Psychiatrist or psychologist? Who do I see? What is the difference between one and the other?

I intend this to be a short, concrete article that answers, no more and no less, the question in the title. So I’m just going to focus on the difference between the two professionals, which I understand is the most important and significant.

How do you choose between a psychologist and a psychiatrist?

The cardinal difference lies in the tools that both professionals use to tackle the problem presented by the patient.

The psychiatrist’s main tool is the psycho-pharmaceutical, through which he tries to induce changes in brain chemistry, which in turn will result in an improvement or relief of the symptoms that afflict the person.

In a complementary way, the main tool of the psychologist is the personal resources available to the patient who consults him/her. This professional pursues the same objective as the psychiatrist, but by appealing to the strengths and abilities of the person to achieve changes in his/her way of thinking and behaving.

But… which one is better?

The answer is: both. As we have seen above, are not opposite approaches, but complementary , and there is plenty of evidence that mixed treatments (combining both approaches) are generally more successful for a wide range of disorders.

The dichotomy or rivalry between psychiatrists and psychologists is a myth . With some regrettable exceptions, both want the same thing for the patient and collaborate with each other in pursuit of that goal.

While the psychiatrist goes “inside out” (from the brain to the behavior), the psychologist goes “outside in” (from the behavior to the brain). These are two sides of the same coin.

The reader friend may be thinking, “But how can a psychologist make structural changes in the patient’s brain? Don’t fuck with me, that’s only possible with a psychopharmaceutical!”
If this is your case, you have to know that the brain changes permanently throughout our lives ; in fact, it is life itself that makes it change.

When we learn to play the violin, our brain changes. When we learn a new language, our brain changes. When our partner leaves us for someone else, our brain changes. When our neighbor insults us because we play the music too loud, our brain changes.

And I’m very serious, no metaphors or exaggerations. Thanks to the great permeability and capacity of the human brain to modify itself and adjust to the daily experiences and demands of the environment, we have become the dominant species on the planet. So you know, the psychologist can do a lot for you in that respect.

Beyond Psychopharmaceuticals

In line with this, you should also know that while medication can be very beneficial, there is something that it is impossible to do for you: resolve the conflicts that you face in the lottery of life .

There are no pills to help us reconcile with a brother we are at odds with, for example. Or that help us choose a career to study. Or any other problem inherent in life itself that we have to solve.

Psychotherapy helps us to think about what we want for ourselves and to implement the necessary steps to achieve it. No medication has yet been invented to which we can delegate these matters.

In closing, I leave you with this question: What do you need if you want to learn to play the piano? The obvious answer is: A piano and a piano teacher. Well, the drug prescribed by the psychiatrist is the piano in this nice metaphor; and the psychologist is the teacher who teaches you to play it.