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Psychiatry or psychology - which is right for you?

By Anna Sayburn
WebMD Feature
Medically Reviewed by Dr Rob Hicks

What's the difference between a psychologist and a psychiatrist, and how do you know which profession can help you best?

If you have a mental health problem the first place to go is usually your GP. They can assess you, may offer you some treatment and may refer you for specialist help. Whoever you are referred to, they are likely to be working either in the field of psychology or psychiatry.

Clinical psychologists and psychiatrists all work to help people experiencing mental health problems. Both professions have extensive training, and work with people who have conditions like depression, eating disorders and anxiety. Psychiatrists, however, can prescribe medication, while psychologists cannot.

Training and theory

Psychiatrists train and qualify as doctors before they specialise in psychiatry.

Some types of psychiatric treatment aim to correct an imbalance of the chemicals affecting brain function. So, for example, people with depression may have too little of the chemical serotonin in their brains. They may be prescribed a drug to raise serotonin levels - often a selective serotonin reuptake inhibitor (SSRI). But psychiatric treatment is far wider than that, says Professor Sir Simon Wessely, president of the Royal College of Psychiatrists, who has spent much of his career researching psychological therapies.

"Psychiatric treatments range from the physical (drugs obviously), the psychological (talking therapies, many invented by psychiatrists starting with a certain Dr Freud) and the social, which includes a vast range of interventions [such as] therapeutic communities, family approaches, public mental health population approaches," he says. "Psychological therapies also create changes in brain chemistry. The impact for example of psychological interventions for OCD [obsessive compulsive disorder] can be seen in fMRI [functional magnetic resonance imaging, a type of brain scanning] studies and resembles the changes seen after antidepressant therapy."

Most psychiatrists in the UK work for the NHS, usually as part of teams that include other mental health professionals. Professor Wessely adds that training in psychiatry "always includes training in psychotherapy - it is mandatory in many parts of the world."

Psychologists take a degree in psychology, then work as an assistant and complete a postgraduate degree course before they can practise alone. Because they are not medically trained, they do not prescribe medication.

Psychological therapies are based on the theory that mental health problems are triggered primarily by experiences in people's lives. Different types of talking therapy are then used to help people cope with these experiences. People with high levels of anxiety, for example, might have cognitive behavioural therapy ( CBT), which is intended to help them overcome unhelpful patterns of thought and behaviour, which reinforce anxiety and make it worse.

Dr Pat Frankish, a clinical psychologist from Lincolnshire, explains that the psychological therapy offered may differ from one person to another, depending on their circumstances. "It's person to person. The person's idiosyncratic experience of the world is what is focused on in therapy. It is about that individual's life experience and the impact of events on the self," she says.

Psychologists may work in the NHS, as part of a mental health service, or alone in the private sector.

Other healthcare professionals working in mental health services include psychotherapists, counsellors and mental health nurses.

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