Psychiatry vs. Therapy

What is the difference?

When we think of psychiatry or therapy, many of us imagine lying on a couch talking about our childhood experience or our dreams, while the therapist takes notes and says "mm-hmm" often. In truth, this situation represents the Freudian Psychoanalytic approach to therapy. It is one of many types of therapeutic techniques practiced by therapists today.

Therapy

Therapy is short for psychotherapy, which is often used synonymously with counseling. In short, it is talk therapy. The people that are served are referred to as clients. There are several different schools of thought including psychoanalytic therapy, Adlerian therapy, Jungian therapy, existential therapy, Gestalt therapy, cognitive behavior therapy, integrative therapies and positive psychotherapy, and marital and family therapy, etc.

Several people may provide counseling and psychotherapy including psychologists (PhD, PsyD, or EdD), school psychologists, industrial/organization psychologists, professional counselors, marriage and family therapists, social workers, pastoral counselors, substance-use counselors, etc. Training varies by type.

Psychiatry

Psychiatry is a medical specialty that involves diagnosing and treating mental health conditions with medications. Psychiatric diagnoses are based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The people that are served are referred to as patients. Psychiatry may include the use of psychotherapy, or it may be limited to medication management only. This will depend on the provider and patient.

Typically, only psychiatrists, PAs, and NPs, practice psychiatry. However, many primary care physicians (those trained in Family Medicine or Internal Medicine) may diagnose and treat psychiatric conditions, such as depression and anxiety. They will typically refer their patients to psychiatry if the case becomes more complex, such as multiple diagnoses or more than one medication. Some will refer out automatically due to time constraints in primary care.

Which is right for me?

Depending on the specific diagnosis, treatment guidelines usually recommend a combination of therapy and medication management. For example, ADHD is usually more effectively treated with medication as opposed to therapy, while PTSD is usually more effectively treated with therapy as opposed to medications alone. With most conditions, however, a combination of multiple therapeutic approaches has been shown to be most effective.

It is important to speak with you provider to determine with best course of treatment for your situation.