psychotherapy -- talking with their patients about their problems. But the differences in background and training translates into different approaches to solving your mental health problems.
Psychologists look closely at your behavior. “If you’re depressed and can’t get out of bed, there’s a behavioral activation,” says C. Vaile Wright, PhD, a director at the American Psychological Association. Psychologists will track sleep patterns, eating patterns, and the negative thoughts that might be causing or contributing to the problem.
“Psychiatrists have a stronger sense of biology and neurochemistry,” says Ranna Parekh, MD, a director at the American Psychiatric Association. “Theirs is going to be a diagnosis of exclusion. For instance, before we call someone depressed, we’re going to make sure they don’t instead have some vitamin deficiency or thyroid problem.” Once they’ve made a mental health diagnosis, psychiatrists often prescribe you medicine.
Whom Should You Call?
Both psychologists and psychiatrists are generally covered equally by health insurance programs, and both often work on a sliding scale when it comes to patients paying out of pocket.
One possible advantage of seeing a psychiatrist is that, as a medical doctor, they have the knowledge and training to evaluate underlying medical problems or drug effects that could cause emotional or behavioral symptoms. Psychiatrists can also work more readily with your primary care doctor or other specialists. “As part of our residency, we’re trained in different settings, like pediatrics, outpatient, and the emergency room,” says psychiatrist Gorrindo. “We speak the language of any other part of the hospital.”
For serious kinds of mental health problems, such as major depression, bipolar disorder, or schizophrenia, where physical symptoms may be severe and it may be hard to take basic care of yourself, psychiatrists generally have more formal training and treatment options available.
In the treatment of less severe kinds of mental health problems, who you see can often be more a matter of personal preference. “A lot of people don’t like the idea of medication,” Wright says. “They’re afraid they’re going to get addicted, or that by changing their body chemistry, they are somehow broken.” They’re more likely to see a psychologist first.
Wright says your choice should be guided by the type of problem you’re having. Someone who may be clinically depressed could benefit from taking medication, while someone dealing with a phobia might find therapy with a psychologist the most effective choice. Usually, if a psychologist is treating someone whom they feel has severe symptoms (such as suicidal or highly irrational thoughts), they may suggest a consultation with a psychiatrist to help clarify a diagnosis and possibly prescribe medications.
Just Get Help
If you’re still struggling with the decision between psychology and psychiatry, Wright recommends talking it over with your primary care doctor. “One size does not fit all,” she says. “Different things can work at different points or work together. There is no wrong way as long as you’re doing something and being open with your provider about what’s working and what’s not.”
Gorrindo is in agreement. “If you’re worried about being depressed or some other mental issue, it doesn’t matter who you go to,” he says. “Just go to someone.”
“At the end of the day,” Wright says, “both psychology and psychiatry are built around strong relationships based on trust and confidentiality.”
Once you’ve made a choice about the type of help, you may need to see a few different doctors before you decide on the one who’s right for you.