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What's the difference, psychiatrist vs. psychologist?
Tennessee Psychiatric Association
The following information is modified from the APA website, https://www.psychiatry.org/patients-families/what-is-psychiatry
What is Psychiatry?
Psychiatry is the branch of medicine focused on the diagnosis, treatment and prevention of mental, emotional and behavioral disorders.
What is a psychiatrist?
A psychiatrist is a medical doctor (an M.D. or D.O.) who specializes in mental health, including substance use disorders. Psychiatrists are qualified to assess both the mental and physical aspects of psychological problems
Why do people go see a psychiatrist?
People seek psychiatric help for many reasons. The problems that cause people to seek care from psychiatrists can be sudden, such as a panic attack, frightening hallucinations, thoughts of suicide, or hearing "voices," or problems may develop over the long-term, such as feelings of sadness, hopelessness, anxiousness, distraction, irritability, or other feelings that never seem to lift. Sometimes people are referred to psychiatrists because they have problems functioning in social situation, at home, or at work, which can cause everyday life to feel distorted or out of control.
What do psychiatrists do?
Because psychiatrists are physicians, they can evaluate, assess, diagnose and treat illnesses that effect the brain.
They can order or perform a full range of medical, laboratory and psychological assessments or 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 & 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 psychiatric diagnoses are based on descriptive criteria established in APA's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, w Text Revisions (DSM-5-TR) and these illnesses or conditions are often coded with health insurance companies using the International Classification of Disease (ICD) system.
What treatments are offered by psychiatrists?
Psychiatrists use a variety of treatments, such as:
- Medications, Psychotherapy, and other Psychosocial interventions
- Other newer interventional treatments are used when the first treatment options don't work: Transcranial Magnetic Stimulation (TMS) is approved for Treatment Resistant Depression (TRD), Obsessive Compulsive Disorder (OCD), Smoking Cessation and Major Depressive Disorder with anxiety; Esketamine or Ketamine Treatments for Suicidal Patients and TRD; 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, but can be used for other disorders; Vagus Nerve Stimulation (VNS) has been FDA cleared since 2005 for Treatment Resistant Depression and is being used experimentally for Bipolar Depression; Light therapy is used to treat seasonal depression; and even Deep brain stimulation (DBS) is a surgical procedure for refractory OCD and is being used experimentally for Dementia.
What is psychotherapy?
Psychotherapy, sometimes called talk therapy, is a treatment that involves a talking relationship between a psychiatrist (or therapist) and 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.
What kinds of psychotherapy are there?
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.
Psychiatrists often prescribe medications in combination with psychotherapy.
Why do psychiatrists use medications?
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 brain or 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 disorders. Patients 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.
What kinds of medications are used?
- 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
What kind of training do Psychiatrists get?
To become a psychiatrist, a person must complete medical school and take a written examination for a state license to practice medicine, and then complete four years of psychiatry residency.
The first year of residency training is typically in a hospital working with patients with a wide range of medical illnesses. The psychiatrist-in-training then spends at least three additional years learning the diagnosis and treatment of mental health, including various forms of psychotherapy and the use of psychiatric medications and other treatments. Training takes place in in-patient, out-patient, and emergency room settings.
After completing residency training, most psychiatrists become board certified. Board-certification occurs after a review of satisfactory residency training, medical licensure in the state of practice. Certification by the American Board of Psychiatry & Neurology includes taking comprehensive test. Recertification can be obtained via ABPN or National Board of Physicians & Surgeons (NBPS).
Are there specialities in the psychiatry field?
Some psychiatrists also complete additional specialized training after their four years of general psychiatry training. They may become certified in:
- Interventional treatments
- Child and adolescent psychiatry
- Geriatric psychiatry
- Forensic (legal) psychiatry
- Addiction psychiatry
- Pain medicine
- Psychosomatic (mind and body) medicine
- Sleep medicine
Some psychiatrists choose additional training in psychoanalysis or in psychiatric research.