How to Choose Between a Therapist and a Psychiatrist

If you’ve been feeling unlike yourself lately, you’re not alone. Millions of people wrestle with mental health challenges like anxiety every day. The good news is, help is out there. But it’s not always clear who you should talk to first. Should you go to a therapist or seek out a psychiatrist? 

Let’s clear the fog. Choosing the right kind of mental health support doesn’t have to be confusing. This guide will help you understand the difference between therapists and psychiatrists, when to seek each one, and why you might benefit from both.

What Does a Therapist Do?

Therapists are trained professionals who help you talk through emotional, psychological, and behavioral issues. They create a safe, nonjudgmental space where you can work through challenges, change patterns, and grow.

They come in different forms, including:

• Psychologists (PhD or PsyD)
• Licensed Clinical Social Workers (LCSWs)
• Licensed Professional Counselors (LPCs)
• Marriage and Family Therapists (MFTs)

What do all these professionals have in common? They provide psychotherapy. This is a structured, evidence-based approach to improving mental health through conversation, insight, and skill-building. They don’t prescribe medication, but their work is incredibly effective, especially for anxiety, depression, trauma, grief, and relationship issues.

What Do Psychiatrists Do?

Psychiatrists are medical doctors (MD or DO) who specialize in mental health. That means they’ve completed medical school and psychiatric residency training. They have deep knowledge of how the brain, body, and behavior are interconnected.

Psychiatrists can:

• Diagnose mental health conditions
• Prescribe and manage psychiatric medications
• Offer brief psychotherapy (though this is increasingly rare)

In recent years, psychiatrists have moved toward medication management as their primary role. This shift is largely due to rising demand for treatment, limited availability of psychiatrists, and the growing use of psychotropic medications for mood and anxiety disorders.

Therapy Use Is on the Rise

Recent data from the Medical Expenditure Panel Survey (2018–2021) reveals a compelling trend in mental health care:

• Use of psychotherapy alone (from therapists) increased from 11.5% in 2018 to 15.4% in 2021 among adults receiving outpatient mental health services.
• During the same period, the share of patients receiving psychotherapy from psychiatrists decreased from 41.2% to 34.2% 

Why the shift? It’s because more people are recognizing the value of talk therapy. Similarly, more psychiatrists are focusing on medication due to time and systemic constraints.

Fig. 1. Trends in outpatient psychotherapy use from 2018 to 2021 show a rise in therapy provided by non-psychiatrist professionals and a decline in psychotherapy delivered by psychiatrists.

It’s also worth noting that from 1996 to 2016, the percentage of psychiatrist visits involving psychotherapy dropped dramatically: from 44.4% to just 21.6%. In short, psychiatrists are becoming less focused on “talk therapy” and more focused on the biology and medication side of treatment.

So… Whom Should You See First?

So, how do you decide who to see first: a therapist or a psychiatrist? It depends on what you’re experiencing. If you’re feeling overwhelmed, anxious, grieving, or navigating stressful life changes, a therapist is often the best starting point. They provide emotional support, help you process challenges, and teach tools to manage your mental health. 

On the other hand, if you’re dealing with more severe symptoms, such as intense depression, mood swings, or you suspect you might need medication, a psychiatrist may be more appropriate. 

Psychiatrists are also the go-to if you’re already on medication and need it adjusted. Both professionals play vital roles in your mental health journey, and neither is better than the other—it’s simply about finding the right fit for your needs. 

If you’re not sure where to begin, starting with a therapist is a great first step. They can guide you and refer you to a psychiatrist if necessary.

Can You Work With Both a Therapist and a Psychiatrist?

Absolutely. In fact, a collaborative approach is often ideal.

Many people see a therapist for weekly talk therapy sessions and check in with a psychiatrist every few months for medication monitoring. This combination helps treat both the emotional roots and biological symptoms of mental health conditions.

Think of it like this:

• The therapist helps you understand and manage your thoughts, behaviors, and relationships.
• The psychiatrist helps fine-tune your brain chemistry when needed.

When these professionals work together, the results can be powerful.

What If You’re Still Not Sure?

Don’t worry. The fact that you’re even asking this question means you’re already moving in the right direction. Mental health is deeply personal. There’s no one-size-fits-all solution, and that’s okay.

Here are a few questions to ask yourself:

• Have my symptoms lasted more than a few weeks?
• Are they interfering with my daily life?
• Am I struggling to function at work, school, or in relationships?
• Do I feel hopeless, numb, or constantly overwhelmed?
• Have I tried talk therapy before, and if so, did it help?

If you answered “yes” to several of these, consider reaching out to a therapist first. They can guide you toward the next step, whether that’s ongoing counseling or a psychiatric referral.

You Deserve to Feel Better

Mental health struggles are more common than you think. And just like any other health concern, they deserve care, support, and attention.

Whether you’re navigating anxiety, depression, burnout, or just a sense that something’s “off,” don’t go it alone. Whether it’s a therapist, a psychiatrist, or both, the right professional can help you get back to feeling like yourself again.

At Mind Body 7, our integrated team of therapists and psychiatrists works together to provide holistic, personalized care, so you don’t have to choose blindly. We’ll help you find the support that fits your needs and your goals.

Questions to prepare for reaching out to a practice: 

1. Reflecting on your current mental health needs, do you feel that your challenges are more related to emotional coping strategies, or do they involve symptoms that might benefit from medical evaluation and potential medication?
2. Have you previously tried psychotherapy (talk therapy), medication, or a combination of both? What was your experience with each, and how did they impact your well-being?
3. Are you seeking support for a specific issue (e.g., anxiety, depression, trauma), or are you looking for a comprehensive evaluation to understand underlying causes of your mental health concerns?