6 fundamental differences between a psychologist and a psychiatrist

Mental health

When our mental health is affected, for whatever reasons, we usually go to either a psychologist or a psychiatrist. In general, it is thought that if we go to a psychiatrist it means that we have "something more serious", although this does not have to be so. Moreover, both therapies, psychological and psychiatric (drugs), are not incompatible with each other, but rather the opposite.

Often, although not always, people first need medication to alleviate their discomfort, improve their mood and thus be able to start a psychotherapeutic process with a psychologist. But it can also happen that a person only needs to see a psychologist and does not need medication.

These terms, psychologist and psychiatrist, can generate confusion... What are the differences between psychologist and psychiatrist? Which one to go to? We have to start from the following basis: the psychiatrist is a doctor, and as such, works through drugs and, on the other hand, the psychologist is not a doctor and therefore works without drugs (in addition, legally he/she does not have the competence to prescribe). In other words, the psychologist helps the patient through words and listening, tools that make up, among others, psychological therapy.

But how else do these figures differ? Find out what each of these mental health professionals does and how they work.

How does a psychologist differ from a psychiatrist?

1. Academic training: a psychiatrist is a medical doctor and a psychologist is not.

The first difference between psychologist and psychiatrist that we find has to do with training. Thus, while the psychiatrist is a doctor, that is, he/she has completed a medical degree (6 years) and a subsequent specialization, in this case the MIR in Psychiatry (4 years), the psychologist is not a doctor.

A psychologist has completed a degree in psychology (4 years) and, subsequently, depending on the case, he/she may or may not have also completed complementary Master's degree training (which he/she usually does). In fact, to be able to practice in the clinical field, for example, treating mental pathology, the psychologist must complete a 2-year Master's degree as a General Health Psychologist.

2.Type of therapy: drugs vs. psychotherapy

Another difference between psychologist and psychiatrist has to do with the type of therapy they practice. The psychiatrist works through pharmacology, that is, through pharmacotherapy. He prescribes psychotropic drugs that directly affect the patient's nervous system, producing effects such as: improvement of mood, reduction of anxiety and reduction of obsessive thoughts, among others. The psychotropic drugs used in psychiatry are:

• Anxiolytics (to address anxiety).
• Antidepressants (to improve depressive symptoms).
• Mood stabilizers.
• Antipsychotics (to address psychotic symptomatology and aggressiveness).

In contrast, the psychologist works through psychotherapy and, in essence, through words. In this case, he cannot prescribe drugs. So the approach is very different; broadly speaking, we can say that the psychiatrist works with drugs and the psychologist works through psychological therapy.

Psychological therapy encompasses a set of techniques, tools, strategies and resources to improve the patient's symptomatology (that is, to improve their mood, reduce maladaptive behaviors and enhance adaptive ones, improve their well-being and quality of life, their self-esteem and self-knowledge, etc.).

3.Techniques used and ways of working

Closely related to the previous point, we also find significant differences in the more specific techniques used by each professional in helping the patient to recover wellbeing and feel better.

For his part, the psychiatrist works by prescribing drugs: this includes the administration of psychotropic drugs, their increase, decrease, withdrawal... In other words, he adjusts the medication to each moment, according to the phase of the patient's illness, his vital moment, his improvements, his response to treatment, side effects, etc.

Logically, during psychiatric visits, work is also done through words, although a psychiatrist, if not trained in psychological techniques, does not delve so deeply into this aspect. On the other hand, the psychologist does not work with drugs, as we were saying, but works through different psychological tools.

How does the psychologist work? Carl Rogers, American psychologist, states that a good psychologist must have 4 attitudes that favor the therapeutic relationship: active listening, empathy, unconditional acceptance and authenticity.

As characteristics that favor the relationship with the patient we find: cordiality, competence, trust and attraction. Finally, as techniques used by the psychologist we find two types of communication skills: listening skills and action skills.

4.Problems addressed by both professionals

Although a psychiatrist and a psychologist can treat a patient at the same time, since they are not at all incompatible approaches, the truth is that the type of patients that each professional deals with may vary.

While it is true that in the clinical setting the patients are the same (patients with some type of mental disorder: for example, schizophrenia, depression, panic disorder, anorexia, social phobia, etc.), in other areas of psychology this varies.

For example, psychologists who are not clinicians, or who are clinicians but who work in private practice and not in public health care, tend to deal, as a rule, with less severe cases (especially if they are just starting to work).

That is, patients with problems that do not involve an underlying mental disorder (e.g. anxiety, stress, conflicts in interpersonal relationships, etc.). On the other hand, let us remember that a psychologist can specialize in multiple areas beyond the clinic: human resources, educational psychology... and all these areas are further removed from psychiatry.

5.The psychiatrist's approach and the psychologist's approach

The approach also constitutes another difference between psychologist and psychiatrist. While the psychiatrist has a biomedical approach to human behavior and emotions, the psychologist tends to adopt more heterogeneous and not always medical positions. In the first case, the psychiatrist focuses on the physiological, anatomical and chemical aspects of the human body, especially those related to the brain, neurons, hormones and neurotransmitters.

On the other hand, the psychologist emphasizes other aspects of the person, such as: his or her social context, personality, culture, interpersonal relationships, work environment, family dynamics, etc.

In this second case, the vision is more holistic (although a psychiatrist can also have a holistic vision of the patient, of course). On the other hand, the psychologist can also adopt a more biological or medical approach to the patient (this will also depend on the theoretical orientation of the professional); however, the biological will never be the main focus of therapy, as is the case in psychiatry.

6.Changes produced in the patient by psychology and psychiatry

Another of the differences between both professions, equally valid and necessary, has to do with the effects they produce or type of changes. In this sense, it is important to emphasize that the changes produced by psychological therapy are more profound and lasting than the changes produced by drugs, since the latter, when the patient stops taking the drugs, cease to exist.

On the other hand, through psychotherapy one can learn strategies that can be applied throughout life, and not only while undergoing therapy.

Differences between psychologists and psychiatrists

Final Reflection on Psychology and Psychiatry

We have seen some of the differences between psychologist and psychiatrist that allow us to understand the nuances between one professional and the other. Although both share an objective, the improvement of the patient's mental health, the truth is that, in order to achieve this, they use different paths.

It is important to note that psychopharmaceuticals have been a great advance in the field of mental health, especially in patients with disorders related to the psychotic spectrum or mood (bipolar disorder or severe depression, for example), as they have allowed these people to lead a normalized life outside psychiatric institutions, something that would not have been achieved only through psychological therapy.

So both professionals are complementary, as each of them brings something that the patient needs. And remember, if you feel you need help, both psychological and psychiatric, do not hesitate, you are neither crazy nor there is something in you that "is wrong"... you simply need at that moment a type of help focused on your emotions, thoughts and behavior patterns. Isn't it true that when your leg hurts you go to the doctor? Same thing... no more taboos!