Hi, it’s Jenny at AnxietyBoss.com. Our question today is from Laura in Kennewick, Washington. Should I go see a primary care physician or a psychiatrist? What is the difference?
Generally speaking, you will not be able to see a psychiatrist without a referral from your physician or your counselor. A PCP or primary care physician also known as a family physician is a general practitioner. They are generalists and treat a broad variety of common medical problems from suturing and laceration to giving vaccinations to checking your blood pressure and cholesterol.
A psychiatrist is a medical doctor who specializes in treatment of psychological and emotional problems. They may do this through prescribing medication or providing psychotherapy. In some regions, if there is a shortage of available psychiatrists, PCPs may be the main prescribers of medication for mental health issues, particularly for anxiety and depression which are the most common mental health complaints.
In the United States, most prescriptions for antidepressants and antianxiety medications are written by PCPs, even in areas which do have sufficient psychiatrists with openings for new patients. This is partly due to most patients with anxiety or depression first voicing the complaint to their PCP, and partly due to patients wishing to avoid seeing a psychiatrist. There is a social stigma involved with seeing a psychiatrist. The public may hold the belief that only people who are very disturbed need a psychiatrist or one may believe there must be something very wrong with me if I need a psychiatrist.
Once again, a PCP is a generalist. A psychiatrist is a specialist. PCPs may be capable of prescribing meds for depression and anxiety based on their knowledge base that they have cultivated through continuing education conferences and also independent reading and experience treating patients with anxiety and depression. However, if your PCP thinks that your condition is too complex or is beyond their area of competence, then they must refer you out to a specialist.
If you have high blood pressure which has been left untreated and it’s affecting your heart, a consult with a cardiologist or a heart specialist may be recommended. This could be a one-time consult where the two doctors will share information about you with each other so that they can provide the best quality treatment or you may need to see a cardiologist on an ongoing basis.
So the same can be true for mental health problems. You may see your PCP first and if the PCP is not certain how to proceed, they may refer you to a psychiatrist for a one-time consult or you may need to see the psychiatrist on an ongoing basis.