Going to see a doctor about your mental health is not an easy step to take. It may have taken you months or years to reach this decision.
And that’s just the first step. The next question is: “What kind of doctor should I see?”
You could see your primary care doctor. Many people do. Of the 8 million appointments for depression, about half of them are made with primary care physicians, according to a news story on PBS.com.
If the primary care doctor route is not for you, you are then faced with another choice: should you see a psychologist or a psychiatrist? How do you know who is right for you?
What’s the Difference Between a Psychiatrist & a Psychologist?
Before we explore the difference, you should first know that many psychiatrists and psychologists work closely together.
The primary difference between the two types of doctors comes down to medication: a psychiatrist can prescribe it, while a psychologist cannot.
In addition to offering treatment through medication, psychiatrists will often conduct talk therapy, cognitive behavioral therapy or other forms of treatment. They may also make referrals to counselors or therapists (like psychologists).
According to Psychology Today: “Psychiatrists receive the same medical school education as any other medical doctor, such as an internal medicine physician or a pediatrician and, therefore, hold a doctor of medicine degree (M.D.).”
When to Choose a Psychologist
A psychologist doesn’t hold an M.D. degree. Psychologists will assess patients and treat them through counseling or talk therapy.
Talk therapy is a method of treatment that helps patients re-evaluate their feelings and attitudes, creating healthier behavior according to the American Psychological Association. The Association states that psychologists are “highly trained professionals with expertise in the areas of human behavior, mental health assessment, diagnosis and treatment, and behavior change.”
Applying scientifically validated procedures, a psychologist will work with a patient to help them identify and isolate a problem, recommend potential behavioral changes, and determine the best course of action.
Marian Margulies, PhD, a psychologist in New York City and candidate in psychoanalysis at the Institute for Psychoanalytic Education at the NYU Medical Center, said talk therapy is important because you aren’t just treating the symptoms – you are finding out what’s causing the pain.
“If you’re not getting to the cause of the pain, you’re essentially chained to the past,” Dr. Margulies told “Psychotherapy gets to the root.”
When to Choose a Psychiatrist
Even if psychotherapy is getting to the root of the problem, you still may need additional help.
With a medical background, a psychiatrist can review your complete medical history. Understanding the full picture is important because some mood disorders may be caused by physical conditions like hormonal changes (pregnancy or thyroid disorder), according to the Mayo Clinic.
“Because we learned how the body interacts with the mind, we can rule out physical disorders as a cause of mental illness. This is important, since a person may have a hyperactive thyroid, for example, which can trigger panic attacks, anxiety, insomnia, or anorexia. We can look at thyroid blood tests or have a patient consult an endocrinologist if we suspect the problem stems from thyroid disease,” Carol W. Berman, M.D., a clinical assistant professor of psychiatry at NYU Medical Center in New York City, wrote in the Huffington Post.
If depressive symptoms are significantly impacting your body and daily life, a psychiatrist can help determine if medication will help. Importantly, a psychiatrist can consider drug-drug interactions if you are already taking medication for other conditions.
If a patient needs it, a psychiatrist has the authority to recommend hospitalization. However, Dr. Berman writes that hospitalization is often a last resort:
“The most common types of psychiatric hospitalizations are for suicide attempts, detoxifications from drugs or alcohol, psychotic episodes caused by mania or from schizophrenia. Most psychiatrists use hospitalization sparingly as a last resort if no other treatment will work.”
If you are considering medication as a form of treatment, a psychiatrist may order a pharmacogenomics test, which can help them get a better understanding of what medication might be more likely to work for you based on your genetic makeup. The GeneSight test is an example of a pharmacogenomic test that psychiatrists can use as an additional tool to guide medication selection – and help you avoid a lengthy trial-and-error process.
Choosing A Provider who is Right for You
If you feel you may be experiencing depressive symptoms, a good way to start is to talk to your primary care physician about a referral. This way, the physician who sees you the most can determine which type of mental healthcare provider you should see based on your medical history.
Once you’re ready to take the next step, you can read more about how to choose a psychiatrist vs. a psychologist And learn more about the GeneSight test