Would you recommend seeing a psychiatrist or psychologist?

it depends on what your reason for going is

Well let me just ask you, how do you feel about that? sorry couldn’t resist.

Relationship issues = psychologist

All other reasons – psychiatrist

Why wouldn’t you want to see a professional for a problem were the option available?
Asking for help is a strength not a weakness.

yes, but you must remember that a psychologist/psychiatrist can only do so much. it ultimately comes down to you to solve your problems.

@smack I agree, figuring things out or working things out on your own is much better than some shrink asking you how you feel about everything, plus it makes you a stronger person by doing so, admitting there is a problem is a strength not a weakness.

Whenever I’ve gone to a psychiatrist, it was for medication and doseage monitoring while I was already under the care of a Licensed Clinical Social worker for counseling.

I did not get the impression that Psychiatrists get involved much with the counseling aspect of treatment. So I would only recommend one if a person thought there was a true chemical imbalance involved in their problems.

I did see a Psychologist for my first round of therapy. I didn’t feel that I benefitted much from that experience, but I wouldn’t discount Psychologists as a whole because of it.

In subsequent treatment, I saw LCSWs and found them to be more warm and down-to-earth and resourceful. Again, this doesn’t mean that all LCSWs are great, either.

I also know several people who are in the counseling profession who are completely nuts themselves. Regardless of their degrees and certifications, I would not recommend them to anyone.

So my suggestions would depend on the symptoms that a person was experiencing, and also on what the coverage and protocol of their insurance company required. Then I always remind people that this is someone you really have to trust. If you don’t feel comfortable with or confident in your therapist or doctor, try another until you find someone that you do.

@The_Compassionate_Heretic (moderator!),
@OutOfTheBlue, and @smack:
Those responses are not helpful. Did you read the ‘Details’ at all?

To clarify: I am not asking if I should seek counseling. I am asking specifically about psychologists and psychiatrists and the benefits/downfalls of the two.

Forget the psychologist. Counselor/therapist from any number of degree programs/titles and a psychiatrist for meds. They’re more interested in real-world solutions and applications and try to help you work through your problems instead of asking you how you feel and what you think. They’re also less likely to keep you coming and milking you for money. Many believe in what’s called “brief therapy.”

@five99one: Once I read the details, I understood the question more clearly; I don’t know if it’s too late to edit, but perhaps a comma (e.g. ”... a psychiatrist, OR a psychologist…”) would help people ‘get it’.

…..seeing a psychiatrist or psychologist?

Socially or Professionally?

The problem with your having limited this question to only two possible answers is that it makes it difficult to assist you, because as a matter of fact, neither a psychologist nor a psychiatrist is, in all likelihood, what you need. If you are willing to listen to a different option and to the reasons for choosing it, say something, and I will return.

There’s no problem with admitting that you don’t need help if you don’t need help. ;)

I wish people would pay attention to that, @five99one, but the question leads to people trying to offer help when none is needed. The first think they teach you in counseling/therapy programs is that sometimes none is needed. At some point in psychiatry and/or psychologist training, they tell them that help is always needed.

There’s a wide world of mental health workers out there, not just the two. The downside to both that you mention is that they’re somewhat overeducated and over-analytical (and over-pathologizing and so on).

@pdworkin I’m listening.

I think @avvooooooo‘s posts are very wise. Psychiatrists nowadays largely manage medications, and psychologists are overeducated for your needs. You would likely do well with a psychotherapist of some sort. My background leads me to suggest someone familiar with Cognitive Behavior Therapy. There are many people who are well trained in this modality, and it should not be difficult to find someone competent.

The days of psychodynamic “talk therapy” are over. There was never any empirical evidence as to whether it was ever worthwhile at all. It may have been, it may not have been. It was certainly lengthy and expensive. There is, however, empirical proof that CBT and some of its offshoots like Marsha Linnehan’s Dialectical Behavior Therapy help people.

It’s hard to make a recommendation without knowing what your issues are and what you are looking for but most psychiatrists deal mainly with prescribing and supervising meds. I’ve had very good experiences with both a psychologist as a therapist and an MSW and would not say their therapeutic approach was very different from one another.

@hearka Not sure how your post was more helpful than mine,,,,,

@pdworkin I don’t think anyone in the psychology industry uses the psychodynamic perspective anymore. Psychology is not strictly Freudian bs; CBT is part of psychology, and could be done by a psychologist.

I agree, though, that CBT would probably be the best. Thanks for your input.

@Outoftheblue Well, Hearkat actually answered the question instead of giving me an irrelevant opinion.

I’m sorry if my post was so poorly worded that it seemed to suggest that psychologists are still in the main Freudian. They really haven’t been for years, except maybe in New York City. But @avvooooooo made a very good point about their tendency to over-pathologize.

@OutOfTheBlue: The question asked for recommendations for one professional as opposed to the other, and personal experience, if possible; it was about the distinction between mental health professions.

Your responses generically lumped all mental health services into one, as if it were a yes/no question. I understand how the header could be interpreted as such, which is why I suggested reformatting the header, but it seems that too much time had passed.

Still, the details section was quite clear in asking: once a person has decided to pursue mental health services, which professional is recommended?

@hearkat So why is it wrong to say neither????????

If there is any doubt that this is only a “worried well” situation, or situational depression, I would go to a shrink first, to see if meds are indicated. If not, then I’d seek out a therapist. Therapists come with a wide range of titles, and their competency has nothing to do with their title. It’s mostly about the relationship you can establish with whoever it is. If you feel you can work with them, it’s good. If not, try someone else.

My therapist, for what it’s worth, uses psychodynamic theories to inform her approach. She’s not wedded to it, though, and will have her patients try a variety of things to see what approach is most helpful. She is, I believe, a psychologist.

I wasn’t sure that therapy was useful at first, but I’m starting to see some use. It is helping me with coping techniques. It is helping me see what works for me. Couples counseling, in particular, seems very useful. That’s more focused on specific, obvious goals. Individual therapy is a little more amorphous. Yes, you are focusing on feeling better, but the milestones aren’t so concrete.

My psychiatrist prescribed my meds, and has me come back every so often, to see if everything is ok. I also report to him once a month. He’s a nice guy, but he’s expensive. His bedside manner is not the warmest. But he’s also a big deal researcher, and I like talking to him about his work.

I think my experience is somewhat unusual in that I have resources to go to whoever I want to, and I have a wife who gets things done. She asked a psychologist friend about my symptoms, and was told to get me seen immediately, and when I couldn’t get an appointment for months, our friend got my psychiatrist to see me almost immediately.

Most people spend a lot of time finding the right therapist. I couldn’t get appointments with the top ones on my list, but the one I ended up with has been fine for me. I feel very lucky that my experience with mental health professionals has been so good. My psychiatrist actually listens to me, which is something that not a lot of people seem to be able to find—at least, if you have bipolar disorder. Then again, I got diagnosed late in life, and I have almost as much education as they do, so perhaps they respected me despite my illness.

For anyone who thinks they need help from a therapist, I wish you the best of luck!

@OutOfTheBlue: I did not interpret your response as meaning “neither”, Because even when a person chooses to see a mental health professional, the patient is the one who must do the work. The professional is there to serve as a guide or facilitator.

I did not mention it in my original comment, because it was not relevant to the question regarding the professions… but most of the healing and growth I have done has been independent of medical or spiritual advisement. In my 20s and early 30s, I tried different therapeutic approaches and medications. My history includes familial history of depression, as well as childhood psychological and sexual abuse. I also have a Minor in Psychology (1990).

I have written about my journey in many posts here on Fluther. Ultimately, what worked for me seems similar to CBT. I had not studied anything and was not familiar with it until recently. The closest anyone had ever come to suggesting something like CBT was the first LCSW I saw (~1997), who said, “fake it ‘til you make it”.

But it was nearly a decade later that I decided to stop struggling with my depression and accept it as a part of who I am. That released me from shame and expectations. Then I began consciously choosing actions that would leave me with the fewest regrets in the future.

I have since been talking very openly about my life experiences in order to help others – especially those who have been victimized in childhood – to realize that they did not choose that for themselves, and therefore, they have nothing to be ashamed of. I have chosen honesty, accountability, and openess in all areas of my life. Diplomacy and tact are skills I am still practicing! But I sleep much better at night when I haven’t held anything back.

I have found a love for myself that I once thought was impossible (my first clear memory of a suicidal thought was the night before my 12th birthday… I prayed not to wake up, because 12 years of hell was more than I felt I could handle; and yes, I there was a time that I made a serious attempt on my own life). I have found a sense of serenity that I would never have dreamed of. I have found my version of happiness.

That said, I have been struggling with some of those all-too familiar depressed feelings lately. As I discussed it with a friend today, it occurred to me that it I’d likely triggered by the impending holiday season. Since I have identified it, and talked about it, and written about it, I am feeling considerably better again. I know the next 6 weeks will be challenging, but I also know that they will pass, and I will still have my integrity when all is said and done.

@hearkat I appreciate your efforts at honesty very much. I’m glad that people like you are able to face the stigma head on, and are strong enough to fight for us. Maybe some day, I’ll be able to do that, but for the moment, I have to rely on people like you.

I am like you, however, in using this place to work things through. Well, that’s obvious, I guess. I feel like I’ve been trying people’s patience lately, since it seems like I’m not making any progress. But what the hell! It’s my life, not theirs. And while I am affected strongly by what other people think, I also do this for myself.

@hearkat by “you” i meant one in general. i’ve been seeing a psychiatrist since i was 9; although it has helped me, the most growing i have done was by myself, with my own insight.

from someone being trained in psychoanalysis in NYC Why must we assume that Freudian therapy is bs? As pdworkin says, empirical results regarding the effictiveness of talk therapy are hard to come by – but while Freudian therapy is certainly characterized by its use of associative symbol-gathering through talk, it’s hardly limited to this. Every time we say to my analysis professor, “Come on, Alan. Does this whole registration and repudiation of reality (aka ego-splitting and disavowal) thing actually happen?”, he says, “Yes, absolutely. I’ve dealt with it in my practice. Let me give you an example…” They are pretty convincing examples – both in that his interpretation seems to fit the situation, and that this interpretation would seem to uphold certain of Freud’s conclusions.

My own experience in therapy is limited. I found psychiatrists to be almost totally unhelpful. Based on my education in the field, I would recommend psychoanalysis. Even if analysts can’t help “fix” you, they can show you a lot about how and why the ways you think are troubling you. The goal is really to get you to monitor your own mental health, not to have endless talk sessions.

The first step to either choice is to visit your primary provider and ask for a referral. With the initial diagnosis, your GP will be able to guide you. In my experience (and I have had with both) the phychologist is the first choice for your issues. If you need the services of a psychiatrist, who is able to prescribe medicine and other relevant therapy, your psychologist will refer you.

The main difference between the two is the psychiatrist is the higher authority/expert than the psychologist. It is similar to the difference between a general surgical procedure versus brain surgery, (without the surgery).

@smack: I think you may have typed that while I was crafting my most recent response to OutOfTheBlue… please refer to those comments, as they clarify the issue that I, and the OP, had with your first reply, and I explained how I have come to rely on my own insights as well. :-D

@pdworkin :oP

Edited to add: Aw, you mods are so protective. Thanks! But to put my two cents in, and to let everyone else know, I didn’t take it as a personal attack. Analysts and psychologists are expected to gently snipe at one another, and I think pdworkin and I know where we stand as fellow jelly-buddies :o)

@daloon: I beg to differ! Your writings here have the same impact as mine – if not more (seeing as how you have mountains more Lurve than I). The only difference is that I will discuss experiences from my past that played a large part in the mental health issues I have struggled with, and I have shown my face on the Photobucket page. I totally respect your decisions not to do so. But in all honesty, I do hope that you get past that soon… because I’d like to meet you one day – if we haven’t already!

apologies for typos… the iPhone app isn’t well suited for these long replies

@daloon and @hearkat Thanks, you guys have given me a lot of good information.

Jeeze, it was a joke to amuse my friend @wildpotato. Lighten the fuck up. You are ruining our fun with your overreacting.

I always understood that the main differences were as follows:
Psychiatrists can medicate and psychologists don´t.
The psychiatrist’s viewpoint I understand is to look at how to treat a mental disease. He studies pathology much more in depth and will do a treatment based on that viewpoint. The psychologist is trained to look at how to optimize people´s strengths or how to get them to make use of their social networks or other resources to help them cope with a difficult situation they are going through or to overcome a maladaptive trait or habit.

I see I didn´t answer your question. I guess I would prefer going to a psychologist but that is not necessarily the best option for a person who does have a serious condition and who needs medication. Nonetheless, a psychologist would refer a person to a psychiatrist if they realize they need one.

I’d like to see some more emphasis and analysis on society rather than fixating on the individual’s personal issues per se, i think sometimes it’s nice to hear that it is society that’s dysfunctional. Rather than the people it continuously spits out.

@mammal Systems theory is the basis of Marriage and Family Therapy. You might find that interesting. Bateson brought it to therapy.

@hearkat I was under the impression that you did this kind of work in real life, not just here. Is that wrong? That’s what I think makes a real difference.

Right now, my son is seeing a psychiatrist for meds, a psychologist for emotional issues, and a licensed counselor for behavior issues that have gotten him in big trouble.

Nowadays, very few psychiatrists really do talk therapy with patients. They expect you to tell them what meds are working and what ones aren’t and they prescribe accordingly.

@daloon: No, I am an Audiologist, which is a hearing and balance specialist. I do use counseling skills in developing a rapport with my patients, explaining the diagnosis and treatment plan, and guiding them through the rehabilitative process, when applicable.

I initially was a Psych major – with the stereotypical intent of figuring myself out – but it didn’t take long to realize that as an unstable person, I was not well-suited to a mental health career. That was when my first major depression occurred and I dropped out of college for a couple years.

The best therapist I have seen was a psychologist.
However, now that I have seen daloons avitar enlarged, I may need a psychiatrist, or someone who can treat hysterical blindness.

the horror! the horror!

I think it’s most important to find someone you are comfortable with and (for myself) someone who will push you through the murky stuff you shy away from. Interview different providers and ask for recommendations.

The person I have found most instrumental in helping me is a life coach.

-Best of luck!

About 13 years ago I saw a psychiatrist who prescribed meds and referred me to a psychologist. That psychologist was horrible and the psychiatrist took on my therapy himself. He saved my life, I swear. He never told me what to do, but he woke me up.

After I moved away from there, I didn’t see anyone for years. I continued my medication through my GP. Not a great idea. My GP eventually sent me to a psychiatrist – 5 minute appointments, very impersonal.

I had a big breakdown a couple of years ago. A friend promised she knew a great therapist so I made an appointment. I love her. We don’t dwell on the past, we talk about what I can do to improve certain behaviors (CBT) and she also helps me understand why I have certain tendencies.

Since I trust her, I asked her to refer me to a different psychiatrist and I am delighted to now have both a therapist AND a psychiatrist that I think the world of. My psychiatrist talks to me for about 15 minutes to see how I am feeling, how the medications are working or not working, and to get a sense of my mental status.

I guess my recommendation is to find a therapist or psychologist you trust (keep trying until you find the right one) and then ask them the need for and where to go for psychiatric help.

@hearkat By “this work,” I meant the work of destigmatizing mental illness.

@filmfann Do you need some Maalox?

@daloon: I have only reached out to others online, really. I know people in other states that volunteer for rape crisis centers, but I don’t think I’m strong enough for that – yet. I do speak of my experiences in face-to-face conversations, if such topics come up… but they don’t often (which relates back to your post about the depth of interactions online vs. in person).

A Psychologist every time. They will actually listen to you, & help you work through your issues regardless of how long it takes. & eventually you should actually start feeling better. A Psychiatrist however will simply throw medication at you, medication they have no idea how it works, nor do the manufacturers for that matter. At best these medications will help you forget, temporarily, the reason you went to see them.

@TheJoker There are any number of counselors and therapists who do the same thing, maybe better, and for a better price.

@avvooooooo….. I wont argue with you but I doubt it.

@TheJoker I happen to know this for a fact.

@avvooooooo…. every fact is open to interpreation, & I could easily say that I know Psychologists are the best & thats a fact, I just choose not to :)

That’s an interesting question. What do you think?

In my experience working with both psychiatrists and psychologists, both, have specific tasks to do. To see a psychiatrist in a community based system, first you must see a LCSW for intake. The LCSW determines if you could benefit from a psychiatrist; it takes some time to schedule an appointment with one. But a psychiatrist will diagnose a disorder and prescribed medication for someone suffering from MI, determine on follow up whether the medication is therapeutic or not, and order labs to determine whether the medication is at therapeutic or toxic levels. If someone has need of medication it is imperative to see a psychiatrist. The problem these days is that Primary Care Physicians diagnose and prescribe psychotropic medications and they are not fully educated in the chemical imbalances of the brain. As for psychologists, they too have a important job to do, but mostly for behavior based issues such as for children with ADHD, Autism, and so on. This is where we run into behavioral therapies such as CBT or DBT. I’m a huge fan of CBT because behavior based issues need to be resolved through the person suffering; it is only that individual who can truly understand his/her own symptoms and get a handle on how to deal with these symptoms. Medications only go so far and the rest comes down to the individual. I work daily on changing the stereotyping people with MI! MI is a result of a PHYSICAL IMBALANCE in the brain chemicals, not a dysfunction of a person’s character!