Psychiatrist vs. Psychologist: What’s the difference and which is right for you?

Many people incorrectly use the terms psychiatrist and psychologist interchangeably. Though the two roles sound similar, there are actually a number of important differences, in terms of education, training, and role in treatment.

Here’s what you need to know to help you decide which practitioner is right for you:

How are psychiatrists and psychologists similar?

Psychiatry and psychology are in fact overlapping professions. Doctors in both fields - psychiatrists and psychologists - are mental health professionals trained to help patients cope with mental health issues. They both study the mind and how it affects our well-being and behaviour. Psychiatrists and psychologists often work together to diagnose, treat, and prevent mental illness. Both practitioners must be licensed in their area to practice and are dedicated to helping people find the means to optimise their mental health.

How are psychiatrists and psychologists different?

Psychiatrists and psychologists differ in two main areas: education and practice.

Differences in education:

Psychiatrists and psychologists have different educational backgrounds and training.

Psychiatrists are medical doctors who graduate from medical school with a Bachelor of Medicine, Bachelor of Surgery (MBBS), sometimes abbreviated as MBChB (for Medicinae Baccalaureus Baccalaureus Chirurgiae). After receiving their degree, they must complete a two-year foundation programme of general training, followed by three years of core psychiatry training during which they work with patients in a number of different areas of psychiatry. Their studies conclude with three years of Higher Psychiatry Training, in the specific sub-specialty chosen they have chosen for practice. It is during these training periods that psychiatrists apply what they’ve learned in school to properly diagnose and treat mental health conditions using therapy, medicine, and other treatments. After full completion of training and having successfully passed all their exams, they are then entered onto the General Medical Council's specialist register and are able to practice. Some of the sub-specialties in psychiatry include, such as:

• Child and adolescent psychiatry
• Geriatric psychiatry
• Forensic psychiatry
• Pain medicine
• Addiction medicine
• Sleep medicine

Psychologists, on the other hand, do not attend medical school and are not medical doctors. Instead, they attend graduate school to obtain a Doctor of Clinical Psychology (DClinPsy) degree. This degree requires three years of study which includes full-time supervised training with patients. After their studies, they must have achieved the qualifications and met standards to register with the Health & Care Professions Council and to apply for Chartered status with the British Psychological Society. Chartered Psychologist status reflects the psychologist's commitment to the highest standards of psychological knowledge and expertise. Similar to psychiatrists, psychologists can also complete specialty training in specialties such as:

• Child and adolescent psychology
• Geropsychology
• Clinical psychology
• Psychoanalysis
• Neuropsychology
• Forensic psychology

Differences in practice:

While both psychiatrists and psychologists are normally trained to practice psychotherapy (talk therapy; working through a patient’s issues via discussion), their different educational background and training provides them with different approaches to addressing mental health conditions.

Psychiatrists are trained to look at one’s overall health to differentiate mental health conditions from other underlying health conditions that could cause psychiatric symptoms, such as thyroid problems or vitamin deficiencies, for example. They also monitor how mental illness impacts other health conditions (such as conditions affecting the heart or blood pressure), and how medications affect the body, including how they impact one’s weight, blood pressure, blood sugar, liver or kidney function, and sleep. When a mental health condition has been identified, the psychiatrist will often prescribe medication. In some cases, medication is enough to treat the condition, but in other cases, a combination of medicine and psychotherapy is needed. The psychiatrist may provide the psychotherapy, or he or she may refer the patient to a psychologist or other mental health professional.

Psychologists take a more behaviour-based approach to treating mental health issues. They diagnose mental illness through interviews, tests, surveys, and observations with the patient, taking note of behaviours and habits (such as eating and sleep patterns), as well as negative thought processes the patient has that may cause or contribute to the condition. Psychologists often treat patients with talk therapy in which the patient and practitioner talk through issues to understand symptoms and identify ways to cope with them. Cognitive behavioural therapy (CBT) is a type of talk therapy that is commonly used, focusing on overcoming negative thoughts and thinking patterns. Psychologists cannot prescribe medication to their patients, so they may work in tandem with a psychiatrist to comprehensively treat a patient’s mental illness.

How to choose between the two?

Making the choice between the two professionals depends on your specific situation and needs.

Because of their ability to prescribe medications, a psychiatrist may be a better choice for mental health conditions that are more complex or require medication, such as severe depression, bipolar disorder, or schizophrenia.

If you’re generally having a difficult time at work or at school or want to focus on understanding your behaviours and thought processes, a psychologist trained in talk therapy may be a better choice. In any case, if the psychologist sees that you need medication or that he or she cannot treat you, it is stated in the ethics code that he or she should transfer your case to a psychiatrist or work in tandem with them.

It is important to remember that treatment for many common mental illnesses such as anxiety and depression often combines medication and talk therapy, so it may be helpful to see both practitioners - a psychiatrist to manage medications and a psychologist for therapy sessions.

Whichever you feel is right for you, it is important to ensure that they have experience treating your mental health condition, have a manner and approach that puts you at ease, and have enough availability so that you can be treated regularly without having to wait.

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