Deciding to seek help is an important step. Then comes another question that can make the process feel more confusing:
Should I see a psychiatrist, a therapist or both?
The answer depends on what you are experiencing and what kind of support you need. There is no single right starting point for everyone.
Why the Difference Can Be Confusing
Psychiatrists and therapists both help people with mental and emotional concerns, but their training and roles are different.
To make things more confusing, “therapist” is a broad term. Therapists may be psychologists, clinical social workers, professional counselors or marriage and family therapists. Their education, credentials and areas of expertise can vary.
Understanding the basic differences may help you feel more confident about where to begin.
What Does a Psychiatrist Do?
A psychiatrist is a medical doctor who specializes in mental health. Psychiatrists evaluate conditions such as depression, anxiety, bipolar disorder, ADHD, and OCD
Because psychiatrists are physicians, they can prescribe medication and consider how mental-health symptoms may interact with sleep, physical health, other medications and medical conditions. Some psychiatrists also provide psychotherapy, although many focus primarily on psychiatric evaluation and medication management.
Seeing a psychiatrist does not automatically mean you will be prescribed medication. The first step is usually a careful evaluation of what you have been experiencing, how it is affecting your life and what treatment options may be appropriate.
What Does a Therapist Do?
Therapists generally focus on psychotherapy, often called talk therapy.
Therapy gives you a place to better understand your thoughts, emotions, relationships, and patterns of behavior. Depending on your needs, it may help you work through grief, manage anxiety, respond differently to stress or make sense of experiences that continue to affect you.
Different therapists use different approaches. Finding the right person may depend on the therapist’s training, experience and whether you feel comfortable speaking openly with them.
Why Do Some People Work With Both?
Psychiatric care and therapy are not competing forms of treatment. They often address different parts of the same struggle.
Medication may help reduce symptoms that make daily life difficult. Therapy may help a person understand recurring patterns, develop new ways of coping or work through painful experiences.
For some people, therapy alone may be a reasonable place to begin. Others may benefit from a psychiatric evaluation, particularly when symptoms are persistent, significantly affecting daily functioning or have not improved with previous treatment.
Many people receive both forms of care, with a psychiatrist and therapist communicating when appropriate.
What Should I Ask When Contacting a Practice?
You do not have to know exactly what kind of care you need before making the first call. A few practical questions may help:
- Does the clinician treat the concerns I am experiencing?
- Does the practice provide psychiatric evaluation, psychotherapy, or both?
- What should I expect during the first appointment?
- If another type of care is recommended, can the practice help with a referral?
You may also want to ask about insurance, appointment availability, telehealth options and how different clinicians coordinate care.
There Is No Universal Starting Point
Some people begin with a therapist and later meet with a psychiatrist. Others start with a psychiatric evaluation and are then referred for psychotherapy. A primary care clinician may also help identify an appropriate next step.
What matters is not choosing the “perfect” professional on the first try. It is beginning a thoughtful conversation about what you are experiencing and what kind of care may help.
Central Ohio Behavioral Medicine provides adult psychiatric evaluation and treatment in Columbus, Ohio. If you are unsure whether psychiatric care is the appropriate next step, our office can explain the services we provide and help you determine whether scheduling an appointment makes sense.
Peter Zafirides, MD
