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.
kiyel williams says
I had no idea there were medications a doctor couldn’t prescribe but a psychiatrist could. Medicine’s like Adderall are only given by your licensed psychiatrist which I did not know until recently. I will have to pass this on to my friend. maybe the help and medication he needs can only come from a psychiatrist and not his primary care doctor. Thank you for the information!
Dr. Carlo says
Just as a clarification, all doctors can prescribe the various different medications. However, primary care physicians (PCPs) will often defer the prescription of specialty medications like Adderall to psychiatrists. Of course, if you needed a refill, then the PCP can do this, but they tend to leave the management of treatment with specialty medications to the specialists.
Derek Mcdoogle says
In your article, you stated that 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. My sister has been having a lot of anxiety and depression ever since her husband died last year. I wonder if most people need a referral in order to be treated by a psychiatrist.
Dr. Carlo says
Yes, referral to a psychiatrist usually comes from their family doctor, or from a specialist who sees the need for a psychiatrist.
Demetrius Hyman says
If My PCP recommends Medical Marijuana instead of pillsdo I still have to see a psychiatric Dr?
Dr. Carlo says
That’s for your psychiatrist to answer.
Tammie Houston says
It’s good to know that a physician can prescribe me some meds for depression and anxiety. My mother recently passed away and it’s begun to really affect how I work and I feel unproductive most days in a week. I think that having access to someone who has the industry knowledge to help me perform as I did before will be quite helpful. I’ll be sure to talk to a physician in my area and see if they can help remedy how I feel even for just a bit with some meds.
Dr. Carlo says
Tammie- condolences on your loss. Having a psychiatrist and an industry mentor are great ideas to help you personally, and at work. The other option is to take some time from work to recover.
Alice Carroll says
You made a good point that familiarity with my medical history is a huge boon when trying to find a primary doctor that would suit my needs. I’d like to look for one soon because I’ve been having trouble sleeping these past few months. I’d like to see if I could get prescribed some sleeping pills.
Dr. Carlo says
Good idea- hope you find a doctor to suit your needs.
Zoe Campos says
Thanks for explaining that a primary care physician could deal with a variety of general medical issues. My husband and I recently talked about wanting to get ourselves regularly checked. Perhaps we should have a primary care physician from our area and schedule an appointment with them soon.
Dr. Carlo says
You’re welcome, and hope you find a family doctor or nurse practitioner.