What is a Psychologist vs a Psychiatrist?

The “psychologist vs psychiatrist” debate has been around for decades. Although both fields revolve around mental health, each has its own set of theories, explanatory models, and intervention tools.

So perhaps it’s time for all of us to get a better understanding of the similarities and differences between psychologists and psychiatrists.

And that’s because, in everyday life, we sometimes face situations and challenges that can impact us on a cognitive, emotional, and social level. In an ever-changing and increasingly challenging society, many of us experience sadness, fear, anxiety, panic attacks, feelings of inadequacy, depression, and other mood disturbances that can affect our overall sense of health and well-being.

When it comes to mental health, subjects like ‘normal vs abnormal’ and ‘healthy vs unhealthy’ spark heated debates among healthcare professionals and confusion among the general population.

Unfortunately, these controversies can generate myths that spread across the general population, sometimes building stigma around mental illness. As a result, those who need specialized help fail to receive it because either they don’t know whom to address or they’re not quite sure how a psychologist or psychiatrist will be of use.

In fact, the lack of education on mental health (or psychoeducation) is one of the factors responsible for the increasing number of people dealing with mental illness. One of the most widespread confusion is that between psychologist and psychiatrist.

Although both professions are complementary and seek to promote mental health, there are notable differences regarding professional training, theoretical framework and intervention strategies.

Let’s try to solve the ‘psychologist vs psychiatrist’ issue by getting a better understanding of the two fields and how they relate to mental health.

What is a Psychiatrist

Ask anyone to name a difference between psychiatry and psychology and the most common answer you’ll hear is that psychiatrists prescribe drugs while psychologists use ‘talk’ therapy.

But there’s more to being a psychiatrist than prescribing drugs, just as there’s more to being a psychologist than talking to people about their problems.

Before we get to what psychiatrists do and how they promote mental health, we must first look at what psychiatry is.

In broad lines, psychiatry is a branch of medicine that specializes in the diagnosis, treatment, and prevention of mental disorders. Psychiatric disorders can have a profoundly negative impact on various aspects of our life, from physical health, emotions, and behavior to interpersonal relationships, career, and love life.

According to psychiatrists, the source of mental illnesses is a combination of biological, psychological, and social factors. The biology of mental disorders is probably the area where psychiatry thrives most.

As you probably guessed psychiatrists identify, assess, and treat psychiatric disorders mostly through drug therapy. A psychiatrist is a physician who went to medical school and specialized in psychiatry.

Nowadays, aside from treating severe psychiatric disorders, psychiatrists also deal with healthy people who are struggling with emotional and behavioral problems. That’s because it’s impossible to draw a clear line between ‘normal’ and ‘abnormal’ or ‘functional’ and ‘pathological.’

Fortunately, psychiatrists have the necessary training and experience to assess the seriousness of mental pathology properly. By examining the symptoms and overall mental condition of the patient, psychiatrists can then prescribe medication designed to alleviate the diagnosed disorder.

When dealing with patients who don’t suffer from diagnosable conditions but are vulnerable and in need of specialized support, psychiatrists usually recommend counseling or psychotherapy services.

If the symptoms are severe and the patient presents a risk to himself or others, the psychiatrist will recommend supervision or admission to a specialized hospital.

Scope of Practice

Situated at the crossroads between medicine and psychology, psychiatry represents the study of the human brain. This filed seeks to explain the biological mechanisms behind our thoughts, emotions, and actions. By understanding how the brain works, psychiatrists can determine the cause of mental illness and prescribe the appropriate medication.

But their expertise extends far beyond pharmacology and pharmacotherapy.

Most of today’s psychiatrists receive extensive training therapy which means they can offer counseling services as well. Considering that mental illness, regardless of severity and other factors, impacts all aspects of the individual’s life, addressing the problem solely from a medical standpoint wouldn’t be enough.

To provide an accurate diagnosis, psychotherapists use the Diagnostic and Statistical Manual of Mental Disorders. This taxonomic and diagnostic tool – which is published and updated regularly by the American Psychiatric Association – is an encyclopedia of mental disorders, each with its own diagnostic and treatment criteria.

Given that psychiatry is a branch of medicine, healthcare professionals who work in this filed are required to follow the same ethical guidelines and code of conduct as any other medical doctor.

Training

To become a psychiatrist, one must go through medical school first. After obtaining a degree in medicine (M.D.), one can choose psychiatry as a specialty. That means four years of residency training during which psychiatrists specialize in diagnosis and treatment strategies for psychiatric disorders. [1]

A psychiatry residency program is not different than other residency programs. It involves studying, taking exams, and doing some ‘real’ work at a psychiatric hospital. Part of being a psychiatrist also means receiving extensive training in psychotherapy. Most residency programs opt for cognitive behavioral therapy since it’s among the few psychotherapeutic approaches with a solid scientific foundation.

After completing their residency, some psychiatrists choose to pursue a sub-specialization. Although it’s optional, this extra step can help psychiatrists become experts in a particular niche, thus boosting their reputation and expertise.

Having a solid background in medicine means psychiatrists know precisely how the human brain works and, more importantly, how this organ influences (and is influenced) other structures of the human body. That’s the reason why only they have the freedom to prescribe medication for psychiatric conditions.

What Happens When You See a Psychiatrist

When seeing patients, the first thing psychiatrists do is assess the problem and determine the diagnostic. This allows them to devise an appropriate treatment strategy that includes both medication and psychotherapy.

Being under psychiatric care means you’ll have to visit your psychiatrist regularly to adjust the dosage of your medication, assess your overall condition, and monitor any changes that occur after treatment.

Since many categories of mental disorders require a mix of drug therapy and psychotherapy, psychiatrists often recommend counseling and therapy sessions. You can either request counseling services from your psychiatrist (if he/she is trained and licensed to practice psychotherapy) or go to another licensed healthcare professional.

Psychologist vs Psychiatrist

Considering that mental health and well-being rely on more than just being properly medicated, perhaps the ‘psychologist vs psychiatrist’ paradigm should be replaced by a ‘psychologist and psychiatrist’ approach.

What is a Psychologist

Often presented as “mind readers” or “mentalists” by the movie industry, psychologists are actually trained professionals who seek to understand the inner workings of the human mind and develop strategies to treat and prevent mental illnesses.

Psychologists work with thoughts, emotions, behaviors, and other mental constructs. They provide psychological counseling and promote mental health through psychotherapy.

Unlike psychiatrists, who tend to place more emphasis on the biological component of mental disorders, psychologists follow an integrative approach to mental health and pathology. In other words, they focus on the psychological, emotional, and social aspects of mental health and pathology. Since their expertise in brain biology is limited, psychologists often ‘team up’ with psychiatrists in hopes of tackling mental health issues on all fronts.

Not being a physician means a psychologist can not prescribe drugs and use psychiatric diagnosis to assess severe mental conditions. Even though most of them have basic knowledge of psychiatric diagnosis and have access to psychiatric diagnostic tools (e.g., Diagnostic and Statistical Manual of Mental Disorders), a psychiatrist’s opinion in irreplaceable.

In a way, we could argue that psychologists treat the ‘normal’ end of the psychiatric spectrum, providing support and guidance for people who struggle with manageable conditions.

Using psychological tests, they assess the individual’s functioning on an intellectual, cognitive, emotional, behavioral, and social level. Psychological testing is perhaps the most significant contribution that psychology – as a stand-alone field – has made to science.

Once they zero in on a specific problem (or diagnostic, depending on the case), psychologists begin to implement a set of therapeutic strategies that will help clients discover themselves, improve their relationship with others, overcome emotional struggles, develop healthy coping mechanisms, reach professional growth, and achieve mental health.

Scope of Practice

Psychology, as a science, deals with the study of the human mind and behavior. This field aims to determine the causal factors of mental illnesses and increase the quality of life. From this perspective, psychologists are specialists in mental health, whether we are talking about treating or preventing mental disorders.

Regarding strategies and procedures, psychologists use assessment tools and therapeutic techniques that have been scientifically proven effective in treating various emotional or behavioral problems.

People who are dealing with problems like depression, stress, or anxiety and wish to tackle them by consulting a psychologist will first go through a thorough assessment and evaluation process. Based on the results, psychologists can design an intervention plan comprised of regular therapy sessions that stretch over a couple of months (sometimes years).

Depending on the severity of the problem, psychologists can also encourage clients to consult a psychiatrist who could prescribe medication to alleviate the symptoms that may be interfering with the therapeutic process.

Lastly, practicing psychologists are required to obtain a license, follow a rigorous set of ethical principles, and stick to a code of conduct.

Training

Becoming a psychologist is somewhat easier and less expensive than becoming a psychiatrist.

Many psychologists aim for Master of Science (M.S.), followed by training courses in a specific psychotherapeutic approach. Although they have a robust set of skills that allows them to provide counseling and psychotherapy services, psychologists who don’t hold a doctoral degree are required to work under the supervision of a Ph.D. or Psy.D.

To obtain the necessary accreditation to practice in a clinical setting (and with no supervision), psychologists must first get a doctoral degree in philosophy (Ph.D.) or psychology (Psy.D.).

By focusing on the psychosocial aspects of mental health, psychologists manage to provide an integrative approach to mental illness and help people better themselves without the use of medication.

What Happens When You See a Psychologist

Most of us are probably familiar with the image of the therapist sitting on the chair and nodding while the vulnerable client cries out his/her problems.

In reality, a counseling or therapy session involves much more than just a 50-minute crying session where you get an “mhm” or “I see…” every couple of minutes.

Psychologists tend to focus on the way in which you perceive and adapt to the external environment, helping you achieve emotional, social, and professional well-being. Compared to psychiatrists, psychologists can provide a more in-depth assessment of your overall health and well-being.

In fact, the evaluation phase of the therapeutic process represents a crucial step towards recovery. Using various psychological testing tools, counselors or therapists can evaluate your personality, behavior, coping mechanisms, cognitive functioning, and many other crucial elements of your mental architecture. [2]

Equipped with a robust set of science-backed techniques and with the ability to cultivate empathy, understanding, and meaningful interactions, psychologists help struggling individuals manage and prevent emotional struggles.

Unlike psychiatric consultations, which are scheduled once every couple of months, psychotherapy sessions usually take place once a week.

Which One Should You See?

Many of us know that psychiatry is the science of the brain while psychology is the science of the mind. But perhaps it is this oversimplification that causes all the confusion which fuels the ‘psychologist vs psychiatrist’ debate.

Since mental illness is the result of biological, psychological, and environmental factors, it’s obvious that both psychology and psychiatry play a central role in mental health and well-being.

In many cases, the collaboration between the two similar-but-different specialists means a better understanding of the patient’s condition which paves the way to speedy recovery.

There are also cases when a mix of psychological and psychiatric interventions is not just beneficial but mandatory. Without the help of medication, it would be almost impossible for severe patients to follow through with therapy and achieve significant progress.

If you feel like you’re dealing with a problem that exceeds your ability to cope, consult a mental health professional as soon as possible. It doesn’t matter if it’s a psychologist or psychiatrist. The only thing that matters is getting the opinion of a specialist who can suggest a course of action.

References

R. Ryback, “Psychiatrist vs. Psychologist,” Psychology Today, 4 Jan 2016. [Online]. Available: https://www.psychologytoday.com/us/blog/the-truisms-wellness/201601/psychiatrist-vs-psychologist.

T. Rehagen, “Psychologist or Psychiatrist: Which Is Right for You?,” WebMD, n.a.. [Online]. Available: https://www.webmd.com/mental-health/features/psychologist-or-psychiatrist-which-for-you#1