Navigating Anxiety Treatment in Cincinnati: Do I need a Psychiatrist vs. Counselor?

When you’re at your breaking point with anxiety or depression and are ready to reach out for help, you might be wondering who can help you. One big question is whether you need to see a psychiatrist or a counselor. It’s important to know the difference, so you can get the help that’s right for you. I’d like to explore what each professional does, so you can be on the road to feeling better. In my next blog post, I talk about the ins and outs of scheduling with each.

Understanding Psychiatrists: Medication Evaluation and Management

Psychiatrists have gone to medical school, and got specialized training in treating mental health disorders with medicine. A psychiatrist is going to be well-versed in antidepressants, anti-anxiety medication, mood stabilizers, as well as antipsychotics for more severe illness. They have also had training in screening for any medical causes for your symptoms. They may run lab work or ask your medical history to determine if something is contributing (like a vitamin deficiency, thyroid issue, anemia, etc) before writing a prescription. 

Typically, a psychiatrist does not provide much counseling. 

Your first appointment will be a diagnostic assessment, where you answer a lot of questions to determine what the diagnosis is, then discuss treatment options. This may take an hour. Follow-up appointments are usually 15 minute medication check-ups. So you’ll talk about your symptoms, side-effects, and any changes they’ll want to make. You’ll usually see a nurse as well to take vitals and your weight to monitor any changes. 

Psychiatrists are people, too, and they are all different! 

Some may take more of an interest in your lifestyle and stressors. Some may suggest therapy exercises, books, or even diet and supplements. Some may not talk at all about this and simply treat your symptoms medically. They should ask if you’re in therapy, if you’ve tried it, and offer to refer you if you’re interested. You may also see a Psychiatric Nurse Practitioner or a Physician’s Assistant who are also trained and able to prescribe medications (state laws vary on what they can prescribe, and if they have to collaborate with a physician). A great psychiatrist will be open to talking with your therapist so you can have a team approach to your treatment. 

Understanding Counselors: Therapeutic Solutions for Symptom Relief

A counselor or therapist is generally a Masters level professional trained in the treatment of mental health disorders. We do not prescribe medications (there are outliers where someone is doubly-licensed though!). They may have a Masters degree in Social Work, Counseling, Marriage and Family Therapy, or Psychology (depending on the state, they might be required to have a PhD or PsyD in Psychology). We are trained to assess, diagnose, and treat the same mental health disorders that a psychiatrist would; however, we treat with therapeutic techniques like talk therapy instead of medications. 

Each therapist is trained differently.

There are a variety of evidence-based treatments that can help you based on your specific problem. In the initial appointment, which can last 45-90 minutes depending on the counselor, you’ll be asked a lot of questions about your symptoms, environment, medical history, family history, and goals for therapy. We’ll want to know what medications you’ve taken, if any, as well as any relevant lab results or medical problems contributing to your symptoms (referring you to a doctor if needed). 

If you have a medical issue that is likely causing your anxiety or depression, then we’ll want that assessed and treated before digging into therapy. A great therapist will want to collaborate with your PCP (primary care provider) or psychiatrist so you have a whole team approach to treatment. 

Some counselors have more experience with medications than others.

We also have various beliefs about medications. This is important for you to know and to know yourself when deciding on a therapist. For instance, some clients don’t want to be pushed to take meds. So you don’t want a therapist who routinely refers everyone to psychiatry! Or on the flip side, if your medication is working well for you and you want to continue, you may not do well with a therapist who doesn’t believe medications should be routinely prescribed. 

Navigating Treatment Paths: Collaboration and Communication

Most of us have been trained to work with you where you are, regardless of personal belief, and have a base knowledge about medication. Often in my practice, this is an ongoing conversation. Many people want to try therapeutic or lifestyle changes before starting medicine. If therapy isn’t helping, it’s our responsibility as professionals to seek to understand why, and to change course, or make a referral to a different therapist, doctor, or psychiatrist if it’s appropriate.

I hope this helps to understand the difference in your options for medication or anxiety therapy in Cincinnati. Ready to embark on your journey to better mental health? Call/text me at 513-461-2045 or click here to schedule your free consultation today for virtual anxiety therapy in Cincinnati. Online therapy in Indiana and Ohio.