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Psychiatry vs. Psychology vs Therapy

Psychiatry, psychology, and therapy are distinct fields within mental health care. Psychiatry is a medical specialty focused on diagnosing and treating mental health disorders. Psychiatrists, who are medical doctors, and psychiatric nurse practitioners (PMHNPs), along with physician assistants (in some U.S. States), are the only mental health providers who can prescribe medications. They often manage conditions like depression, anxiety, and schizophrenia with medication and may order neurological tests to understand underlying issues.

In contrast, psychologists (in most U.S. States) hold doctoral degrees (PhD or PsyD) and specialize in psychological assessments, diagnosis, and talk therapy (psychotherapy) but cannot prescribe medications. Therapists, such as licensed clinical social workers (LCSWs) and marriage and family therapists (MFTs), typically hold master’s degrees and provide counseling to help individuals cope with emotional challenges.

Conditions That Can be Treated Through Psychiatry, Including Online Psychiatry

Anxiety Disorders
People with anxiety experience fear and dread as a response to certain situations or objects. Symptoms can include physical signs of panic or anxiety (such as an increased heartbeat) that are not appropriate for the environment. Anxiety disorders include generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobias.

Mood Disorders
Mood disorders can bring repeated feelings of sadness or periods of feeling overly happy – or fluctuations between the two extremes. Common mood disorders include depression and bipolar disorder.

Psychotic Disorders
Psychotic disorders involve distorted awareness and thinking. Two of the most common symptoms of psychotic disorders are hallucinations and delusions. Schizophrenia is an example of a psychotic disorder.

Eating Disorders and Disordered Eating
Eating disorders can involve extreme emotions, attitudes, and behaviors relating to weight and food. Anorexia nervosa, bulimia nervosa, and binge eating disorder are the most common eating disorders.

Personality Disorders
Personality disorders are often characterized by extreme and inflexible personality traits that may cause problems in work, school, or social relationships. Examples include antisocial personality disorder, histrionic personality disorder, schizoid personality disorder, and paranoid personality disorder.

Obsessive-Compulsive Disorder (OCD)
OCD is where people are troubled by constant thoughts or fears that cause them to perform certain rituals or routines. An example is a person with an unreasonable fear of germs who constantly washes their hands.

Post-Traumatic Stress Disorder (PTSD)
PTSD is a condition that can develop following a traumatic and/or terrifying event. People with PTSD often have lasting and frightening thoughts and memories of the event and tend to be emotionally numb.

Neurodevelopmental Disorders (including ADHD)
Attention Deficit-Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder that can affect a person’s attention, impulsivity, memory, and other cognitive functions. While it is often diagnosed in childhood, ADHD can affect people well into adulthood.

Psychiatric Medication

The treatment of mental health conditions with medication involves the careful prescribing, monitoring, and adjusting of medications. It plays a vital role in psychiatric care, requiring collaboration between the psychiatrist, the individual, and sometimes other healthcare providers. The primary objective is to maximize the effectiveness of the medication while minimizing side effects, all while prioritizing the individual’s overall well-being and quality of life.

Online psychiatry can sometimes be used for medication-related appointments, depending on factors such as the type of medication in question.

Antidepressants
Antidepressants are the most widely used type of medication in psychiatry. As their name indicates, these medications are designed to combat the symptoms of depression.

Some types of antidepressants our providers prescribe when appropriate:

  • Common Selective Serotonin Reuptake Inhibitors (SSRIs) include fluoxetine, sertraline, citalopram, escitalopram, paroxetine, and fluvoxamine.
  • Common Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) include duloxetine and venlafaxine.
  • Common Tricyclic Antidepressants (TCAs) include amitriptyline, clomipramine, and nortriptyline.
  • Common Monoamine Oxidase Inhibitors (MAOIs) include tranylcypromine, phenelzine, and isocarboxazid.
  • Common Serotonin Antagonist and Reuptake Inhibitors (SARIs) include trazodone.

Anti-Anxiety Medicines
Many of the antidepressants listed above also function as first line treatments for anxiety disorders. When appropriate, other anti-anxiety medications, including Lorazepam, Xanax, Clonazepam, and Buspirone, can be prescribed in conjunction with first line treatments to help individuals with symptoms ranging from generalized anxiety to panic attacks. They can be prescribed to treat acute conditions that require medication to work quickly, or for chronic management of long-term conditions, as well.

Antipsychotics
Antipsychotics are prescribed to treat many disorders, including PTSD, severe depression, generalized anxiety disorder, and OCD. The most commonly prescribed second-generation antipsychotics are ziprasidone, olanzapine, quetiapine, risperidone.

Stimulants
Stimulants are prescribed to treat a diverse spectrum of disorders, including ADHD and binge eating disorder.

Some types of stimulant medications our providers prescribe when appropriate:

  • Methylphenidate: Examples include Ritalin®, Concerta®, Metadate®, and Daytrana® (a patch applied to the skin). These medications come in immediate-release (short-acting) and extended-release (long-acting) formulations.
  • Amphetamines: Examples include Adderall®, Vyvanse®, Dexedrine®, and Evekeo®. Similar to methylphenidate, these medications come in immediate-release and extended-release forms

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Online Psychiatry

Depending on the particular circumstances involved, some prescriptions and medication-related services can be provided via online psychiatry appointments.

Online psychiatry allows psychiatrists to meet with individuals (and, when appropriate, prescribe medications) remotely via the internet using teleconferencing software provided by LifeStance. This process gives individuals a way to meet with their psychiatrist from the comfort of their own homes.

Several studies have shown that in certain circumstances, certain mental health services delivered via telehealth were just as effective as comparable in-person services, with no significant differences in treatment outcomes. While telehealth is a convenient option for many situations, LifeStance also offers in-office appointments, and sometimes an in-office visit is necessary in order for our clinicians to provide the most appropriate care.

If your treatment includes a controlled substance, for example, we’ll need to see you in person periodically to comply with legal requirements and industry best practices and to help make sure that everything is on track and that you’re getting the best care possible.

References

Greenwood H, Krzyzaniak N, Peiris R, Clark J, Scott AM, Cardona M, Griffith R, Glasziou P. Telehealth Versus Face-to-face Psychotherapy for Less Common Mental Health Conditions: Systematic Review and Meta-analysis of Randomized Controlled Trials. JMIR Ment Health. 2022 Mar 11;9(3):e31780. doi: 10.2196/31780. PMID: 35275081; PMCID: PMC8956990.