Psychiatrist vs psychologist: Who does what and whom to approach for help

Confused between a psychiatrist, psychologist, psychotherapist, or counsellor? Here's a simple guide to understanding their roles and knowing whom to approach for your mental health needs

“Do I need a psychiatrist or a psychologist?” It is one of the most common and confusing questions people ask when mental health begins to feel overwhelming. With therapy becoming mainstream and stress levels running high among people, it is easy to blur the lines between who does what.

 

A psychiatrist, a psychologist, a psychotherapist, and a counsellor all work toward better mental health, but their training, approach, and roles are very different. Understanding these differences can help you reach the right expert faster and get the care you truly need.

Psychiatrist vs psychologist vs psychotherapist vs counsellor: Basic difference

• Psychiatrists are medical doctors (MBBS + MD Psychiatry). They diagnose conditions, prescribe medication, and often manage overall treatment. 
• Clinical psychologists are experts in testing, assessment, and therapy. In India, they hold an MPhil in Clinical Psychology and are registered with the Rehabilitation Council of India. 
• Counselling psychologists focus on emotional and behavioural concerns, offering therapy but usually not formal clinical assessments. 
• Psychotherapists is a broader term referring to anyone trained in psychotherapy (like cognitive behavioural therapy, dialectical behaviour therapy, or psychodynamic therapy).

 

Psychiatrists, psychologists, or counsellors can also be psychotherapists if they have specialised training.

 

 

As Dr Trideep Kumar Choudhury, Consultant Psychiatrist at Fortis Healthcare, explains, “These roles often overlap in practice. A psychiatrist may incorporate psychotherapeutic principles, while psychologists and counsellors collaborate with psychiatrists for holistic care.”

Who can prescribe medicines, and who cannot?

Only psychiatrists can prescribe medication.

 

If your symptoms are severe, for instance, depression that keeps you in bed for weeks, panic attacks that disrupt work presentations, or hallucinations, psychiatrists are the go-to experts.

 

Psychologists, psychotherapists, and counsellors focus on therapy, not prescriptions.

 

As Roshni Sondhi Abbi, Head of Psychological Services at Adayu (a Fortis Network Hospital), explains, “Psychologists, including counsellors and psychotherapists, provide therapeutic interventions, not medication. Psychiatrists hold the medical licence for pharmacological treatment.”

When is talk therapy enough, and when do you need medication too?

This is one of the biggest doubts among people. Here’s a simple way to look at it: 

• Mild issues (workplace stress, relationship strain, occasional anxiety): Therapy alone, via a counsellor or psychologist, often works well. 
• Moderate to severe issues (major depression, bipolar disorder, schizophrenia, suicidal thoughts): Medication from a psychiatrist, often combined with therapy, is the best approach.

 

Dr Choudhury explains, “When symptoms impair functioning, work performance, relationships, or personal life, medication may be necessary. Once stabilised, therapy can build coping skills and promote recovery.”

Whom should you approach first if you are feeling low or anxious?

According to both experts, there is no wrong first step.

 

If you walk into a counsellor’s office, they will guide you to a psychologist or psychiatrist if needed. If you go to a psychiatrist first, they may refer you for therapy. What matters most is reaching out.

 

“Globally, 70 per cent of individuals who need mental health support still refrain from seeking help,” says Roshni Sondhi Abbi. “Being proactive in reaching out is more important than choosing the ‘perfect’ professional as a first step.”

When should you move from a counsellor to a psychiatrist or psychologist?

Here are some signs: 

• Sleep, appetite, or energy levels are badly affected. 
• You have been persistently sad, anxious, or irritable for months. 
• Counselling feels supportive, but the problem is not improving. 

That’s your cue to consult a psychologist for structured therapy, or a psychiatrist if medication may be required.

Why do people confuse these roles so often?

Because mental health still carries stigma, and open conversations are rare. Myths spread easily, like “psychiatric medicines are addictive” (they are not, when prescribed properly), or “anyone can do therapy” (therapy requires formal training and certification).

 

Dr Choudhury points out, “Effective therapy depends on the therapist’s training, technique, and understanding. Not everyone who offers advice is a therapist.”

So, whom should you really go to?

Here’s your quick guide: 

• Workplace stress, relationship issues, lifestyle concerns: Counsellor 
• Anxiety, depression, emotional struggles needing therapy: Psychologist / Psychotherapist 
• Severe or long-standing conditions (schizophrenia, bipolar disorder, major depression): Psychiatrist + therapy support 

Still not sure? Go to anyone qualified, and they’ll guide you to the right place.

Who’s who in mental health care: At a glance

Professional	Qualifications/training	What they do	Can prescribe medicines?	When to go to them
Psychiatrist	MBBS + MD/DNB in Psychiatry	Diagnose and treat mental health conditions medically; can provide psychotherapy but focus is on  medication management	Yes	Severe mental illnesses (schizophrenia, bipolar disorder, major depression, OCD, severe anxiety, suicidal thoughts)
Psychologist	Master’s/PhD in Psychology (clinical, counselling, or related fields)	Psychological testing, assessments, talk therapy; focus on thoughts, emotions, and behavior	No	Emotional distress, anxiety, depression, trauma, personality issues, learning difficulties
Psychotherapist	Psychologists, psychiatrists, or trained counsellors can become psychotherapists (additional certification in psychotherapy methods like CBT, DBT, psychoanalysis, etc.)	Specialized talk therapy to help change behavior, thought patterns, and emotional responses	No	Long-standing emotional or relational issues, trauma recovery, deep-seated behavioral patterns
Counsellor	Diploma/Master’s in Counselling or Applied Psychology	Provide guidance, support, and coping strategies for everyday life challenges	No	Stress, relationship issues, work pressure, adjustment problems, academic stress

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This content is for informational purposes only and is not a substitute for professional medical advice.