What is the Difference Between Psychotherapy and Psychiatry?

Psychotherapy and psychiatry sound alike, so it can be confusing to know what the differences are and when to see a psychotherapist versus when to see a psychiatrist.

The Difference Between Psychotherapy and Psychiatry

What is the Difference Between a Psychotherapy and Psychiatry?

While the two terms might sound interchangeable, there are important key differences:

Psychotherapy

Psychotherapists tend to focus on thoughts, including unconscious thoughts, emotions and behavior.

The Difference Between Psychotherapy and Psychiatry

Psychotherapists have at least a two year Masters degree and many of them also have an additional four years postgraduate training from postgraduate institute (like the Institute for Contemporary Psychotherapy, National Institute of Psychotherapies and other institutes).

Aside from traditional talk therapy, psychotherapists who go on for advanced training also provide specialized therapy including (but not limited to):

• Eye Movement Desensitization and Reprocessing (EMDR)

Eye Movement Desensitization and Reprocessing (EMDR)

• Internal Family Systems Parts Work (IFS)

• Accelerated Experiential Dynamic Psychotherapy (AEDP)

• Somatic Experiencing

• Hypnotherapy

• Emotionally Focused Couples Therapy

• Sex Therapy (for individuals and couples)

Depending upon their skills and training, many psychotherapists can help clients to:

• Manage Stress and Anxiety

• Overcome Depression

• Develop Resilience and Better Coping Skills

Couples Therapy

• Improve Relationships

• Process Unresolved Issues, including Unresolved Trauma

• Improve Communication Skills

• Cope with Workplace Issues

• Process Unresolved Grief

• Improve Self Esteem

And many other behavioral and interpersonal issues.

Most psychotherapy sessions occur at least once a week for 45-60 minutes.

Psychiatry

Psychiatry focuses on the medical side of mental health.

Psychiatrists are mental health professions who are medical doctors (MDs or DOs). They provide differential diagnoses, prescribe psychotropic medication such as antidepressants, anti-anxiety medication, antipsychotic medication and other similar medications.

In the past, psychiatrists provided traditional psychotherapy, like Cognitive Behavioral Therapy (CBT), psychoanalysis and psychodynamic psychotherapy. However, these days most psychiatrists provide medication management. 

Some specialized psychiatrists also provide Electroconvulsive therapy (ECT) for severe mental health conditions such as treatment-resistant major depression, ADHD, schizophrenia and  catatonia (a state where someone is awake but unresponsive to other people or the environment).

After the initial evaluation session, psychiatry sessions tend to be shorter in duration (15-20 minutes) to assess how a client is responding to medication management. After a client has been stabilized on medication, sessions might occur every 3-4 months unless the client needs help with medication.

Integrating Psychotherapy and Psychiatry

Clients, who need medication management, benefit from integrating both psychotherapy and psychiatric treatment and many psychotherapists and psychiatrists collaborate to integrate both treatments (see my article: Medication Alone Isn't As Effective As Including Psychotherapy).

For instance, a psychotherapist who is helping a client with anxiety will often be in touch with the client's psychiatrist to provide feedback on what she has observed in therapy sessions and to get information about medications prescribed. This is only done with a written consent from the client.

While some clients choose to only take medication, research has shown that combining psychotherapy and psychiatric treatments is most effective (when psychiatric treatment is needed) rather than just relying on medication because clients learn coping skills and strategies to deal with their mental health issues. 

Psychotherapy can get to the underlying issues that cause the mental health issues and if worked through in therapy, it's possible that medication won't be necessary for certain clients. 

In addition, when clients stop taking medication for certain mental health issues, they often go back to having the same problems they had before they took medication. For instance, if they never learned to manage anxiety symptoms or get to the root cause of their anxiety in therapy, once they stop taking the medication, they are back to where they were before they stopped taking the medication.

At the same time, there are certain mental health conditions that require medication such as schizophrenia, some forms of ADHD or bipolar disorder to mention just a few.

How to Choose Between Psychotherapy and Psychiatric Treatment

Making a decision about mental health treatment can be a big step, especially if you are new to it.

Consider what you need:

Are you looking for help with understanding yourself, improving your relationships, dealing with situational anxiety or working on unresolved trauma or are you dealing with more complex long-standing psychiatric problems?

If you are dealing with a mental health issue that requires medication (e.g., ADHD, bipolar disorder), starting with a psychiatrist is a good first step. Then, once you are stabilized on medication, you can see a psychotherapist to help you to make the behavioral changes that medication alone won't do.

How to Discover What is Right For You

It's easy to get confused about the differences between psychotherapy and psychiatry.

The Difference Between Psychotherapy and Psychiatry

You're not a broken machine that needs to be "fixed". You're a human being which means that, like everyone else, you have messy, complicated and wonderful parts of yourself. We all do.

Rather than focusing on being "perfect", the goal is developing a better understanding of yourself, practicing self compassion, finding the right tools and strategies to deal with life's inevitable ups and downs and living a meaningful life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

I have helped many individual adults and couples over the years.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Also See My Articles:

Why is Experiential Therapy Better Than Traditional Talk Therapy to Deal With Trauma? 

With Experiential Therapy, There Are No Blank-Slate Therapists 

The Mind-Body Connection: Experiential Therapy Offers a Window Into the Unconscious Mind 

How to Support a Friend Who is Depressed

Supporting a depressed friend can be challenging, especially if you don't understand what it means to be depressed, so it can be helpful to familiarize yourself with the symptoms of depression (see my article: What is the Difference Between Sadness and Depression?).

Supporting a Friend Who is Depressed

What is Major Depression?

Major depression is a common serious mood disorder.

Depression isn't just "feeling bad". It's a persistent condition that is often episodic and which usually lasts at least two weeks.

Depression isn't a sign of "weakness." It's a mental health condition that is treatable for most people.

Approximately 8-9% of adults in the U.S. experience at least one episode of major depression in their lifetime.

Approximately 15-20% of children ages 12-17 experience depression in the U.S. (see my article: Adolescent Depression).

There are gender differences with women being twice as likely to experience depression than men in the U.S.

Symptoms can include:

• Intense sadness

• Irritability

• Loss of interest in activities that were once enjoyable

• Problems sleeping

• Feeling worthless

• Problems concentrating

• Poor appetite

• Weight loss

• Possible suicidal thoughts

• Possible intent and plan to commit suicide

What Causes Major Depression?

Major depression is often a combination of genetic and environmental factors including (but not limited to):

• A genetic predisposition for depression

• A traumatic history including:
• Emotional neglect
• Abuse
• Loss of a loved one
• Other losses

• Major life changes including (but not limited to):Moving to a new areRelationship problems
• Separation or divorce
• Children moving out of the house (see my article: Coping With Empty Nest Syndrome)

• Low self esteem

• Pessimism

• Medical conditions

• Substance misuse/abuse

• Financial problems

• Medications

How Can You Help a Friend Who is Depressed?

Supporting a friend who is depressed can be challenging.

Supporting a Friend Who is Depressed

Here are some tips for helping a depressed friend:

• Listen without judgment

• Keep in touch to check in with them

• Offer help including
• Helping with chores
• Running errands
• Offering childcare to give them a break
• Helping with other tasks

• Encourage your friend to get professional help which might include helping them to find a psychotherapist or psychiatrist in their area.

• Be patient and understand that recovery from depression can take a while.

What Should You Not Do?

• Don't say things like "Snap out of it' or "Cheer up" or "You have so much to be grateful for."

• Don't minimize or dismiss their pain by saying, "Things could be worse."

• Don't compare them unfavorably to others (see my article: Comparison and Judgment Are the Thieves of Joy).

• Don't blame them for their depression.

• Don't try to be their psychotherapist. Be their friend.

Take Care of Yourself

Supporting a loved one who is depressed can be physically and emotionally draining 

Self Care

Make sure you have your own friends and support system.

Set boundaries.

Seek help for yourself if you feel overwhelmed by your friend's depression.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, Parts Work (IFS and Ego States Therapy), EFT (for couples), Somatic Experiencing and Certified Sex Therapist.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Also see my articles: 

Seasonal Affective Disorder (SAD)

Are You Concerned About Your Spouses Depression? 

What is the Connection Between Anxiety and Depression?