Demystify the therapy. How do the roles of psychologists, psychiatrists, and psychotherapists differ?

Mental health in Poland

Data from Statistics Poland (GUS) and police records from 2017 to 2022 indicate that:

• 12 million people suffer from various kinds of mental disorders,
• 3.8 million people struggle with anxiety disorders,
• 3.8 million people suffer from depression,
• 2.4 million people experience insomnia.

Statistics clearly reveal the significant scale of the issue, yet many individuals still fail to get adequate help. One of the possible obstacles to seeking specialized consultation is the presence of unsupportive and misleading beliefs about mental health.

Debunking mental health myths

Many people have misconceptions about mental disorders and the role of psychotherapy. Below, we dispel various myths surrounding these issues.

Myth 1. Only individuals with severe mental disorders can benefit from psychotherapy.

In fact, psychotherapy can be beneficial for anyone struggling with mental health issues or seeking support to manage stress, relationships, or life transitions – not just individuals with severe disorders. Studies confirm that psychotherapy is effective for treating a range of issues, including anxiety, depression, and relationship troubles. For many individuals, psychotherapy serves as a means for personal growth and navigating daily life challenges, rather than focusing solely on the treatment of mental disorders.

Myth 2. Psychotherapy takes time to yield meaningful results.

Although therapy can be a time-consuming process, many approaches, such as cognitive behavioral therapy (CBT), are designed to be short-term and structured. Studies indicate that individuals with depression, anxiety, or post-traumatic stress syndrome can experience significant improvement after 12 to 20 sessions. The duration of therapy depends on the severity of the problem, but the notion that it always takes years is often incorrect.

Myth 3. Mental disorders subside over time.

While some mild symptoms of stress or sadness may resolve on their own, serious mental health disorders such as depression or obsessive-compulsive disorder, rarely disappear without treatment. They often require intervention to prevent their progression. Untreated mental health issues can result in more severe complications, including chronic stress. Research indicates that early diagnosis and intervention are crucial in halting the progression of mental disorders.

Myth 4. Mental disorders are rare.

The reality is that mental disorders can affect anyone, and the number of affected individuals is on the rise. For example, it was estimated that in 2017 approximately 264 million individuals around the globe were affected by depression.

Myth 5. Pharmacological treatment changes personality.

In some cases, treating mental disorders may require the use of medication. Antidepressants and mood stabilizers are meant to help reduce symptoms. These medications work to balance brain chemicals, improving mood and alleviating anxiety or psychosis, without causing personality changes. For instance, selective serotonin reuptake inhibitors (SSRIs) are frequently prescribed to manage depression and anxiety, with research indicating that they do not change personality traits.

Myth 6. Psychiatric treatment is a source of stigma.

It’s important to recognize that mental health issues and mood disorders often result from brain dysfunction. Imbalances in neurotransmitter secretion or deeply rooted unsupportive beliefs can considerably diminish the quality of life and lead to suffering. This isn’t anyone's fault, so it’s important to view psychiatric treatment just like any other form of medical care.

Psychologist, psychiatrist or perhaps a psychotherapist?

Mental health is supported by psychologists, psychiatrists, and psychotherapists. Here’s a summary of the key differences between various mental health specialists and the issues they typically address: 

A psychologist is a specialist trained in conducting psychological tests, providing therapy, and offering counseling. Psychologists are not authorized to prescribe medications. Their areas of expertise include:

• Counseling. For mild to moderate mental health issues – such as thought pattern disorders or adaptive challenges – a psychologist might recommend a brief, evidence-based intervention.
• Behavioral and cognitive disorder assessments and tests. Psychologists are trained to carry out detailed assessments for disorders like learning disabilities, ADHD, autism spectrum disorders, and personality disorders, along with evaluations of people’s personality traits. These evaluations contribute to diagnosing conditions and guide the development of treatment plans.

A psychiatrist is a medical doctor trained to diagnose and treat mental illnesses, utilizing both medical and psychological methods. Psychiatrists are the only mental health professionals authorized to prescribe medication, which is sometimes essential for effectively managing severe disorders. Psychiatrists are particularly helpful in the following areas:

• Medication management. Patients suffering from conditions like schizophrenia, bipolar disorder, clinical depression, or anxiety disorders may need pharmacological treatment to stabilize their symptoms. Psychiatrists focus on overseeing medication effects and adjusting dosages as needed.
• Severe or complex symptoms. Individuals experiencing psychosis, suicidal thoughts, or severe mood disorders should consult a psychiatrist, who is specifically trained to provide immediate medical interventions, including hospitalization and intensive treatment options.
• Medical complications. Mental health issues linked to other conditions, like neurodevelopmental disorders, dementia, or post-stroke depression, often need additional psychiatric care.

A psychotherapist is a trained professional who has typically completed a 4-year course of specialized education and is licensed to treat various mental, emotional, and behavioral disorders using psychological techniques. Psychotherapists don’t prescribe medication; their support involves regular weekly sessions with patients, typically lasting about 50 minutes.

During these sessions, the psychotherapist helps the patient to understand their challenges and they collaboratively develop more supportive ways of thinking and behaving. Psychotherapy can be conducted in different ways, depending on the therapeutic approach adopted by the psychotherapist. Examples include cognitive-behavioral therapy, psychodynamic therapy, systemic therapy, Gestalt therapy, and humanistic therapy, among others.

If you observe severe symptoms that might need medication, consulting a psychiatrist is often the best course of action. If you’re looking for therapeutic interventions and ongoing support without requiring medication, a psychotherapist would be a more suitable option. If you’re in need of counseling, want to take psychometric tests, or feel unsure about whom to approach with your concerns, consulting a psychologist for advice is a good first step. A psychologist will provide expert guidance on where best to seek help. It’s important to note that in many cases combining psychiatric treatment with psychotherapy is essential, for example in individuals with severe depressive episodes.

_References:

1. _{American Psychological Association, How long will it take for treatment to work?, 2017.}
2. _{American Psychological Association, APA Dictionary of Psychology (2nd ed.), 2015.}
3. _{Kaczkurkin A. N. & Foa E. B., Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence, Dialogues in clinical neuroscience, 17(3), 337–346, 2015.}
4. _{American Psychiatric Association, Practice Guideline for the Treatment of Patients with Major Depression, 2000.}
5. _{Schofield M. J., Mumford N., Jurkovic D., Jurkovic I. & Bickerdike A., Short and long-term effectiveness of couple counselling: a study protocol. BMC public health, 12, 735, 2012.}
6. _{Patel V., Flisher A. J., Hetrick S. & McGorry P., Mental health of young people: a global public-health challenge. Lancet (London, England), 369(9569), 1302–1313, 2007.}
7. _{Spencer J. et al., Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017, The Lancet, Volume 392, Issue 10159, 1789 – 1858, 2017.}
8. _{Jylhä P., Ketokivi M., Mantere O., Melartin T., Holma M., Rytsälä H. & Isometsä E., Do antidepressants change personality?--a five-year observational study. Journal of affective disorders, 142(1-3), 200–207, 2012.}
9. _{Tolin D. F. and Worden B. L., Combining Pharmacotherapy and Psychological Treatments for OCD, The Oxford Handbook of Obsessive Compulsive and Spectrum Disorders, Oxford Library of Psychology, 2012 (ed. 2018).}
10. _{Levenson J. L., The American Psychiatric Publishing Textbook of Psychosomatic Medicine: Psychiatric Care of the Medically Ill, American Psychiatric Pub, 2011.}