I am hoping someone can help me here. I started going to a psychologist a few months and I like her but I don't feel like she has helped me. I thought a psychologist would be able to help me sort out my feelings and get to the underlying issues of why I feel the way I do. For instance, I have very low, I'm sorry let me rephrase that...I have no self esteem whatsoever. I thought I would be able to have a discussion with her and she could maybe help me figure out why I feel worthless. Instead, she gave me a book to read which I did read it but I still don't know where this stems from.

I didn't go to a psychiatrist because I heard all they do is prescribe drug after drug. Am I wrong? Should I be going to a psychiatrist? I just feel like I am not getting the help I need. I have been to other 'social workers' before but no one has been able to help.

Can someone shed some light on the differences between a psychiatrist and a psychologist please? Thank you in advance!

[Sabrina]

I am in no way nearly as knowledgeable as some of our wonderful members - but from my experience, a psychologist will (or should) assist with therapy on various levels but is unable to prescribe meds. A psychiatrist goes deeper into the dynamics of mental illness and prescribes drugs accordingly.

Often, one goes to a psychologist first and is referred to a psychiatrist if further intervention is needed in the form of medication.

Good luck.

Have you thought about looking for a psychotherapist that deals specifically with your issues of self-esteem?

You might want to start there as psychotherapy is referred to as "talk therapy."

Here's a link from PC's home page.

http://therapists.psychcentral.com/psychcentral/

[DePressMe]

Not to make this any more complicated…but I have had good luck with therapists who have a counseling degree in social work. They specialize in all sorts of therapies. Of course I also had a wonderful psychologist. It sounds like you are not making a good connection with your current psychologist—maybe you should try a new one.

I have a psychiatrist and a therapist. The therapist spends an hour with me and helps me work through issues. My psychiatrist spends 30 mins with me and manages my meds—we don’t get into the deep issues. He is more concerned with how my thought processes are and the effects of my meds.

[WinterRose]

Usually the psychiatrist deals with the physical side of mental illness. They are medical doctors and can prescribe medications. Some of them will also do a little therapy, but I don't think they do that much and it's not their major focus or training. A psychologist is trained in the mental and emotional side of mental illness as well as human nature and they do more therapy. There are also therapists who do the same thing. (Someone else has to say the difference between a therapist and a psychologist besides the degree and amount of education.) There are lots of different therapy styles and methods so if the current psychologist is not working out for you, try another one or a therapist instead. How many visits have you had with this psychologist? You usually can't judge by the first visit anything other than whether you might be able to connect (which is an important first step), but even then more than one session is sometimes needed to get the ball rolling.

This page may help you out with definitions:
Guide to Psychology

[Beaglefun]

There isn't big money in psychiatry like there is in general medicine, so we tend to have fewer psychiatrists to choose from and a harder time finding one that spends the needed time with us.

Psychologists are good at assessing and treating a wide variety of mental illnesses that relate to maladaptive behaviors or thinking errors that cause distress in our lives. It takes a while to change a behavior or a thought process that has been in place for a long time, so patience is vital. In the mental health arena, some view psychologists as being the coordinator of services and may direct you to where you need to go for some specialized treatment.

I have found social workers to be good with knowing what community resource are available, have extensive knowledge on social maladjustment issues, and works well with the family as a unit.

[(JD)]

(((hugs)))

I think you're probably right where you need to be. Let the T decide if you also need medication.

Depression is tough, and will make you doubt things that are good, and be sure of things that are negative and incorrect.

You didn't become depressed overnight, I imagine. Depression comes from reactions to a few main things, but really generally develops from incorrect ways of coping with life, or feeling overwhelmed from life for a long time.



Keep working with the T. Do you know what modality of therapy the T uses, what type of treatment T has planned for you? Please talk with the T, tell him your concerns, the T will be able to help you work through making this good decision for yourself, to get help.

In the USA Psychiatrists generally only prescribe drugs, a 15 minute encounter usually. No therapy to speak of.
Medications in addition to talk therapy can help things feel better faster. For nominal depression I think the research says 6 months of either and you'll feel better. TC!

[pachyderm]

Psychiatrists are medical doctors (MD) who have taken additional training or specialization in psychiatry. These days most of them rely on medications as their primary approach to treating "mental illness."

Psychologists come in many varieties, but they are not medical doctors, so if they want you to take medications they have to rely on psychiatrists to prescribe them. Many psychologists have an academic approach. Clinical psychologists are supposed to be trained to treat people with emotional problems; they use what appears to be an unlimited variety of approaches: cognitive-behavioral, aversion therapy, "psychodynamic" and so on.

Psychoanalysts are trained in a particular psychodynamic theory following Freud, although many have developed beyond Freudian theory. Psychoanalysts are supposed to go through analysis themselves. Freud was an MD, but not all psychoanalysts are.

You have to find someone that seems to resonate with you, regardless of their theoretical framework. It is not easy for someone with emotional uncertainties to find someone who is good for him/her.

[Just Jenny]

It's my understanding a psychiatrist is a medical doctor and can perscibe medications where a psychologist cannot. Persoanally I've see both and my sense is a psychologist is better at therapy. If you need medications, go to a pyschiatrist for meds.

Originally Posted by bootiebear1

I am hoping someone can help me here. I started going to a psychologist a few months and I like her but I don't feel like she has helped me. I thought a psychologist would be able to help me sort out my feelings and get to the underlying issues of why I feel the way I do. For instance, I have very low, I'm sorry let me rephrase that...I have no self esteem whatsoever. I thought I would be able to have a discussion with her and she could maybe help me figure out why I feel worthless. Instead, she gave me a book to read which I did read it but I still don't know where this stems from.

I didn't go to a psychiatrist because I heard all they do is prescribe drug after drug. Am I wrong? Should I be going to a psychiatrist? I just feel like I am not getting the help I need. I have been to other 'social workers' before but no one has been able to help.

Can someone shed some light on the differences between a psychiatrist and a psychologist please? Thank you in advance!

[possum220]

Are the rules for Psychiatrists and Psychoanalists that strict in America?
P'doc just dispense drugs and Therapists talk?

I live in Australia. Some p'docs just do meds and therapists talk. But the are some Psychiatrists do both dispense meds but also listen and teach me things about myself. P'docs are in short supply but the Medicare system basically funds most of the visits. Therapists on the other hand do charge the same amount but you can only claim on 10 visits per year. It gets too expensive.

Over here its a matter finding some-one that you can connect with regardless of their title. That connection paves the the way for therapy that is most productive. I dont really think that you can say one title is better the than the other.

[Perna]

There aren't any rules in America and there are psychoanalysts who may/may not be psychiatrists. But psychiatrists are all medical doctors, specializing in psychiatry (as opposed to internal medicine, like most primary care physicians (PCP)).

Some psychiatrists talk too, but being doctors, they are more expensive and they mostly prescribe medication and one sees them for 15-20 minutes as one would see one's PCP (I go to my PCP quarterly). It's a medical checkup. Often there are groups, a psychiatrist and several psychologists and social workers and one may see different members of the same group for different "tasks", one for med checks, one for individual psychotherapy, and one for group therapy, perhaps.

Many people have their PCP prescribe their meds, don't even see a psychiatrist. There are others who can prescribe meds, nurse practitioners, for example (but they usually have to be in a group with a doctor to oversee them) and about a zillion different types of people who can do psychotherapy.

The US is a bit like 50 different countries, each state decides how people are licensed to operate in that state and usually one can't practice in another state (though you can drive through one, just can't stay there without giving up your one state's driver's license and getting one from the new state you live in :-) the Federal Government isn't like most other countries' Governments, it just governs things that apply to everyone, like interstate commerce and interstate roads, immigration, censuses/Federal taxes, military/wars, National Parks, etc.

The US doesn't have a national school system, which is why our education/school scores lower than other nations; if you take an "average" of the 50 states that would not be the same as if you took 10 states with "good" education or 10 states with not-so-good and used them. Where they are getting the students taking the tests that decide how the "nation's" education is, makes the difference. The US is so very large, that there are bound to be states/pockets of places that have problems that other states don't have or that value education more and have the resources to back that up, etc. I still vividly remember living in Norfolk, Virginia when I started 7th grade and working on multiplying fractions and then moving after a month to California where I was thrust into the Yale University School Mathematics Study Group and suddenly trying to understand how to multiply base 7 numbers as well as doing non metric geometry; very avant garde for the mid-1960's. My father could not help me with math because he, like all the other adults, had learned plane geometry and had no clue about this "new" math :-)

The main difference between psychiatrists and psychologists is not whether one is better than the other but the thrust of their studies. The psychiatrist, as a medical doctor, is studying how medicine affects the brain and the psychologist is studying psychology, which is about behavior.

[Rose76]

Psychiatrists in America aren't likely to do much other than prescribe meds. They'll go through drug after drug, if there is no response. I had over 2 and 1/2 years of that, and I got completely disgusted. Some of the drugs made me feel worse.

I'm real disappointed to hear that going to a psychologist didn't help you, bootiebear. Unfortunately, there is great variability in the competency of psychologists. (I found that psychiatrists tend to be more similar to each other.) It's not necessarily true that psychiatrists go "deeper" than psychologists. It tends to be true a lot of the time just because a lot of psychiatrists are better educated than a lot of psychologists. Really top notch psychologists tend to have contracts with important clients like the federal government. That makes them unavailable to someone like you. If you look in the yellow pages, or on-line, and notice the psychologists who do formal evaluations for the courts or the government, then you are looking at the cream of the crop. What they charge, you probably can't pay.

Someone I know real well got the best evaluation of a lifetime from an excellent psychologist who was contracted by the federal government. This was part of a work up ordered by a court. Of course, the government paid a lot to have the psychologist spend a massive amount of time doing the evaluation (over 40 hours.)

What any of these docs can figure out based on one hour once a week is not that much.

I would suggest you speed up the process by asking the psychologist to allow you to sit for a lot of formal written testing . . . or at least some. Just sitting in an office across from each other, shootin' the breeze, tends to go nowhere. That has been my experience.

Ask to be given the Minnesota Multiphasic Personality Inventory, as a start. Testing shouldn't cost you a fortune, since the psychologist doesn't have to sit with you, while you take it.

Basically, all any of these docs know is what we tell them. So, if you have absolutely no idea as to what damaged your self-esteem, then the docs probably will have no better idea. I'm sorry to sound negative, but I spent an awful lot of time and money to find this out.

You're not worthless. You probably need to have someone in your life who sincerely values you before you will begin to value yourself. That can be hard to find. I hope you do find it.

[turnall]

Psychiatrists aren't trained in therapy like psychologists are. Therapists can be social workers, psychologists, or all sorts of other degree holders, but research shows that the relationship you have with the therapist is one of the biggest factors in benefitting from therapy, so look for someone you connect with, more than focusing on their degree.

[turnall]

Also be aware that in some states, psychologists may be able to prescribe, as some states that have limited availability of psychiatrists are starting to allow that.

Here in the Uk Psychiatrists have the authority to section you (admit you to a psych ward) along with a social worker or a CPN too, Psychologists do therapy, My therapist works with my Psychiatrist.

[DocJohn]

Psychiatrists get paid more to prescribe, so they don't do much psychotherapy any longer. You may find the occasional exception here in the U.S., but it's becoming increasingly rare (the exceptions usually don't accept insurance; cash only and starting at $175/hour).

Psychologists get more in-depth and deeper training in actually doing psychotherapy compared to any medical doctor (including psychiatrists). They are the psychological equivalent of an "MD" in psychology. So most are well-versed in the form of therapy they prefer to practice (today, that tends to be an eclectic, solution-focused approach although cognitive-behavioral is also a popular orientation).

The key isn't to focus so much on degree (unless you want/need meds) -- they key is to find the right therapist that seems to work and click with you. That is, unfortunately, a trial-and-error process. You have to sometimes try a number of different professionals before finding one that seems to work best for your needs.

Good luck!

DocJohn

[mimi2112]

Originally Posted by turnall

Also be aware that in some states, psychologists may be able to prescribe, as some states that have limited availability of psychiatrists are starting to allow that.

If this is true that a psychologist will be allowed to prescribe meds then we are in for a world of hurt.
It's my understanding that only MD's, Pa's and ApRn's , who have medical training, are allowed to prescribe meds.

I hope Doc John steps in here and elaborates.

[Rose76]

Here is something answering the question about who can prescribe meds. (It used to be only physicians, but not anymore.)

Can Psychologists Prescribe Medications?

Personally, I wouldn't be too comfortable with anyone other than a physician prescribing meds. Actually, I'm not all that comfortable with the way psychiatrists prescribe meds. Since that's all that they can really do, I think they way overemphasize the role of medication in helping people with psychological pain. I think psych patients are very apt to end up way over-medicated because of this. That happened to me.

The best med management I ever got was from a regular family physician.

[mimi2112]

I apologize for not knowing that psychologists are now allowed to prescribe in some states. Thank you for the link Rose.
I agree with you about over-prescribing. I think there is something very wrong here that a psychologist is now able to prescribe. This stuff isn't aspirin for pete's sake!

[healingme4me]

Originally Posted by Sabrina

Often, one goes to a psychologist first and is referred to a psychiatrist if further intervention is needed in the form of medication.

Good luck.

In my case, I was referred by my neurologist, my psychologist didn't feel I needed to see one, but I went anyways. ((I'll have to share this story some other time))

Originally Posted by mimi2112

I think there is something very wrong here that a psychologist is now able to prescribe. This stuff isn't aspirin for pete's sake!

That is concerning. What about the chemistry involved?? I get that now-a-days we can ask pharmacists about drug interactions, but wow....that's not what they go to school for.

[prototype]

JMHO - One factor in this area to factor in is cost benefit (unless you have some "platinum" type medical coverage and cost is not an issue"). An LCSW type (therapist), will generally cost less per hour, than a psychologist, and a psychologist will generally be cheaper per hour than a psychiatrist. I can'y say I have seen enough of each, but based on what I have read, heard from people I know, and my limited experience therapists and psychologists make much better "talk to" mental health professionals than psychiatrists. An ideal situation is to have a therapists or psychologist as "talk to" MH professional who works with a psychiatrist. That way you can you spend most of your time with the therapist or psychologist and they can pass their "diagnosis" to the Psychiatrist which can cut down on duration and number of med checks/script refill visits ($$ savings) to the more expensive psychiatrist. One caveat - From what I understand, psychiatrists will be much more reluctant to prescribe a specific medication based on the recommendation of a therapist than they will a from a psychologist. As far as PCP's go, unless it is psychologist they recommended and know, they may or may not prescribe based on psychologists recco. The ideal situation is a Mental Health Practice that has all three (Therapists, Physiologists, and Psychiatrists). One person I know goes to a place like this and it really minimizes overall costs because they spend very little time (15 minute med checks with the Psych Dr for med checks, scripts and more time with the therapist and psycholgists for the tests and talk-to type stuff). (Unfortunately - the place I mentioned is not taking new patients...stopped by a couple of weeks ago, they did put me on some type of waiting list...not sure where the backup is, therapists, psychologists or MD/Psy. Oh well...my hunt continues.

[Rose76]

How good a person is at helping you to sort out your feelings may have very little to do with what kind of a degree that person has. It really has more to do with what kind of a person the therapist has and how well you "click" together.