Psychologist or psychiatrist? What you should know before seeking help

This is one of the most common questions people ask when taking their first step towards mental health care. Psychologists and psychiatrists are both key professionals, but many people don’t clearly understand the difference between them or how they work together.

I’m Helena, a licensed and experienced psychologist in Spain, and in this blog post I’d like to explain the difference to help you make an informed decision when looking for support.

Different training, different roles

Let’s start with the basics:

• A psychiatrist is a medical doctor who specializes in psychiatry—the medical study of the brain and how it relates to thoughts, emotions and behaviour.

• A psychologist holds a degree in psychology and additional training in therapy. Psychologists work on emotions, behaviour and thought patterns from a psychological, environmental and social (not physiological) perspective.

They both work on mental health, but from different angles.

So, what’s the difference in approach?

While both may help with issues like anxiety, depression or emotional distress, their tools are different:

• A psychiatrist can prescribe medication.

• A psychologist works through therapeutic techniques to help people change behaviour and thinking patterns.

Think of it this way: the psychiatrist is like a mechanic, and the psychologist is like a driver. They both “work on the car,” but in different ways

Who should I see first?

Most of the time, it’s best to start with a psychologist.

If you’re going through a tough time, feeling low or overwhelmed, a psychologist can help you explore what’s going on and work with you in therapy.

Many emotional and mental health concerns improve with therapy alone. Therapy can help you:

• Break harmful habits.

• Understand and reframe past experiences..

• Build coping tools for future challenges.

When should you see a psychiatrist?

In some cases, the psychologist may recommend seeing a psychiatrist. For example:

• When anxiety is so intense it interferes with daily life or therapy.

• If there are major sleep issues.

• In cases where medication is essential.

In these situations, psychiatrists and psychologists work together. Medication and therapy often complement each other for better outcomes.

Is the psychiatrist only for “serious” cases?

Not necessarily. That’s a common misconception.

It’s not about “mild = psychologist” and “severe = psychiatrist.” Each professional plays a different role.

And personal preferences matter too—some people prefer not to take medication, while others aren’t ready for therapy.

What about public healthcare?

In Spain’s public healthcare system, the process is often different:

1. You start with your general practitioner (GP).

2. The GP might prescribe medication or refer you to mental health services.

3. Usually, the first appointment is with a psychiatrist. In some cases, you may also see a psychologist, but long wait times are common.

This process varies depending on the city and region, and the system is often overwhelmed, especially in mental health.

Conclusion: psychologist or psychiatrist?

• Both can help.

• In many cases, starting with a psychologist is a good first step.

• A psychiatrist can provide medical support if needed.

The important thing is to seek professional help when you need it. You don’t have to figure everything out alone—professionals are here to guide you.

Prefer watching the video? (Spanish)

You can watch the full video on my YouTube channel here: