First of all, a lot of people do not know the difference between a psychologist, psychiatrist, counselor and therapist. Let me start by clarifying what those terms mean. Counselor is the most general term. It can refer to a therapist, psychologist or psychiatrist. Counselor is also the term used for a person with an associates degree or certification in addiction counseling. A therapist refers to either a psychologist or a master’s level person with a license. A therapist is someone who will spend an hour with you on a regular basis talking about ways to work through your struggles, and can also do psychological testing. A psychologist has a doctorate (either a Ph.D. or a Psy.D.), can do psychological testing, and can do therapy. A psychiatrist is a medical doctor, who completed medical school and a residency. The psychiatrist can do therapy, but typically chooses to refer out for therapy. The psychiatrist evaluates patients to determine whether medicine can help a psychological condition, and if so, prescribes that medication.
Sometimes people hesitate to take medicine for a psychological condition, preferring to address the problem in therapy. Usually your therapist will let you know when it is time to seek a psychiatric evaluation. It is also a good idea to see a psychiatrist if you feel extremely depressed, are considering suicide, have been hallucinating, or have extreme anxiety like panic attacks. There are other conditions where seeing a psychiatrist is advisable as well. For example, if you suspect your child has ADHD, then you can get a diagnosis and treatment from a psychiatrist. Use your therapist or primary care doctor as a guide in terms of when to contact a psychiatrist, and often they will have good referrals to give you.
When you go to your psychiatry appointment, come prepared. Keep a list of your symptoms, what caused them, and what time of day they occurred. Be extremely honest about any drugs or alcohol you use. Your psychiatrist is required to keep everything confidential, so don’t be afraid to tell him or her. If you smoke marijuana every so often, your psychiatrist NEEDS to know this. The reason it is so important to give your psychiatrist this information is that you are being given medication. Alcohol and illegal drugs interact with legal medication, affecting how well the medicine works. In some cases you actually are putting yourself in danger by mixing certain medications with certain drugs or with alcohol. Your psychiatrist isn’t going to be judgmental of you, believe me. Your psychiatrist has heard it all, and I mean ALL. You will not shock your psychiatrist. He or she has seen some of the seemingly most normal looking people take drugs, have an alcohol problem, lose touch with reality, make poor decisions, participate in extremely risky behavior, and anything else you can think of. Just keep in mind that your psychiatrist can only help you to the extent that you share everything about what is going on with you.
Also come to your appointments with a list of any physical symptoms you might be dealing with. Remember, this is a medical doctor. Sometimes psychological problems are caused by a physical problem or a disease. Your psychiatrist is trained to look for signs of physical disease and help you connect the dots. They are also trained to look for the opposite (physical problems caused by psychological impairment).
So, is it time to call a psychiatrist? Perhaps, and especially if you’re considering taking medication to deal with a psychological struggle. Consult with your therapist or primary care doctor to find out. If you don’t have a therapist or primary care doctor, you can call a psychiatrist directly for an evaluation in most cases.
Helping teens grow and families improve connection,
Lauren Goodman, MS, MFT