We all experience suffering, go through difficult life situations, and face crises. Not everyone requires specialist assistance in such moments. The ability to cope with stress is an individual matter; the same factor might trigger only a fleeting reaction (e.g., anxiety) in one person, while in another, it may mark the beginning of escalating symptoms (depression, anxiety, sleep disorders) that significantly hinder daily functioning. Even among those in the latter group, some avoid professional help—many feel the pressure to “handle their problems on their own.” This often stems from shame; admitting to problems regarding the mental or emotional sphere is still synonymous with admitting weakness for many people. This often applies more to men than women. It happens that men attempt to solve their problems “like a man”—that is, with the help of alcohol—which in the long run not only fails to help but generates additional, more serious problems (I will expand on these threads in future posts). Women find it somewhat easier to seek help, whereas men usually want to be absolutely certain that they cannot help themselves. Regardless of gender, many people (especially when facing their first major life crisis) face a dilemma: who should they actually turn to? And here we arrive at the question posed in the title.

The titles of specialists dealing with the human mental and emotional sphere sound quite similar, yet the roles they play are significantly different. Starting with the psychiatrist—this is a medical doctor with a specialization in the field of psychiatry (this is the correct terminology; “psychiatrist” is a common term, much like pediatrician or geriatrician, but it is so widely accepted that I will stick to it here). A psychiatrist can write prescriptions for medication, issue sick leave certificates, etc. Therefore, if someone has symptoms so severe that they cannot go to work and want immediate relief (which is most often provided by medication), the choice of specialist is obvious. Of course, issuing a prescription or sick leave is preceded by an examination that allows for a proper diagnosis. The examination is predominantly based on conversation, with a detailed interview—not only regarding mental symptoms but also general health, medications taken, and past illnesses. A psychiatrist also possesses general medical knowledge, and a holistic assessment of the patient’s physical health is no less important to them than the mental state. There are systemic diseases that may lie at the root of mental symptoms—a situation may arise where a somatic illness needs to be addressed first. Sometimes diagnostic doubts occur which a psychiatrist cannot resolve without additional testing, including psychological testing—and here we come to the role of the psychologist.

A psychologist is not a medical doctor and does not prescribe medication (I have frequently met patients in my practice who said that “years ago, they went to a psychologist who prescribed them pills”—well, no—that must have been a psychiatrist). However, they play a very important role, sometimes complementing the psychiatrist (e.g., by performing psychological tests to facilitate diagnosis), and sometimes providing independent aid to patients through, for example, psychological support. There are many situations where, to regain inner peace and balance, all people need is an honest conversation with someone who listens with attentive understanding and provides guidance. Such individuals most often do not expect or want pharmacological help. For this group of people, seeing a psychologist will be the right choice. Every psychologist is prepared for such a role. The issue of psychological diagnostics looks slightly different—not every psychologist deals with this, as additional qualifications in the form of completed training are required. A separate issue is conducting psychotherapy—and here we come to the profession of the psychotherapist.

Exactly—a profession. A psychotherapist is actually a separate profession, the acquisition of which requires completing specialized training. Many (perhaps most) people who need mental health help for the first time do not understand the difference between a psychologist and a psychotherapist and use these terms interchangeably. Indeed, many psychologists acquire additional qualifications and simultaneously become psychotherapists, but this is not a rule. To begin training in psychotherapy, it is necessary to first complete a master’s degree—however, there is no requirement for it to be a degree in psychology. Psychotherapy is a form of treatment—in many mental disorders (e.g., so-called neurotic disorders), it constitutes the primary and best method of treatment—so-called causal treatment. This means that thanks to psychotherapy, it is possible to remove the causes that triggered the symptoms interfering with daily functioning. Consequently, successfully completed therapy allows the patient to fully recover and not just “get rid of” bothersome symptoms, but to understand themselves better and live more consciously. This form of treatment does not exclude the simultaneous use of medication, which provides symptomatic relief relatively quickly, and sometimes is even necessary to make undertaking psychotherapy possible at all. Unfortunately, not all mental health problems can be treated equally effectively by addressing the root cause; in many situations, pharmacological treatment forms the basis of therapy.

I have touched upon each of the above topics very broadly, trying to draw attention only to what might help someone make a choice regarding whom to turn to in case of difficulties in the mental sphere. The roles of these specialists—psychiatrist, psychologist, psychotherapist—could be described much more extensively, but I do not think it would be sensible from the point of view of a person seeking help. All the listed specialists refer patients to each other when necessary to ensure they receive the best possible help, and they explain issues related to diagnosis or treatment on an ongoing basis. I hope that this text will be a useful signpost for someone and will help in choosing the right specialist.