What Is a Psychiatrist and What Do They Do?

A psychiatrist (MD or DO) is a medical doctor with the education and training to diagnose mental disorders and prescribe medications. They can also evaluate for medical conditions that may be contributing to your psychiatric symptoms. Psychiatrists can also provide psychotherapy services. 

Psychiatrists go to medical school and complete residency training specializing in mental health. Psychologists are also highly specialized mental health professionals. They have PhDs or PsyDs, and offer psychotherapy as well, but they can't prescribe medications in most states and don't have medical training.

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Concentrations

Psychiatrists are available to help with any mental health concern, especially if it is causing significant distress in everyday life.

Psychiatrists can help treat the following conditions:

Your symptoms will of course depend upon what type of mental health conditions you’re dealing with (especially because it’s common to be diagnosed with more than one at once). You can get help from a psychiatrist for symptoms such as:

  • Low moods (excessive sadness)
  • Excessively elevated moods
  • Irritability
  • Impulsivity
  • Loneliness and isolation
  • Relentless worries or fears
  • Sleep problems (too much or too little or not restful sleep)
  • Increased substance use (recreational or prescription)
  • Personality shifts, unstable identity
  • Extreme indecisiveness

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-4357 for information on support and treatment facilities in your area.

Procedural Expertise 

Psychiatrists diagnose mental disorders using criteria outlined in the Diagnostic and Statistical Manual, 5th Edition (DSM-5). They will ask about your symptoms and determine whether they match the criteria in the DSM-5 for a particular mental disorder.

They may use additional diagnostic tools to gauge the severity of your mental disorder. These may include:

  • Anxiety tests, such as the Beck Anxiety Inventory and Liebowitz Social Anxiety Scale
  • Depression tests, such as the Hamilton Depression Rating Scale and the Beck Hopelessness Scale
  • Eating disorder tests, such as the Minnesota Eating Behavior Survey and the Eating Disorder Examination
  • Mood disorder tests, such as the My Mood Monitor Screen and the Altman Self-Rating Mania Scale
  • Personality disorder tests, such as the Shedler-Westen Assessment Procedure and the McLean Screening Instrument for Borderline Personality Disorder
  • Psychosis tests, such as the Scale for the Assessment of Negative Symptoms and the Scale for the Assessment of Positive Symptoms

They may also order other tests to rule out physical conditions that could be causing your symptoms, including:

  • Brain imaging tests such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) to check for tumors, hemorrhage, or lesions
  • Blood tests to check blood chemistry, electrolytes, liver function, and kidney function that may directly or indirectly impact the brain
  • Drug screening to detect illicit or pharmaceutical drugs in a blood or urine sample
  • Electroencephalogram (EEG) to identify electrical irregularities in the brain, including epilepsy

Medications

Your psychiatrist may prescribe medications to help alleviate your symptoms, including:

  • Antidepressants for depression, anxiety disorders, eating disorders, and borderline personality disorder
  • Antipsychotics for schizophrenia and psychotic episodes
  • Anxiolytics for anxiety disorders
  • Mood stabilizers for bipolar disorder and schizoaffective disorder
  • Stimulants for attention deficit hyperactivity disorder (ADHD) and narcolepsy

Your psychiatrist may prescribe more than one medication. This combination approach is common in psychiatry and may require ongoing adjustments to achieve optimal effects over time.

Psychotherapy

Your psychiatrist may also offer different types of psychotherapy, including cognitive behavioral or psychodynamic therapy, or refer you to a psychologist or therapist for psychotherapy. Therapy can take place in one-on-one sessions or in family, couples, or group settings. 

Talk therapy helps patients understand the thoughts and feelings influencing their behavior. With this insight, behavioral changes are possible in a range of conditions, including addictions, phobias, depression, and anxiety.  

Subspecialties

The subspecialties for psychiatrists are just as broad as the conditions they treat. If your psychiatrist has a subspecialty, it means they studied beyond their four-year residency through a fellowship to gain more expertise in one field. 

Child Psychiatry

Psychiatrists in this subspecialty work with children and adolescents to address the unique challenges during this life stage. Topics may include family life, school, peer pressure, bullying, sexual orientation, substance use, body image, and more. 

Psychotherapy 

Psychiatrists who specialize in psychotherapy have often done further training in psychoanalysis or other modalities of psychotherapy. They can offer patients from all demographics talk therapy to peel back the layers of what’s causing or triggering belief systems that are negatively influencing thoughts and behaviors. 

Addiction Psychiatry

This subspecialty focuses on the diagnosis and treatment of people suffering from one or more addictions, including substance use addiction and also behavioral addictions such as gambling disorder. 

Geriatric Psychiatry 

Psychiatrists in this subspecialty work with older adults to address challenges related to aging, disease, and the ways in which emotional and mental disorders can present in elderly individuals.

Forensic Psychiatry 

This subspecialty focuses on providing psychiatric evaluations for civil or criminal court cases. Psychiatrists act as consultants in this setting.

Training and Certification

In general, psychiatrists will have completed a bachelor's degree while taking courses to prepare for medical school. In medical school, your psychiatrist will have chosen to work on a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree. DOs complete extra training in the musculoskeletal system.

After medical school comes the four-year residency in psychiatry. The first year is often in a more general medical setting, and the remaining years the resident is exposed to a variety of psychiatric issues in different settings.

Finally, your psychiatrist is required to obtain and maintain medical licensing in their state. They are not allowed to practice in other states without proper licensing in those states.

After licensing, psychiatrists can apply for board approval from the American Board of Psychiatry and Neurology (ABPN), a member of the American Board of Medical Specialties (ABMS). All licenses and certifications have their own regulations and expiration dates.

Appointment Tips

You may be referred to a psychiatrist by your primary care doctor, or you can seek a psychiatrist for help on your own. If you’re concerned about how you’ll be paying for appointments, mention this when you book an appointment.

You can ask your healthcare team for referrals, and check their certification online with the ABPN verification system.

Before the appointment:

  • Write a list of your top symptoms.
  • Make a list of any medications and supplements you are using.
  • Prepare and bring notes regarding any past care related to your mental disorder.
  • Think about what you want to get out of the appointment.
  • Write down some questions you want to ask during the appointment.

Some questions you want to ask the psychiatrist may include:

  • What do my symptoms mean?
  • What kind of treatment is necessary? 
  • Are there other treatments I should know about?
  • What do you expect treatment to accomplish?
  • Will this medication cause dependency?
  • How long do you expect I need to take a particular medication?
  • What would happen if I miss a dose?
  • How long does it take to work?
  • Will I be seeing you for a follow-up soon? 
  • How often should I come back?
  •  Can I contact you if I’m not doing OK?
  • Are you going to call me when it’s time to come in again?
  • Do I call you about refills or go to the pharmacy directly?

How Long Will It Take for the Treatment to Work?

After finding a professional you can trust and be honest with, it can take some time to improve. In some studies on post-traumatic stress disorder (PTSD), it took an average of 15 to 20 sessions for 50% of patients to recover (as indicated by self-reported symptom measures). People with personality disorders or who live with more than one condition often need longer treatment plans.

Frequently Asked Questions

How do you become a psychiatrist?

You become a psychiatrist by earning a bachelor’s degree and going to medical school to become either a medical doctor (MD) or a doctor of osteopathic medicine (DO). A four-year medical residency follows, where a subspecialty is chosen. You will also need to obtain state licensing to practice as a psychiatrist. 

What’s the difference between a psychologist and a psychiatrist? 

Unlike a psychiatrist, a psychologist is not a medical doctor and in most states cannot prescribe medication. A psychologist has a Doctor of Philosophy (PhD) or Doctor of Psychology (PsyD) degree, and can provide psychotherapy. Psychiatrists can prescribe psychiatric medications and offer psychotherapy at the same time.

How much does a psychiatrist cost?

Rates can vary depending on where you are located. Some psychiatrists have sliding scales depending on your income. Make sure you check whether your insurance plan will cover your visit. 

Summary

A psychiatrist is a medical doctor who is trained in diagnosing and treating mental disorders. They offer psychotherapy and medications as treatment options to help with mental disorders. You can find a psychiatrist who is specialized in your area of concern to help you, such as one who is specifically trained in child psychiatry.

A Word From Verywell

Good for you if you’re considering talking to a psychiatrist. Working with a highly skilled professional who specializes in diagnosing and treating mental disorders can help you cope with the challenges that come with a mental disorder. A psychiatrist can help you recognize why you do what you do and how you can make lasting changes to improve your overall quality of life. They can prescribe medications to alleviate your symptoms if you need them.

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Article Sources
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