Psychiatrist or psychologist: what is the difference?
They are different and complementary professions. Knowing what each one does helps you choose the first step and understand when it makes sense to see both.
Psychiatrists and psychologists both work with psychological distress, but they come from different training and use different tools. It is not about choosing the better one, but the one best suited to each moment.
The essential difference
A psychiatrist is a doctor. They studied Medicine and then completed several years of specialist training in psychiatry. This is why they assess the person as a whole, including physical health, and can order tests, make medical diagnoses and prescribe medication.
A psychologist has a university degree in Psychology and, in Portugal, is registered with the Portuguese Board of Psychologists. They carry out psychological assessment and psychological intervention, including psychotherapy, but do not prescribe medication.
PsychiatristMedical specialist. Medical diagnosis, tests, medication and clinical follow-up.
PsychologistPsychological assessment and intervention, including psychotherapy. Does not prescribe medication.
Two complementary professions: the best results often come from working together.
What a psychiatrist does
assessment and diagnosis of mental disorders, distinguishing them from medical conditions that can cause similar symptoms, such as thyroid problems, side effects of medicines or neurological diseases;
ordering and interpreting blood tests and other investigations, when indicated;
deciding whether medication is needed, choosing the medicine, adjusting the dose and monitoring its effects;
follow-up of more severe or complex conditions, such as severe depression, bipolar disorder or psychoses;
issuing medical reports and certificates and liaising with other specialties;
psychotherapeutic interventions, depending on each psychiatrist’s training.
What a psychologist does
psychological assessment, with interviews, tests and standardised instruments;
psychotherapy, using different models, such as cognitive behavioural therapy;
intervention in difficulties with adjustment, relationships, emotional regulation and behaviour;
neuropsychological assessment, by psychologists with that specialist training.
Where to start
It makes sense to start with a psychiatrist when symptoms are intense or long-lasting, when they clearly interfere with work, studies or relationships, when there are major changes in sleep, appetite or energy, when there are thoughts of death, when psychotherapy alone has not been enough, when you already take medication or when the cause of the symptoms is unclear.
For milder difficulties, a hard period in life or the wish to know yourself better, psychotherapy with a psychologist can be a good first step. If needed, the psychologist refers for a psychiatric assessment, and the psychiatrist refers for psychotherapy.
Both together
In many situations, such as depression and anxiety disorders, combining medication with psychotherapy works better than either alone. Collaboration between psychiatrist and psychologist, with the person’s consent, allows a coherent plan in which each one does what they are best prepared for.
No. For a private consultation you can book directly. If you already have reports, blood tests or a list of your medication, it is useful to bring them.
Does seeing a psychiatrist mean taking medication?
No. The consultation is about understanding what is going on and defining the plan. Medication is helpful in many cases, but it is not always needed, and the decision is made together.
Do psychiatrists also do psychotherapy?
Some psychiatrists are trained in psychotherapy. In most plans, the psychiatric consultation works alongside psychotherapy provided by a psychologist or psychotherapist.
References
Law no. 57/2008, of 4 September. Establishes the Portuguese Board of Psychologists and approves its statute.
Cuijpers P, et al. The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta-analysis of direct comparisons. World Psychiatry. 2013;12(2):137–148.
Cuijpers P, et al. Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta-analysis. World Psychiatry. 2014;13(1):56–67.
This page is for information only and does not replace an individual medical assessment. Clinical review: Pedro Zuzarte, psychiatrist · Published and reviewed: .