Psychiatrists are medical doctors, trained in the medical model and oriented toward medicinal intervention for mental health problems. Clinical psychologists have their doctor’s degree in assessment and psychotherapy, and are oriented toward correcting faulty thinking. What if you are depressed, or anxious, or having marital problems, sleepless nights, or any one of a number of psychological and behavioral problems? Should you go to a psychiatrist? Yes, if you are oriented to take medication. Should you go to a psychologist? Yes, if you are willing to work hard to confront your issues and deal with them realistically. Should you face your troubles on your own? Yes, if you can honestly identify the triggers behind your difficulties and have the motivation to attack them yourself. But, what if your efforts at conflict resolution and behavior and thought management are largely unproductive? Then, an initial visit with a psychiatrist or psychologist might be appropriate. The first thing they should do is take a few sessions to reach a clinical judgment and give you one or more psychological tests to help render a diagnosis. A treatment plan should then be discussed with you. If you are with a psychologist, and medication is deemed appropriate, a psychiatrist can be included on your treatment team.
Research shows that the combination of medication (psychiatrist) and psychotherapy (psychologist) is more powerful than either one alone. This combination is especially appropriate in the initial stages of treatment. With respect to long-term management of life stress, however, studies indicate that psychotherapy has an advantage because it helps individuals learn to cope with issues in their life by helping them alter their perspectives and behaviors. Sometimes, attacking and modifying these perspectives can provide significant improvement even when some of the fundamental issues underlying thinking and behavioral difficulties are still present.
For instance, a married couple was in therapy for about six sessions when they abruptly discontinued treatment. About a year later their therapist ran into the husband and asked how things were going. He said their problems were still there but thanks to their sessions they were looking at those problems in different ways than they had previously. It was clear that a change in perspective had allowed them to make stable adjustments in their relationship on their own, even though some fundamental conflicts remained in their relationship. Their change in how they approached those conflicts, however, enabled them to maintain stability and to put the psychological energy behind their conflicts to more productive uses in the relationship.
“I’m troubled and having difficulty with issues in my life. Should I see a psychiatrist for medication? A psychologist for talk counseling? Or should I try to deal with my problems on my own?” There is no simple answer to these questions, and it helps to be aware of differences in the fields of psychiatry and psychology and have some knowledge about the training and techniques available to each professional. It is also important to remember that both medication and psychotherapy play appropriate roles in treating many problems, and studies find that a combination of drugs and therapy works better than either one alone. It is also safe to say that each approach can be appropriate at different points in the treatment regimen. That is, medications can provide quick early relief from intense suffering, while psychotherapy can give wider and more lasting relief.
Then there is the issue of side effects with psychiatric medicines. We will take a look at that in our next post.
