Psychiatrist vs. Psychologist: What’s the difference and which is right for you?

Many people incorrectly use the terms psychiatrist and psychologist interchangeably. Though the two roles sound similar, there are actually a number of important differences, in terms of education, training, and role in treatment.

Here’s what you need to know to help you decide which practitioner is right for you:

How are psychiatrists and psychologists similar?

Psychiatry and psychology are in fact overlapping professions. Doctors in both fields - psychiatrists and psychologists - are mental health professionals trained to help patients cope with mental health issues. They both study the mind and how it affects our well-being and behavior. Psychiatrists and psychologists often work together to diagnose, treat, and prevent mental illness. Both practitioners must be licensed in their area to practice and are dedicated to helping people find the means to optimize their mental health.

How are psychiatrists and psychologists different?

Psychiatrists and psychologists differ in two main areas: education and practice.

Differences in education:

Psychiatrists and psychologists have different educational backgrounds and training.

Psychiatrists are medical doctors (MDs) who graduate from medical school with either a doctor of medicine (MD) degree or a doctor of osteopathic medicine (DO) degree. After receiving their degree, they must pass a licensing exam to be allowed to practice medicine in their state and then complete a four-year residency during which they work with patients both in the hospital and in an outpatient setting. It is in residency that psychiatrists apply what they’ve learned in school to properly diagnose and treat mental health conditions using therapy, medicine, and other treatments. Psychiatrists must also take an American Board of Psychiatry and Neurology exam to become board certified, ensuring that they are committed to keeping current with advances in treating mental illness, maintaining their specialty expertise, and meeting standards of psychiatry practice. Some psychiatrists pursue additional training in a specialty area, such as:

• Child and adolescent psychiatry
• Geriatric psychiatry
• Forensic psychiatry
• Pain medicine
• Addiction medicine
• Sleep medicine

Psychologists, on the other hand, do not attend medical school and are not medical doctors. Instead, they attend graduate school to obtain a PhD (doctor of philosophy) or a PsyD (doctor of psychology) degree. These degrees require four to six years of study, followed by another one to two years of full-time supervised training with patients and a licensing exam. Similar to psychiatrists, psychologists can also complete specialty training in specialties such as:

• Child and adolescent psychology
• Geropsychology
• Clinical psychology
• Psychoanalysis
• Neuropsychology
• Forensic psychology

Differences in practice:

While both psychiatrists and psychologists are normally trained to practice psychotherapy (talk therapy; working through a patient’s issues via discussion), their different educational background and training provides them with different approaches to addressing mental health conditions.

Psychiatrists are trained to look at one’s overall health to differentiate mental health conditions from other underlying health conditions that could cause psychiatric symptoms, such as thyroid problems or vitamin deficiencies, for example. They also monitor how mental illness impacts other health conditions (such as conditions affecting the heart or blood pressure), and how medications affect the body, including how they impact one’s weight, blood pressure, blood sugar, liver or kidney function, and sleep. When a mental health condition has been identified, the psychiatrist will often prescribe medication. In some cases, medication is enough to treat the condition, but in other cases, a combination of medicine and psychotherapy is needed. The psychiatrist may provide the psychotherapy, or he or she may refer the patient to a psychologist or other mental health professional.

Psychologists take a more behavior-based approach to treating mental health issues. They diagnose mental illness through interviews, tests, surveys, and observations with the patient, taking note of behaviors and habits (such as eating and sleep patterns), as well as negative thought processes the patient has that may cause or contribute to the condition. Psychologists often treat patients with talk therapy in which the patient and practitioner talk through issues to understand symptoms and identify ways to cope with them. Cognitive behavioral therapy (CBT) is a type of talk therapy that is commonly used, focusing on overcoming negative thoughts and thinking patterns. With the exception of a few states*, psychologists cannot prescribe medication to their patients, so they may work in tandem with a psychiatrist to comprehensively treat a patient’s mental illness.

*In the states of Idaho, Illinois, Iowa, Louisiana and New Mexico, psychologists may prescribe medication if they have received additional training and/or qualifications. They can also prescribe medication if they work in the military, in the Indian Health Service, or in Guam.

How to choose between the two?

Making the choice between the two professionals depends on your specific situation and needs.

Because of their ability to prescribe medications, a psychiatrist may be a better choice for mental health conditions that are more complex or require medication, such as severe depression, bipolar disorder, or schizophrenia.

If you’re generally having a difficult time at work or at school or want to focus on understanding your behaviors and thought processes, a psychologist trained in talk therapy may be a better choice. In any case, if the psychologist sees that you need medication or that he or she cannot treat you, it is stated in the ethics code that he or she should transfer your case to a psychiatrist or work in tandem with them.

It is important to remember that treatment for many common mental illnesses such as anxiety and depression often combines medication and talk therapy, so it may be helpful to see both practitioners - a psychiatrist to manage medications and a psychologist for therapy sessions.

Whichever you feel is right for you, it is important to ensure that they have experience treating your mental health condition, have a manner and approach that puts you at ease, and have enough availability so that you can be treated regularly without having to wait.

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