Episode 47 – Different Mental Health Professionals

Something confusing to me in the mental illness world is how many different treating professionals there are–some doctors, others just professionals, like most therapists.

When I first started getting treated for my issues, I believe the very first person I saw was a psychiatrist. Psychiatrists have doctorates, they’ve gone to medical school, they are full-on doctors specializing in the brain. They are qualified to give diagnoses and medications. This psychiatrist gave me my initial (slightly mistaken) diagnoses: schizophrenia, major depression, panic disorder, and agoraphobia.

After my very first appointment, he left that office to go somewhere else. So I was placed with someone else. I wasn’t really thinking about whether or not they were a psychiatrist or whatever else. I guess I kind of thought they were all the same thing. She was a psychiatric nurse practitioner. So she also had the qualifications to diagnose illnesses and prescribe medications, which was all we really had in mind. She’s actually the one who explained the difference between schizophrenia, a mood disorder, and schizoaffective disorder, switching my diagnosis from the two separate ones to the proper schizoaffective disorder bipolar type, as I also did not have depression–I have bipolar, since I have manias. So to be fair, it was a psychiatric nurse practitioner who cleared up my messy diagnoses.

The differences in psychiatric nurse practitioners and psychiatrists are their training and education. PNPs are RNs who have completed a graduate program–not necessarily earning a doctorate–and worked as licensed nurses. A psychiatrist has attended medical school, earning an MD or DO. They’ve completed a psychiatric residency. So while both do the same job for the mentally ill, I have learned the hard way that somehow as a result of the differences, Social Security for one does not value a psychiatric nurse practitioner’s words as much as they do a psychiatrist’s. I ended up getting a psychiatrist after learning this for the sake of my SSI case, and frankly, he has been way more helpful in my treatment than the others I’ve seen. Whether that was a direct result of their education and training or not, I can’t say. I think I just got lucky with my psychiatrist.

So now we move on to psychologists and therapists. A psychologist, from my understanding, is essentially a blend of a psychiatrist and a therapist. A psychologist typically holds a doctorate degree and can make diagnoses, but they did not attend medical school and as such are not medical doctors. They often offer some psychotherapy along with diagnosing, but they cannot prescribe medication. They can be seen as a sort of specialized therapist.

“Therapist” is essentially an umbrella term that includes psychologists–kind of like how a square is always a rectangle but a rectangle is not always a square. A psychologist is a type of therapist who has had much more training and a broader set of skills than the typical therapist. Psychologists also work in in-patient facilities while therapists are technically exclusively (I believe) out-patient treatment.

While therapists have qualifications and certifications to treat and provide psychotherapy for people, psychologists are able to handle more particular and difficult problems. Therapists are typically unable to diagnose or prescribe medications. They may suspect a diagnosis, but they are not able to officially diagnose, only treat with therapy.

I have known people who had a team of all a psychiatrist, a psychologist, and a therapist. I believe the three of them communicated with one another and worked together on his treamtment. It didn’t seem very effective to me in his case, but I assume in particularly difficult situations, it might provide benefits to have a bigger team–psychiatrist monthly for medication, psychologist every week or two for more detailed diagnostic information to communicate with the psychiatrist about treatment, and a therapist for weekly detailed psychotherapy. Something like that maybe. I’ve only ever had a psychiatrist (or PNP) and a therapist at once.

Published by Rawry

I'm just a writer and gamer living in the middle of nowhere..

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