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!