When our mental health is affected, for whatever reason, we usually go to either a psychologist or a psychiatrist. In general, it is thought that if we go to the psychiatrist it means that we have “something more serious”, although this does not have to be so. In addition, both therapies, the psychological and the psychiatric (drugs), are not incompatible with each other, but rather the opposite.
Many times, 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 go to the psychologist and does not need drugs.
These terms, psychologist and psychiatrist, can cause confusion… What differences between psychologist and psychiatrist do we find? Which one to go to? We must 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, he does not legally have the power to prescribe). That is, the psychologist helps the patient through words and listening, tools that make up, among others, psychological therapy.
How is the psychologist different from the psychiatrist?
Academic training: a psychiatrist is a doctor and a psychologist is not
The first of the differences between psychologist and psychiatrist that we find has to do with training. Thus, while the psychiatrist is a doctor, that is, he has completed a medical degree (6 years) and a subsequent specialization, in this case the MIR of Psychiatry (4 years), the psychologist is not a doctor.
A psychologist has completed a psychology degree (4 years) and, subsequently, depending on the case, has or has not also completed additional Master’s training (which normally, yes). 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.
Type of therapy: drugs vs. psychotherapy
Another difference between a psychologist and a 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 his nervous system, producing effects such as: improved mood, decreased anxiety and decreased obsessive thoughts, among others. The psychopharmaceuticals used in psychiatry are:
- Anxiolytics (to address anxiety).
- Antidepressants (to improve depressive symptoms).
- Mood stabilizers.
- Antipsychotics (to address psychotic symptoms and aggressiveness).
Instead, the psychologist works through psychotherapy and, essentially, through the word. 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 that the psychologist works through psychological therapy.
Psychological therapy encompasses a set of techniques, tools, strategies and resources that improve the patient’s symptoms (that is, improve their mood, reduce maladaptive behaviors and enhance adaptive ones, enhance their well-being and quality of life, their self-esteem and self-awareness, etc.).
Techniques they use and ways of working
Closely related to the previous point, we also found significant differences in the more specific techniques used by each professional when it comes to helping the patient recover well-being and feel better.
For his part, the psychiatrist works by prescribing drugs: this includes the administration of psychoactive drugs, their increase, decrease, withdrawal… That is, he adjusts the medication at all times, according to the phase of the patient’s illness, his vital moment, his improvements, your response to treatment, side effects, etc.
Logically, during psychiatric visits, work is also carried out through words, although a psychiatrist, if he is not trained in psychological techniques, does not delve as much into this aspect. On the other hand, the psychologist does not work with drugs, as we said, but works through different psychological tools.
How does the psychologist work? Carl Rogers, an American psychologist, affirms 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.
Issues addressed by both professionals
- Although a psychiatrist and a psychologist can treat a patient at the same time, since they are by no means incompatible with each other, the truth is that the type of patients that each professional deals with can vary.
- Although it is true that in the clinical field the patients are the same (patients with some type of mental disorder: for example, schizophrenia, depression, panic disorder, anorexia, social phobia, etc.), in other fields 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, generally deal with less serious cases (especially if they are starting to work).
- That is, patients with problems that do not imply a basic mental disorder (for example: anxiety, stress, conflicts in interpersonal relationships, etc.). On the other hand, let’s 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.
The approach of the psychiatrist and that of the psychologist
- The approach is also another of the differences 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.
- Instead, the psychologist places emphasis on other aspects of the person, such as: their social context, their personality, their culture, their interpersonal relationships, their work environment, their 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 an approach that takes into account the patient in his most biological or medical aspect (this will also depend on the theoretical orientation of the professional); however, the biological will never be the main focus of therapy, as it is in psychiatry.
Changes produced in the patient by psychology and psychiatry
Another of the differences between the two professions, equally valid and necessary, has to do with the effects they produce or the type of changes. In this sense, it is important to highlight that the changes produced by psychological therapy are deeper and more lasting than the changes produced by drugs, since the latter, when they stop taking the drugs, cease to exist.
Instead, through psychotherapy one can learn strategies that can be applied throughout life, and not just while in therapy.
Final reflection on psychology and psychiatry
- We have seen some of the differences between a psychologist and a psychiatrist that allow us to understand the nuances between one professional and another. Although both share an objective, the improvement of the patient’s mental health, the truth is that, to get there, they use different paths.
- It is important to highlight that psychotropic drugs have represented a great advance in the field of mental health, especially in patients with disorders related to the psychotic spectrum or to mood (a bipolar disorder or severe depression, for example), since they They have allowed these people to lead a normalized life outside of psychiatric institutions, something that would not have been achieved through psychological therapy alone.
- So both professionals are complementary, since each one of them contributes something that the patient needs. And remember, if you feel that you need help, both psychological and psychiatric, do not hesitate, you are not crazy or crazy or there is something “wrong” in you… 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? Well, the same… Taboos out!
“Mental health needs a great deal of attention. It’s a big taboo and it has to be faced and resolved.”
