Psychologist vs Psychiatrist: What's the Difference?

Deciding between a psychologist and a psychiatrist can be confusing, especially if you’re new to seeking mental health support. Both professionals help people with mental health issues, but their training and approaches are different. Here’s a breakdown to guide your decision:

Different Roles and Training

• Psychologist: A psychologist has a degree in psychology (the study of mind and behaviour) and focuses on providing talk therapy. Psychologists help you work through your problems using evidence-based techniques like Cognitive Behavioural Therapy, mindfulness, etc. They are not medical doctors, so they do not prescribe medications. Instead, they use conversation, exercises, and coping strategies to help improve your mental well-being. For example, a psychologist can help you learn to manage anxiety through breathing techniques and changing thought patterns, or help you process trauma by talking it through safely.
• Psychiatrist: A psychiatrist is a medical doctor (they attended medical school and then specialised in psychiatry). Psychiatrists can prescribe medication such as antidepressants, anti-anxiety meds, mood stabilisers, etc. They are trained to understand the medical aspects of mental health, including how brain chemistry and physical health affect mood and behaviour. Psychiatrists often focus on diagnosis and medical management of mental illnesses. They can also provide therapy, but in practice their appointments are often shorter and centred on how you’re doing on medication or how your symptoms are from a medical standpoint.

A simple way to remember the difference: Psychiatsrists = “MDs who treat the mind” (can prescribe medication), Psychologists = “Therapists trained in psychology” (do talk therapy). Both are important, but they play different roles.

When to See a Psychologist

You might consider seeing a psychologist if:

• You’re experiencing mild to moderate mental health symptoms (like anxiety, depression, stress, panic attacks) and want to try a therapeutic approach to address them.
• You prefer the idea of talking through your issues and learning coping strategies rather than (or before) taking medication.
• You’re dealing with life challenges such as grief, relationship issues, work stress, or low self-esteem, and you need guidance and support.
• You suspect you have a common mental health condition (e.g. anxiety disorder, mild depression) and want an assessment and therapy, but your symptoms are not so severe that you require medical intervention right away.
• You’re already on medication (prescribed by a GP or psychiatrist) but want additional support in learning skills to manage day-to-day challenges – psychologists often work alongside medication treatment.
• Simply put, if you need someone to talk to and help you change emotional or behavioural patterns, a psychologist is the go-to professional.

A big advantage in seeing a psychologist is accessibility: you don’t need a GP referral to make an appointment (though you’ll need one if you want Medicare rebates – see our referral post for details). Psychologists often spend 50 minutes to an hour with you each session, allowing time to really delve into issues.

When to See a Psychiatrist

You might consider seeing a psychiatrist if:

• You have severe, complex, or potentially biological-based mental health issues. For instance:
  • Symptoms of bipolar disorder (periods of extreme highs and lows),
  • Signs of schizophrenia (such as hallucinations, delusions),
  • Severe depression that significantly impairs daily functioning or includes suicidal thoughts,
  • OCD or severe anxiety that might benefit from medication in addition to therapy,
  • ADHD or other conditions where medication is a primary treatment.
• You suspect you might need medication to help manage your condition. Psychiatrists can evaluate you for medication and prescribe if needed. For example, if you have very severe anxiety or panic attacks that haven’t improved with therapy alone, a psychiatrist might prescribe an anti-anxiety medication to take the edge off while you continue therapy.
• You’ve tried therapy (with a psychologist or counsellor) and while it helped some, you’re still struggling a lot – this might be a clue that adding medication (hence seeing a psychiatrist) could be beneficial.
• You need a medico-legal assessment or report (for instance, in complex cases of mental illness affecting work capacity); psychiatrists often provide these.

Remember that to see a psychiatrist in Australia, you typically need a referral from a GP. Psychiatrists can be in high demand, and sometimes their waitlists are long, especially for non-urgent cases.

Psychiatrists’ appointments are often shorter after the initial evaluation. The first appointment might be an hour (to assess your history), but follow-ups can be 15-30 minutes focusing on how you’re doing on medication or if any adjustments are needed. Psychiatrists tend to approach issues from a medical perspective – they’ll consider physical health, medications, and brain chemistry as well as psychological factors.

Can (and Should) You Do Both?

Absolutely, in many cases a combination is the best approach. Research shows that for conditions like moderate-to-severe depression, PTSD, or OCD, therapy + medication together often yields better results than either one alone.

Here’s how a combined approach might work:

• You might see a psychiatrist for medication to help stabilise your mood or reduce symptoms enough so you can function better.
• Simultaneously, you see a psychologist for therapy to learn long-term skills and address the root causes or triggers of your issues.
• The psychologist and psychiatrist can (with your consent) communicate about your care. For example, you might allow them to share progress notes. The psychiatrist might focus on how you’re responding to medication, while the psychologist then provides tools to handle negative thoughts and rebuild activities, which in turn helps the depression lift further.

A Quick Comparison

• Seeing a Psychologist: No referral needed (for private), focus on therapy (talking), typical session ~50 minutes, helps you learn coping skills, change thought patterns, process emotions. Great for a wide range of issues, especially mild to moderate conditions, or as part of treatment for severe conditions.
• Seeing a Psychiatrist: GP referral needed, focus on medical aspects (can prescribe medication), initial evaluation and then shorter follow-ups, helps ensure any biological factors (brain chemistry, etc.) are addressed. Essential for certain psychiatric conditions and helpful if medication might ease your suffering.

Many people in Australia use a combination approach: for example, an individual with severe depression might see a GP and psychiatrist to get on the right medication, and concurrently see a psychologist (like Erin) for weekly therapy.

Remember, neither professional is “better” than the other – they have different skill sets. In fact, psychologists and psychiatrists often respect each other’s work and frequently refer clients to one another. The key is getting the support that you need.

If you’re still in doubt, consider starting with a psychologist if your instincts lean that way (especially for stress, life issues, or moderate mental health concerns). You can always add a psychiatrist later if needed. Or start with a psychiatric evaluation if you suspect a medical intervention might be necessary (like if you have a history of mental illness or very intense symptoms). There’s no wrong door – what’s important is taking that first step to reach out for help. Both psychologists and psychiatrists ultimately have the same goal: to help you get back to feeling your best.