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Psychiatrist vs. Therapist: Which Do You Need?
Both can help — in different ways. Here's how psychiatrists, psychologists, and therapists differ, and how to decide where to start.
The short answer
A psychiatrist is a medical doctor (MD or DO) who specializes in mental health, can diagnose psychiatric conditions, and can prescribe and manage medication. A therapist — such as a psychologist, licensed clinical social worker, or licensed counselor — provides talk therapy to help you work through thoughts, emotions, and behaviors, but generally doesn't prescribe. Many people benefit from both: a psychiatrist for evaluation and medication, and a therapist for ongoing psychotherapy.
What a psychiatrist does
A psychiatrist completes medical school followed by a residency in psychiatry. That medical training means a psychiatrist can evaluate how physical health, medications, sleep, substances, and hormones interact with mood and thinking — and can order lab work when needed to rule out other causes.
Psychiatrists diagnose mental health conditions, recommend treatment, and prescribe and monitor medication. Some also provide psychotherapy. In practice, many outpatient psychiatrists focus on comprehensive evaluation and ongoing medication management, working alongside a patient's therapist.
What a therapist does
“Therapist” is a broad term for licensed professionals who provide psychotherapy (talk therapy). Therapy helps you understand patterns, build coping skills, process difficult experiences, and make changes in how you think and act. Common credentials include:
- Psychologists (PhD or PsyD) — provide therapy and can perform psychological testing.
- Licensed clinical social workers (LCSW).
- Licensed professional counselors (LPC) and licensed mental health counselors.
- Licensed marriage and family therapists (LMFT).
Key differences at a glance
- Training: psychiatrists are physicians; therapists are trained in psychology, counseling, or social work.
- Prescribing: psychiatrists can prescribe medication; therapists generally cannot.
- Visit focus: psychiatric visits center on diagnosis, symptoms, and medication response; therapy sessions center on talking through experiences and building skills.
- Frequency: therapy is often weekly or every other week; psychiatric follow-ups are commonly monthly once treatment is established.
When it makes sense to see a psychiatrist
Consider starting with — or adding — a psychiatrist if:
- Your symptoms are significantly affecting work, relationships, sleep, or daily functioning.
- You've tried therapy and still feel stuck, or your therapist has suggested a medication evaluation.
- You want a clear diagnosis, for example for adult ADHD, bipolar disorder, or OCD.
- You're already taking psychiatric medication and want it reviewed, adjusted, or managed more closely.
- Your symptoms may involve medical factors, such as hormonal changes, other medications, or sleep problems.
When therapy alone may be a good place to start
If you're navigating stress, a life transition, grief, or relationship challenges — and you're still functioning reasonably well day to day — therapy on its own is often a very effective first step. A therapist can also help you notice if symptoms are persisting or worsening, and refer you for a psychiatric evaluation if that would help.
Other clinicians who can prescribe
Psychiatrists aren't the only clinicians who prescribe psychiatric medication. Primary care physicians often start common medications for depression or anxiety, and psychiatric nurse practitioners are trained to evaluate and prescribe as well.
A primary care visit can be a reasonable first step for straightforward symptoms. A psychiatrist is often the better choice when symptoms are complex, when the diagnosis is unclear, when several medications have already been tried without enough benefit, or when conditions such as bipolar disorder, OCD, adult ADHD, or psychosis are involved. At Momentum, every patient is seen by a psychiatrist — Dr. Egenburg — rather than a rotating team.
How to decide where to start
If you're unsure, a few questions can help point you in the right direction:
- Are you mainly looking to talk things through and build skills? Therapy is a natural starting point.
- Are you wondering whether medication could help, or do you want a clear diagnosis? A psychiatric evaluation makes sense.
- Have symptoms lasted more than a few weeks and made daily life noticeably harder? Consider a psychiatrist, a therapist, or both.
- Still not sure? A free consultation with Momentum is a low-pressure way to talk it through — and if another type of care would suit you better, you'll hear that too.
Why many people see both
For many conditions, including depression, anxiety, OCD, and trauma-related disorders, medication and therapy work well together. The psychiatrist and therapist each focus on what they do best, and — with your permission — they can share information so your care stays coordinated.
At Momentum Modern Psychiatry, Dr. Deanna Egenburg provides comprehensive psychiatric evaluations and ongoing medication management for adults, and coordinates with your therapist when that's part of your care. If you don't yet have a therapist, that can be discussed as part of your treatment plan.
Frequently asked questions
Can a therapist prescribe medication?
Generally, no. Most therapists — including licensed clinical social workers, counselors, and most psychologists — don't prescribe. Psychiatrists and certain other medical clinicians do.
Do I need a referral to see a psychiatrist?
Not at Momentum. You can book a free consultation directly. (If you plan to use in-network insurance benefits, check whether your plan requires a referral.)
Is a psychologist the same as a psychiatrist?
No. A psychologist holds a doctorate in psychology and focuses on therapy and psychological testing. A psychiatrist is a medical doctor who can diagnose, prescribe, and manage medication.
Does Momentum offer therapy?
Momentum focuses on psychiatric evaluation and medication management, and coordinates with therapists as part of your care.
Should I see a psychiatrist or a therapist for anxiety?
Either can be a good starting point. Therapy is often effective on its own for milder anxiety; a psychiatric evaluation can help when anxiety is persistent, severe, or not improving — and many people benefit from both.
Can I keep seeing my current therapist if I start with a psychiatrist?
Yes. Many Momentum patients continue with their existing therapist, and — with your permission — Dr. Egenburg can coordinate with them so your care stays aligned.
Start with a free consultation
A no-cost conversation with Dr. Egenburg's office to talk through what you're looking for and whether Momentum is the right fit. In person in Marlboro, NJ, or by telehealth in New Jersey and New York.
Related
From Momentum Modern Psychiatry, the practice of Deanna Egenburg, MD. Updated September 2026. For general information only — not medical advice.