What Is Psychiatry?

A psychiatrist provides diagnosis and treatment of mental illness affecting people of all ages, specializing in conditions and disorders such as dementia, Alzheimer’s disease, ADHD (attention deficit hyperactivity disorder,) bereavement, bipolar disorder, schizophrenia, eating disorders, sleep disorders, sexual disorders, mood disorders, and anxiety disorders.

People seek psychiatric help for many reasons. The problems can be sudden, such as a panic attack, frightening hallucinations, thoughts of suicide, or hearing “voices.” Or they may be more long-term, such as feelings of sadness, hopelessness, or anxiousness that never seem to lift or problems functioning, causing everyday life to feel distorted or out of control.

Diagnosing Patients

Because they are physicians, psychiatrists can order or perform a full range of medical laboratory and psychological tests which, combined with discussions with patients, help provide a picture of a patient’s physical and mental state. Their education and clinical training equip them to understand the complex relationship between emotional and other medical illnesses and the relationships with genetics and family history, to evaluate medical and psychological data, to make a diagnosis, and to work with patients to develop treatment plans.

Specific diagnoses are based on criteria established in APA’s Diagnostic and Statistical Manual of Mental Disorders(DSM-5), which contains descriptions, symptoms, and other criteria for diagnosing mental disorders.

What Treatments Do Psychiatrists Use?

Psychiatrists use a variety of treatments – including various forms of psychotherapy, medications, psychosocial interventions, and other treatments (such as electroconvulsive therapy or ECT), depending on the needs of each patient.

Psychotherapy, sometimes called talk therapy, is a treatment that involves a talking relationship between a therapist and a patient. It can be used to treat a broad variety of mental disorders and emotional difficulties. The goal of psychotherapy is to eliminate or control disabling or troubling symptoms so the patient can function better. Depending on the extent of the problem, treatment may take just a few sessions over a week or two or may take many sessions over a period of years. Psychotherapy can be done individually, as a couple, with a family, or in a group.

There are many forms of psychotherapy. There are psychotherapies that help patients change behaviors or thought patterns, psychotherapies that help patients explore the effect of past relationships and experiences on present behaviors, and psychotherapies that are tailored to help solve other problems in specific ways. Cognitive behavior therapy is a goal-oriented therapy focusing on problem-solving. Psychoanalysis is an intensive form of individual psychotherapy which requires frequent sessions over several years.

Most medications are used by psychiatrists in much the same way that medications are used to treat high blood pressure or diabetes. After completing thorough evaluations, psychiatrists can prescribe medications to help treat mental disorders. While the precise mechanism of action of psychiatric medications is not fully understood, they may beneficially modulate chemical signaling and communication within the brain, which may reduce some symptoms of psychiatric disordersPatients on long-term medication treatment will need to meet with their psychiatrist periodically to monitor the effectiveness of the medication and any potential side effects.

Class of Medications

  • Antidepressants – used to treat depression, panic disorder, PTSD, anxiety, obsessive-compulsive disorder, borderline personality disorder, and eating disorders.
  • Antipsychotic medications – used to treat psychotic symptoms (delusions and hallucinations), schizophrenia, bipolar disorder.
  • Sedatives and anxiolytics – used to treat anxiety and insomnia.
  • Hypnotics – used to induce and maintain sleep.
  • Mood stabilizers – used to treat bipolar disorder.
  • Stimulants – used to treat ADHD.

Psychiatrists often prescribe medications in combination with psychotherapy.

Other treatments are also sometimes used. Electroconvulsive therapy (ECT), a medical treatment that involves applying electrical currents to the brain, is used most often to treat severe depression that has not responded to other treatments. Deep brain stimulation (DBS), vagus nerve stimulation (VNS), and transcranial magnetic stimulation (TMS) are a few of the newer therapies being used to treat some mental disorders. Light therapy is used to treat seasonal depression.

Psychologist vs. Psychiatrist: What’s the Difference?

Their titles sound similar, and they’re both trained to diagnose and treat people with mental health conditions. Yet psychologists and psychiatrists aren’t the same. Each of these professionals has a different educational background, training, and role in treatment.

Psychiatrists have a medical degree along with advanced qualifications from residency and a specialty in psychiatry. They use talk therapy, medications, and other treatments to treat people with mental health conditions.

Psychologists have an advanced degree, such as a Ph.D. or PsyD. Most commonly, they use talk therapy to treat mental health conditions. They may also act as consultants along with other healthcare providers or study therapy for entire treatment programs.

Both types of providers must be licensed in their area to practice. Psychiatrists are also licensed as medical doctors.

Read on to learn more about the differences between the two and how to decide which you should see.

Differences in practice

Psychiatrists and psychologists use different tools to treat mental health conditions. Sometimes they work in different environments.

Psychiatrists

Psychiatrists can work in any of these settings:

  • private practices
  • hospitals
  • psychiatric hospitals
  • university medical centers
  • nursing homes
  • prisons
  • rehabilitation programs
  • hospice programs

They often treat people with a mental health condition that requires medication, such as:

  • anxiety disorders
  • attention deficit hyperactivity disorder (ADHD)
  • bipolar disorder
  • major depression
  • post-traumatic stress disorder (PTSD)
  • schizophrenia

Psychiatrists diagnose these and other mental health conditions using:

  • psychological tests
  • one-on-one evaluations
  • lab tests to rule out physical causes of symptoms

Once they’ve made a diagnosis, psychiatrists may refer you to a psychotherapist for therapy or prescribe medication.

Some of the medications psychiatrists prescribe include:

  • antidepressants
  • antipsychotic medications
  • mood stabilizers
  • stimulants
  • sedatives

After prescribing medication to someone, a psychiatrist will closely monitor them for signs of improvement and any side effects. Based on this information, they might make changes to the dosage or type of medication.

Psychiatrists can also prescribe other types of treatments, including:

  • Electroconvulsive therapy. Electroconvulsive therapy involves applying electrical currents to the brain. This treatment is usually reserved for cases of severe depression that don’t respond to any other types of treatment.
  • Light therapy. This involves using artificial light to treat seasonal depression, especially in places that don’t get a lot of sunlight.

When treating children, psychiatrists will begin with a comprehensive mental health examination. This helps them evaluate the many components underlying a child’s mental health issues, including emotional, cognitive, educational, familial, and genetic.

A psychiatrist’s treatment plan for children may involve:

  • individual, group, or family talk therapy
  • medication
  • consultation with other doctors or professionals at schools, social agencies, or community organizations

Psychologists

Psychologists similarly work with people who have mental health conditions. They diagnose these conditions using interviews, surveys, and observations.

One of the big differences between these mental health professionals is that psychologists can’t prescribe medication. However, with additional qualifications, psychologists can currently prescribe medication in five states:

  • Idaho
  • Iowa
  • Illinois
  • Louisiana
  • New Mexico

They can also prescribe medication if they work in the military, Indian Health Service, or Guam.

A psychologist can work in any of the same settings as a psychiatrist, including:

  • private practices
  • hospitals
  • psychiatric hospitals
  • university medical centers
  • nursing homes
  • prisons
  • rehabilitation programs
  • hospice programs

They commonly treat people with talk therapy. This treatment involves sitting with the therapist and talking through any issues. Over a series of sessions, a psychologist will work with someone to help them better understand their symptoms and how to manage them.

Cognitive-behavioral therapy is a type of talk therapy that psychologists frequently use. It’s an approach that focuses on helping people overcome negative thoughts and patterns of thinking.

Talk therapy can take many forms, including:

  • one-on-one with the therapist
  • family therapy
  • group therapy

When treating children, psychologists may assess areas other than mental health, including cognitive functioning and academic capabilities.

They may also perform types of therapy that psychiatrists normally don’t do, such as play therapy. This type of therapy involves letting children play freely in a safe playroom with very few rules or limits.

By watching children play, psychologists can gain insight into disruptive behaviors and what a child is uncomfortable expressing. They can then teach children communication skills, problem-solving skills, and more positive behaviors.

Differences in education

In addition to differences in practice, psychiatrists and psychologists also have different educational backgrounds and training requirements.

Psychiatrists

Psychiatrists graduate from medical school with one of two degrees:

  • doctor of medicine (MD)
  • doctor of osteopathic medicine (DO)

After getting a degree, they take a written exam to get licensed in their state to practice medicine.

To become a practicing psychiatrist, they must complete a four-year residency. During this program, they work with people in hospitals and outpatient settings. They learn how to diagnose and treat mental health conditions using a medication, therapy, and other treatments.

Psychiatrists must take an exam given by the American Board of Psychiatry and Neurology to become board-certified. They have to get recertified every 10 years.

Some psychiatrists get extra training in a specialty, such as:

  • addiction medicine
  • child and adolescent psychiatry
  • geriatric psychiatry
  • forensic psychiatry
  • pain medicine
  • sleep medicine

Psychologists

Psychologists complete graduate school and doctoral-level training. They can pursue one of these degrees:

  • doctor of philosophy (Ph.D.)
  • doctor of psychology (PsyD)

It takes four to six years to earn one of these degrees. Once they’ve earned a degree, psychologists complete another one to two years of training that involves working with people. Finally, they must take an exam to get licensed in their state.

Like psychiatrists, psychologists can also get specialty training in areas such as:

  • clinical psychology
  • geropsychology
  • neuropsychology
  • psychoanalysis
  • forensic psychology
  • child and adolescent psychology

Choosing between the two

A psychiatrist may be a better choice if you have a more complex mental health issue that requires medication, such as:

  • severe depression
  • bipolar disorder
  • schizophrenia

If you’re going through a difficult time or want to work on better understanding your thoughts and behaviors, a psychologist may be a better option.

If you’re a parent looking into treatment for your child, a psychologist may be able to provide different types of therapy options, such as play therapy. A psychiatrist may be a better choice if your child has a more complex mental issue that requires medication.

Keep in mind that many common mental health conditions, including depression and anxiety, are often treated with a combination of medication and talk therapy.

In these cases, it’s often helpful to see both a psychiatrist and a psychologist. The psychologist will do regular therapy sessions, while the psychiatrist manages medications.

Whichever specialist you choose to see, make sure they have:

  • experience treating your type of mental health condition
  • an approach and manner that makes you feel comfortable
  • enough open appointments so you don’t have to wait to be seen

Financial considerations

If you have insurance, you may need to ask your primary care doctor for a referral to both a psychiatrist and a psychologist. Other plans may let you see both without a referral.

If you don’t have insurance and are concerned about treatment costs, you still have options. Consider reaching out to local colleges with psychiatry, psychology, or behavioral health programs. They may offer free or low-cost services provided by graduate students under professional supervision.

Some psychologists also offer a sliding-scale payment option. This allows you to pay what you can afford. Don’t feel uncomfortable asking if someone offers this; it’s a fairly common question for psychologists. If they won’t give you an answer or seem unwilling to discuss prices with you, they’re probably not a good fit for you, anyway.

NeedyMeds, a nonprofit dedicated to helping people find affordable treatment and medication, also offers tools for finding low-cost clinics and discounts on medication.

The bottom line

Psychiatrists and psychologists are two types of mental health professionals. While they have several similarities, they play different roles in healthcare settings.

Both treat a variety of mental health conditions, but in different ways. While psychiatrists often use a mix of therapy and medication, psychologists focus on providing therapy.

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