What’s The Difference and Who To See

If you’re thinking about meeting with a mental health professional, you should give yourself a pat on the back for prioritizing your emotional well-being. Then you’ll need to figure out who you actually ought to see since there are a bunch of different specialists to choose from.

That might bring up the question of who you need to make an appointment with: a psychiatrist or a therapist. Could it be both? While there’s some overlap in the types of services the two provide, each has different training that’s better geared toward specific people and individual needs. Here’s what to know about both specialists and how to pick the right one for you.

What is a therapist?

Therapists are licensed mental health professionals who are trained to help people cope with their thoughts, feelings, and behaviors. “Therapists have specialized training in mental health and can diagnose mental health conditions. But they are not able to prescribe medications,” explains Dana Udall, Ph.D., a licensed psychologist and Head of Behavioral Health at Included Health.

You might see a therapist for a variety of reasons, such as trying to manage feelings like anger, chronic stress, anxiety, trauma, and grief, navigating thoughts around chronic illness, addiction, relationship issues, and job loss, or working on self-improvement, per the American Psychiatry Association.

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Therapists can also have different licenses and qualifications. Per the National Alliance on Mental Illness (NAMI), these can include:

• Psychologist (PhD or PsyD): Holds a doctoral degree in clinical psychology, counseling, or education
• Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Alcohol & Drug Abuse Counselor (LCADAC): Holds a masters-level degree in a mental health-related field.
• Licensed Clinical Social Worker (LCSW, LICSW, ACSW): Holds a masters-level degree in social work.

What happens at therapy appointments?

When you first meet with a therapist, they’ll talk with you to learn about your mental health needs. They might ask you questions about the challenges you’re dealing with, or about important aspects of your life like your family, relationships, school, or work.

Once you ID the problems you want to work on, you and your therapist will come up with a treatment plan. You might utilize cognitive behavioral therapy (CBT) to improve symptoms of mood disorder or anxiety attacks, or humanistic therapy (IPT) to boost self-awareness, per the Association for Behavioral and Cognitive Therapies. “The specific approach to care will vary depending on a client’s needs,” Dr. Udall says. “But overall, therapists generally aim to help clients understand patterns that are no longer working for them so that they can make changes and lead happier, healthier lives.”

If your treatment plan includes medication (like antidepressants or anti-anxiety meds), your therapist will also work in tandem with your psychiatrist (a medical doctor who diagnoses and treats mental health conditions). “They may provide comprehensive care, with the therapist focusing on counseling and coping strategies and the psychiatrist managing medication,” Dr. Udall says.

What is a psychiatrist?

Psychiatrists are licensed medical doctors (MDs) who have completed psychiatric training. Like medical doctors who treat physical ailments, psychiatrists have also completed medical school and received on-the-job training via a medical residency program, notes the American Psychiatry Association.

While psychiatrists have some training in providing therapy, their primary roles are to help diagnose mental health conditions and prescribe (and manage) medications. A medical degree allows psychiatrists “to treat biological aspects of mental disorders,” explains Michelle Dees, M.D., a board-certified psychiatrist at Luxury Psychiatry Medical Spa in Chicago, IL. That means they can prescribe psychiatric medications like antidepressants or antianxiety meds, among others.

Because these providers address the biological side of mental disorders and can prescribe medications, psychiatrists are more likely to interact with people who have more serious mental health conditions like bipolar disorder or schizophrenia, Dr. Dees adds.

What can you expect from a psychiatry appointment?

Psychiatrist appointments are similar to therapy appointments, in that you’ll spend time answering questions about your thoughts, feelings, and challenges. However, a psychiatrist will also want to learn about your past medical history and any physical symptoms you might be experiencing.

“Psychiatrists might also request specific lab tests or brain scans if they feel a brain-related illness could contribute to the mental health problem,” explains Dr. Dees. Usually, these would be done at a separate appointment in a different location (like a hospital).

So…should you see a psychiatrist or a therapist?

Both therapists and psychiatrists can offer talk therapy, which is an important component of navigating many mental health issues. “Therapy is often the best choice for people looking to develop coping skills, manage day-to-day stress, change behaviors, or explore life issues, relationship challenges, or personal growth,” Dr. Udall says. She also points out that “research suggests that in some instances, therapy is more effective than medication, so it’s sometimes wise to start with therapy and monitor progress.”

Also good to know: There are more therapists than psychiatrists out there, so you’ll likely be able to get an appointment with a therapist faster, Dr. Udall points out. However, if you know that you or a loved one can benefit from medication to manage a mental health condition, you’ll need to see a psychiatrist.

In many cases, a psychiatrist and therapist can work together to monitor your mental health. While your therapist will likely lead the talk therapy sessions, your psychiatrist will be your go-to for all things meds. This is an important reason why some people choose to have both specialists on their healthcare team.

If you’re not sure what’s best, that’s okay too. You could book a first appointment with a therapist to learn about your options and have them weigh in on who they think you should see, Dr. Udell suggests. “You might also reach out to your primary care physician for input, since PCPs are typically able to screen for mental health conditions and may make a recommendation that’s just right for you,” she adds.

When to seek support from a mental health professional

There’s no downside to reaching out to a therapist any time you need support. “In general, people may consider seeking therapy if they primarily need help working through specific emotional or relational issues and are open to talk therapy,” Dr. Udall says.

However, there are also certain signs and symptoms of mental health conditions you shouldn’t ignore. According to the Mayo Clinic, you should contact a mental health professional if you experience one or more of the following:

• Adjustments in your sleeping or eating habits (e.g., sleeping less, eating more, etc.)
• Changes to your personality that others have pointed out to you
• Difficulty completing daily activities
• Anxious thoughts
• Depressive moods
• Apathy
• Extreme mood swings
• Excessive anger or hostility
• Increased substance use
• Thoughts of suicide or self-harm

Your primary care provider is a good resource for finding therapists or psychiatrists, but you can also ask your loved ones for referrals or check online directories for specialists in your area or providers that are available via telehealth. You can also look through your health insurer’s database, which will give you a list of providers covered by your plan.

Editor’s note: If you or a loved one are experiencing a crisis, please know that immediate help is available. You can call or text the National Suicide Prevention Lifeline at 988 for free and confidential support 24/7. You can also check out the Suicide Prevention Resource Center for additional resources.