Psychologist or psychiatrist: which one do you need

Before booking an appointment, a lot of people get stuck on an earlier question: "Is what I'm going through something for a psychologist or a psychiatrist?" It's a reasonable question, because the two terms are sometimes used as if they were interchangeable, and they're not. They're not mutually exclusive either.

The underlying difference

A psychologist has completed a degree in Psychology and works through conversation and therapeutic tools, without being able to prescribe medication. A psychiatrist is a medical doctor, trained in Medicine and then specialised in mental health, and can make clinical diagnoses and prescribe pharmacological treatment.

Put another way: a psychologist mainly works on the emotional and behavioural side through therapy; a psychiatrist can also intervene on the biological side, when needed.

What each one works on

Psychotherapy is the usual starting point for anxiety, stress, low self-esteem, relationship difficulties, grief, or processes of life change, among many other reasons to seek help. It's a space to understand what's happening to you, where it comes from, and what you can do about it.

Psychiatry comes into play when, alongside therapeutic support, a medical evaluation is considered necessary: for instance, in more intense cases, or when the distress has a component that could benefit from pharmacological treatment.

They're not mutually exclusive

It's common for both professionals to work in a coordinated way: some people only need therapy, others combine therapy and medical treatment for a while, and for others psychotherapy is enough at one point and they need pharmacological support at another. Going to therapy doesn't rule out or replace a psychiatric evaluation if one is ever considered necessary, and the other way around.

Where to start if you're unsure

If you're not sure which of the two you need, starting with a psychologist is usually a safe entry point: the first session serves, among other things, to assess what best fits your situation, and if at some point in the process a medical evaluation seems appropriate, it can be pointed in that direction.

You don't need to get it right from the start. What matters is taking the first step.