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    Psychologist or psychiatrist? If someone is depressed, who is better to see? What is the difference?

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    I don't understand the real difference between a psychologist and psychiatrist... although I do know that psychiatrists can prescribe medications. In terms of therapy, which is better? Or does it not make a difference?

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    Louise Shepherd

    Clinical Psychologist

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    I am a clinical psychologist with 15 years experience working with all sorts of goals and issues. I love working with people, helping them to ... View Profile
    This is a fairly personal decision and I won't pretend to fully answer this here. I'll just give you a few ideas (my opinion on this!!). 

    A psychiatrist is a doctor with a medical degree who has specialised in psychiatry so they are very highly trained in treating mental illness. And yes they can prescribe medications.

    A “psychologist” is someone who has studied psychology, the study of human behaviour. A “clinical psychologist” refers to someone who has studied psychology at a masters and / or PhD level. They have specific training in “clinical” psychology, i.e. mental illness etc.

    I am biased - let me be clear - so I would say that for a mild or moderate depressive episode a clinical psychologist may be the ideal choice. Antidpressant medication is not the first treatment of choice for mild to moderate depression. Psychiatrists and clinical psychologists and psychologists all differ in terms of the training they have done and the amount of knowledge and experience they have in treating depression. Some, but of course not all, psychatrists may be inclined to prescribe medication rather than engage in “talking” therapies. I find this varies enormously. 

    For severe depression (can barely get out of bed, not showering, very little engagement in the world) antidpressant medication is probably worth considering - at least discussing with a doctor. The best combination may be medication as well as seeing a clinical psychologist to get moving and out and about doing the things you usually care about. 

    And the other consideration is the type of treatment that people use. For depression there are some treatments that we know to be more likely to work than others - such as CBT, IPT and what is called behavioural activation. You can look any of these up and read more about them. Wikipedia is often a good basic resource for doing that. 

    Other treatment approaches that are gaining a lot of interest and can be enormously helpful for many people are Acceptance and Commitment Therapy and Mindfulness Based Cognitive Therapy.

    Long answer sorry - I hope that it helps a little. I think a lot will come down to the individual person - but a bit of knowledge and asking a few questions will make it more likely that you receive the best treatment for your issues. 
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    Carolien Koreneff

    Counsellor · Diabetes Educator · Psychotherapist · Registered Nurse

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    Carolien Koreneff is a Somatic (body-oriented) psychotherapist, Health Coach, Counsellor as well as a Credentialed Diabetes Educator with nearly 20 years experience. She currently sees ... View Profile
    I agree with Louise that the choice between seeing a psychologist or a psychiatrist can be a personal one, and largely would depend on whether medication is required or not. 
    Louise mention a few different modalities that can be used in the treatment of depression, but this was of course an incomplete list.
    It was mentioned that some psychiatrists may restrict themselves to “prescribing medication, rather than engaging in talking therapies”; I would like to add that psychologists can also restrict themselves by choosing a particular modality.
    As a somatic psychotherapist I pride myself in the fact that I was trained in a large number of different modalities. This means that we can choose the one (or a combination of modalities) that best work for you. 
    I tried various modalities myself for the treatment of my depression and found that the best thing was to incorporate both body and mind. I have benefitted so much from this myself, that I dicided to do the training myself, so I can help others in a similar fashion.
    Not many people know about this form of psychotherapy, even though it has been around for decades, probably because it does not currently attract Medicare benefits. But if you are interested in finding out more about Somatic Psychotherapy you can take a look at my website http://www.glebetotalhealth.com.au/somatic-psychotherapy/ or check out the site of the Australian College of Somatic Psychotherapists: http://www.somaticpsychotherapy.com.au/
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    Grant McKell Pro

    Psychologist

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    Grant McKell is a counselling psychologist working in Sydney's inner west with over ten years' experience. He founded HeadsUp Psychology in August, 2011. Having worked ... View Profile
    • Hurlstone Park, NSW 0402231839
    • Stanmore, NSW 0402231839
    • Dulwich Hill, NSW 0402231839
    I'll jump in here, too, just to add a little more. A clinical psychologist is a psychological specialist in mental health disorders and has studied to a masters or PhD level. Most other psychologists have also studied to a Masters or PhD level as well and many non-clinical psychologists are qualified and able to deliver CBT, IPT and the like.

    The most important thing is to find a therapist who you connect with and whim you find it easy to talk to, whether or not they be a counsellor, psychologist or psychiatrist. If you're not comfortable with the therapist you see, don't stop getting treatment- go and find another.

    The psychiatrist/psychologist difference, which Louise explained very well, doesn't mean that you have to see one or the other exclusively. Psychiatrists are a bit thin on the ground compared to psychologists, especially in regional areas, so many people get their regular therapy from a psychologist with reviews of progress and medication decisions handled by a psychiatrist. This can also be a cheaper option, as psychiatrist fees tend to be a bit steeper than most psychologist fees. In other words, the psychiatrist is often the case manager. Don't be surprised, because of this, if a psychiatrist ends up referring you to a psychologist for regular therapy anyway.

    In terms of therapy, a psychiatrist is not really better than a psychologist and vice versa. The therapies employed by either should be (and usually are) evidence based, so it makes no real difference. As I said before, the thing that does make a difference is whether you connect with your therapist or not. And to reiterare, you'll probably be able to get in to see a psychologist sooner and more regularly than a psychiatrist.

    Something else not mentioned is that to see a psychiatrist, you will need a referral from your GP. You don't need a referral from a GP to see a psychologist, but I would recommend that you get one anyway, as this may allow you to claim some of your psychologist fees back from Medicare if you do.

    Hope we're making it all a bit clearer for you!

     
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    Dr Carla Rogers

    Psychologist

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    Are you ready to make some changes? I don't have a magic wand, I can't fix all your problems, and when we work together you're ... View Profile
    Well said Grant!  I strongly believe (and research has shown) that the client-therapist relationship is actually the strongest predictor of therapy success.  So definitely find a psychologist/psychiatrist with whom you connect well.  this is hard sometimes as I know how difficult it can be to make that first step in seeking therapy… so having to start again if you don't connect with the first one is difficult but well worth it.  Once you've found someone that you are comfortable with, the entire process will flow a lot more smoothly for you.  Good luck!
    Carla
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    My research interests include immunology and the mechanisms of amyloid formation. The latter has implications for people who are dealing with Alzheimer's Disease, Parkinson's Disease ... View Profile
    I think that (if possible) it is best to have access to *both* a psychiatrist and a clinical psychologist, working togther as a professional team.

    That has been my experience - I am in remission from Major Depressive Disorder thanks to a combination of my hard work and help from my care team.

    I am now on a “care and maintenance” basis with both - I see them every six months for a quick chat and (in the case of my psychiatrist) to also pick up scrip for my anti-depressant.
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