It’s normal to have rough days every now and again — everyone has them. However, if you’re struggling most days of the week for more than a few weeks, that can be a sign of depression, an anxiety disorder or even something else. In that case, it may be time to seek support from a psychiatrist.
The good news: There are tons of treatment options and plenty of providers who can help. When you’re struggling, though, figuring out which type of provider to see can be tough.
Primary care providers and therapists are trained to manage a range of mental health conditions. Some people benefit from also seeing a psychiatrist, a physician who specializes in mental health conditions and primarily treats patients through medication. We break down when you might want to book an appointment.
I’m struggling with my mental health. Who should I see first?
These days, many primary care providers are willing to recommend lifestyle changes that can improve your mental health, refer you to a therapist or prescribe medication for anxiety and depression. PCPs can also rule out medical causes of anxiety and depression symptoms, such as thyroid disorders or diabetes.
Many providers will suggest therapy before medication, or that you see a therapist even if you’re on medication, for best results.
You can get extra support through talk therapy with a licensed counselor, social worker or marriage and family therapist, says Dr. Julian Lagoy, a psychiatrist in San Jose, California. Cognitive behavioral therapy and acceptance and commitment therapy are two approaches shown to help anxiety and depression; your doctor may recommend another type depending on your specific mental health needs.
PCPs and psychotherapists are trained to identify when you might need more specialized mental health care, which often makes them a good point of entry.
When is it time to see a psychiatrist?
If therapy alone isn’t addressing your mental illness completely, then a psychiatrist can prescribe and manage medication for supporting your mental health.
Psychiatrists are specially trained in diagnosing and treating more severe mental health conditions, such as schizophrenia, bipolar disorder, post-traumatic stress disorder and anorexia. If you’re experiencing symptoms like suicidal thinking, mania (a euphoric mood swing linked to bipolar disorder), or hallucinations (visual or auditory experiences that you know are not real outside of your brain), seek out a psychiatrist as soon as possible.
You can also go to a psychiatrist if you’re looking for a provider with more specialized knowledge than you’ve seen in the past. For instance, maybe you’ve tried one or two mental health medications on your PCP’s recommendation but you’re still not feeling like yourself. “In that case, it would be wise to see a psychiatrist who is more knowledgeable about psychiatric medications,” says Lagoy.
What can I expect from an appointment with a psychiatrist?
Your PCP can refer you to a psychiatrist, or your insurance benefits may allow you to see a psychiatrist without a referral. You may see a psychiatrist or a psychopharmacologist, an expert in medication and its effects. Psychiatric nurse practitioners can also prescribe medication.
“Usually the appointments in the beginning are more frequent, because we are working with patients to try out new medications and figuring out the appropriate dosage,” Lagoy says.
If your medication isn’t fully managing your symptoms, your psychiatrist may recommend other therapies or procedures, such as EMDR, transcranial magnetic stimulation or ketamine infusions.
Finally, psychiatrists can also suggest lifestyle changes to help improve your symptoms. All of these professionals are an important component of Team You — and when it comes to your mental health, getting the right support counts for everything.