Psychologist, psychiatrist – what's the difference?

It seems to me that the most mixed up terms in the mental health field are actually two of the most fundamental ones: psychologist and psychiatrist.

There are a variety of types of mental health providers and they all have their purposes. Depending on the issue at hand, it is important to know which practitioner will be of the most help. So whether searching the Internet or checking the yellow pages for someone to help, it's important to know what, exactly, to look for.

There are, of course, other types of practitioners. Therapists, counselors, psychoanalysts, social workers, art therapists – there are a lot. There will be posts about these professionals in the future, but it seems that understanding the difference between psychiatry and psychology is the most pressing.

A psychiatrist is a medical doctor (MD). She will have gone through all of the same medical training as anyone else in medical school, but will have specialized in psychiatric disorders. Although they used to act more like traditional counselors, currently, the primary purpose of psychiatrists is to make diagnoses and prescribe medication. (It should be noted that regular physicians can also, to some degree, prescribe psych meds. This will be discussed in a later post.)

Pros: With a few rare exceptions, psychiatrists are the only mental health practitioners who can prescribe you medication. They also have medical training that might pick up on a physical ailment that is causing mental side effects instead of assuming it is a psychiatric condition. If you have a combination of physical and psychological symptoms, a consultation with a psychiatrist is worthwhile in order to understand the root of your problems.

Cons: Depending on who you're seeing, it is a very real possibility that she will spend ten minutes with you, hand you a prescription for the drug du jour and charge you $200. While a good psychiatrist will at least have an extended first consultation to understand your background and situation, they are usually paid per appointment, not per hour. Do not expect talk therapy.

A psychologist has a doctoral degree (either a Ph.D. or a Psy.D.) in psychology, has passed licensing exams and completed lots of supervised hours. Their training is more or less entirely focused on mental health and other psychological issues. This is the person you see in the movies: the man with diplomas on the wall, sitting in a comfy chair while hysterical clients pour their hearts out. Now, it doesn't always work like that, but it gets to the general idea. It's someone to talk to who has been trained in how to respond to a variety of issues.

Pros: Consulting a psychologist can be a good starting point for receiving treatment. He will be qualified to sort out what, exactly, you are experiencing and will have the academic background to suggest and utilize the optimal treatments. (This could include a referral to a psychiatrist if medication or other health complications should be considered.) Psychologists can also perform certain functions that other counselors cannot, such as administering certain psychological tests. All in all, psychologists are there to listen and to give you a lot more time and attention than a psychiatrist would.

Cons: The most obvious con is that psychologists cannot prescribe medication. (There are a few controversial programs in some states that grant psychologists prescription privileges, but don't count on it.) The field is also more diverse than psychiatry when it comes to treatment options. While a good thing, in practice it means that sometimes it can take a while to find the right practitioner. Additionally, psychologists are generally more expensive than other professionals with similar services, such as licensed counselors and social workers. (These will be discussed in another post.)


All right, there are the basics. Psychiatrists: medical doctors. Psychologists: talk therapists. Often it is a good idea to see both. A combination of antidepressants and counseling has been found to be more effective in treating moderate depression than either on its own.


What has your experience been like with psychologists and psychiatrists? There are so many interesting stories out there.