What Is a Psychiatrist? And How Are They Different from Psychologists?

Psychiatry refers to a specific branch of medicine that focuses on the causes, prevention, diagnosis, and treatment of mental health conditions.

Generally speaking, the field of psychiatry rests on the idea that biological factors, like genetics, lead to the development of mental and emotional health symptoms.

Psychiatrists recognize that social and environmental factors can also play a role, but they typically approach mental health symptoms from a biological angle. They have training in many related fields, including:

• genetics
• biochemistry
• neurology
• psychology
• social science
• psychopharmacology (the effects of medications on mood and mental health)

Psychiatrists will have one of two medical degrees: doctor of medicine (MD) or doctor of osteopathic medicine (DO). They’ll also have advanced qualifications from residency and a specialty in psychiatry.

Learn more about the difference between an MD and a DO.

After getting a degree, they must take a written exam to get licensed to practice medicine in their state. To become board certified, they need to take an exam given by the American Board of Psychiatry and Neurology. They’ll take this exam every 10 years to get recertified.

Practicing psychiatrists also need to complete a 4-year residency. During this residency, they work with people in hospitals and outpatient settings, learning to diagnose and treat mental health conditions using medication, therapy, and other treatments.

Some psychiatrists might train in a specialty such as:

• addiction medicine
• child and adolescent psychiatry
• geriatric psychiatry
• forensic psychiatry
• pain medicine
• sleep medicine

What does a psychiatrist do?

Psychiatrists help diagnose and treat mental health conditions. They’re licensed to provide mental health care and practice as medical doctors. They’ll take your medical history and evaluate whether any underlying conditions or medications you currently take might be playing a role in your symptoms.

Their medical degree also enables them to order medical tests and prescribe medicine to better understand and treat your symptoms.

Psychiatrists work in any of these settings:

• private practices
• hospitals
• psychiatric hospitals
• university medical centers
• nursing homes
• prisons
• rehabilitation programs
• hospice programs

What can a psychiatrist help with?

Your psychiatrist will start by asking questions to get more information about your mental health symptoms.

Here’s what to expect from your first appointment.

Depending on your symptoms, they might use psychological evaluations or recommend certain lab tests to find the right diagnosis.

Medical tests like blood tests or EKGs can’t identify mental health conditions, but these tests can help rule out medical causes of your symptoms. Lab tests can also offer information about underlying health concerns that might raise your risk for side effects when taking certain medications.

Once they’ve made a diagnosis, psychiatrists might prescribe medication or another treatment, refer you to a psychotherapist for talk therapy, or both.

Psychiatrists might prescribe medication to treat:

• anxiety disorders
• attention deficit hyperactivity disorder (ADHD)
• bipolar disorder
• major depression
• post-traumatic stress disorder (PTSD)
• schizophrenia
• substance use disorders

Of course, you might prefer to try addressing your symptoms with therapy rather than medication. If you’re dealing with serious symptoms, though, your therapist may recommend just consulting a psychiatrist to explore medication options.

When treating children, psychiatrists will begin with a comprehensive mental health examination. This helps them recognize key factors underlying neurodevelopmental or mental health concerns, including emotional, cognitive, educational, familial, and genetic factors.

They might recommend a treatment plan that includes a combination of:

• individual, group, or family therapy
• medication
• consultation with other healthcare professionals at schools, social agencies, or community organizations

Medications a psychiatrist might prescribe include:

• antidepressants
• antipsychotic medications
• mood stabilizers
• stimulants
• sedatives

After you start taking the medication, they’ll monitor your symptoms to keep track of signs of improvement, along with any side effects you experience. Based on this information, they might change your dose or prescribe a different medication.

Sometimes, they’ll also order regular, ongoing lab work to make sure the medication doesn’t affect immune system function or the health of your liver, kidney, and other organs.

Psychiatrists can also prescribe other types of treatments, including:

• Electroconvulsive therapy. Electroconvulsive therapy involves applying electrical currents to the brain. A psychiatrist might recommend ECT for severe depression and bipolar disorder, when symptoms don’t respond to any other types of treatment.
• Other types of brain stimulation. Both vagus nerve stimulation (VNS) and transcranial magnetic stimulation (TMS) can help treat severe depression symptoms. With TMS, a coil placed on your scalp delivers magnetic pulses to your brain. With VNS, a generator implanted in your chest, just under your skin, delivers ongoing electrical pulses to your vagus nerve.
• Light therapy. This approach involves the use of artificial light to treat symptoms of depression. It’s often recommended for seasonal depression, especially when you live somewhere that doesn’t get a lot of sunlight.

Compared to psychiatrists, psychologists tend to focus more on social, cultural, and environmental factors instead of biological ones. They help identify negative thought patterns and other areas of brain function that might affect your behavior and emotional health, along with key environmental or life stressors that also play a part.

Often, psychologists use talk therapy to help address and treat mental health symptoms. They might also act as consultants with other healthcare professionals or study therapy approaches for treatment programs.

Differences in practice

Psychiatrists and psychologists work in many of the same healthcare settings: private practices, clinics, rehabilitation programs, schools, and more.

Psychologists treat mental health symptoms with talk therapy, providing a space to share emotional distress and mental health symptoms you experience, over a series of sessions. They can offer guidance and support with understanding these symptoms and teach coping skills to navigate them.

Talk therapy can take many forms, including:

• one-on-one therapy
• couples therapy
• family therapy
• group therapy

You’ve probably heard of cognitive behavioral therapy (CBT), one of the most common types of talk therapy. CBT aims to help people in therapy learn and practice specific techniques to work through unwanted emotions and negative thought patterns.

But plenty of other types of therapy exist. Psychologists can specialize in a range of approaches:

• humanistic psychology
• child psychology
• psychodynamic therapy
• emotion-focused therapy
• art therapy
• mindfulness-based therapy approaches
• mentalization-based therapy
• schema therapy

Psychologists working with children might also assess their thinking skills and academic capabilities and offer approaches uniquely suited for children, like play therapy.

A psychologist can diagnose mental health conditions through interviews and the observations they make in therapy. Depending on their training, they might also administer neuropsychological tests, which look at things like memory and reading ability, to evaluate someone’s cognitive ability.

In most states, though, psychologists can’t prescribe medications or order lab tests to rule out medical conditions. If they believe medication might improve your symptoms, they might refer you to a psychiatrist while continuing to provide therapy.

Psychologists with additional qualifications can prescribe medication in the following states:

• Idaho
• Iowa
• Illinois
• Louisiana
• New Mexico

Psychologists can also prescribe medication if they work in the military, Indian Health Service, or Guam.

Differences in education

Psychiatrists and psychologists also have different educational backgrounds and training requirements.

Psychologists complete graduate school and doctoral-level training to earn one of two degrees:

• doctor of philosophy (PhD)
• doctor of psychology (PsyD)

It takes 4 to 6 years to earn one of these degrees. Once they’ve earned a degree, psychologists complete another 1 to 2 years of training that involves working with people in clinical settings. They also need to pass an exam to get licensed in their state before they can provide therapy.

To prescribe medication in the states mentioned above, psychologists also need to complete training in clinical psychopharmacology and pass an exam. They may also need to complete additional practice hours.

Psychologists might also pursue specialty training in:

• clinical psychology
• geropsychology
• neuropsychology
• psychoanalysis
• forensic psychology
• child and adolescent psychology

A psychologist won’t necessarily become a therapist, though. Many choose careers in education, research, or law and corporate settings rather than clinical settings.

How do I choose between them?

Often, your specific symptoms and situation can guide your search.

If you’re going through a difficult time or want to work on better understanding your thoughts and behaviors, a psychologist may be a good option.

You might also prefer to consult a psychologist if you want to treat your symptoms with therapy rather than a combination of therapy and medication. Just know they might recommend connecting with a psychiatrist if they believe your symptoms may not improve with therapy alone.

A psychiatrist may be a better choice if you have more complex mental health concerns that might require medication, including:

• severe depression
• bipolar disorder
• schizophrenia

Psychiatrists can also offer additional treatment recommendations when therapy doesn’t lead to much improvement.

Keep in mind that mental health professionals might recommend a combination of therapy and medication to treat symptoms of many common mental health conditions, including depression and anxiety. If therapy doesn’t seem to have much effect, it could be worth reaching out to a psychiatrist — medication could make more of a difference in your symptoms.

Psychiatrists usually don’t provide ongoing talk therapy. If you reach out to a psychiatrist first, they’ll likely encourage you to work with a therapist at the same time. They can offer a referral or connect you with resources to find the right therapist.

Whichever specialist you choose to see, it always helps to make sure they have:

• experience treating your type of mental health condition
• an approach and manner you feel comfortable with. It’s absolutely OK to “shop around” until you find someone who feels like a good fit
• enough open appointments so you can schedule regular sessions

Get more tips on finding the right psychiatrist.

Financial considerations

If you have insurance, you might start by asking your primary care doctor for a referral to a psychiatrist or psychologist.

If you don’t have insurance, you still have options for affordable treatment:

• Local colleges with psychiatry, psychology, or behavior health programs may offer free or low cost services provided by graduate students under professional supervision.
• NeedyMeds, a nonprofit dedicated to helping people find affordable treatment and medication, offers tools for finding low cost clinics and discounts on medication.
• Telepsychiatry, or online psychiatric care, offers another option for affordable psychiatric support.

Some mental health professionals use a sliding fee scale to allow clients to pay what they can afford. If you know you can’t pay the standard session rate, it never hurts to ask about reduced cost options. Even if they don’t offer reduced fees themselves, they may be able to refer you to a colleague who does.

Any mental health professional should give you a clear answer about the fees they charge before you begin treatment. One who seems unwilling to openly discuss their prices may not be the best fit for your needs.

Psychiatrists and psychologists both have important roles in mental health care and treatment, though they use different approaches to diagnose and treat mental health conditions.

A psychologist might help you address symptoms through therapy and by teaching coping skills, while a psychiatrist can prescribe medications and other treatments to ease your symptoms.

Not sure what kind of support you need? Either professional can offer guidance with exploring the symptoms you’ve noticed and their possible causes and help you take steps toward getting relief — whether that means providing treatment themselves or referring you to someone who can provide more effective support.