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

Mental health in Poland

Data from Statistics Poland and police records from 2017-2022 show that:

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

The statistics clearly indicate the serious scale of the problem, yet many people do not seek appropriate help. One of the factors that can hinder seeking specialist consultation is unsupportive and false beliefs about mental health.

Myths about mental health

Many people have misconceptions about mental disorders and psychotherapy. Below, we debunk various myths regarding these issues.

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

Psychotherapy is helpful for anyone facing mental health challenges or needing support in coping with stress, relationships, or life changes—not just for those with serious disorders. Research confirms that psychotherapy is effective in treating a variety of problems, such as anxiety, depression, or relationship difficulties. For many people, it is also a tool for personal development and managing everyday life, not just for treating mental disorders.

Myth 2. Psychotherapy takes a long time to be effective.

Although therapy can take time, many forms, such as cognitive-behavioral therapy (CBT), are designed as short-term and structured approaches. Research shows that significant improvement can occur after just 12–20 sessions for issues such as depression, anxiety, or post-traumatic stress disorder. The duration of therapy depends on the severity of the problem, but the belief that it always takes years is often unfounded.

Myth 3. Mental health disorders will go away on their own over time.

While some mild symptoms of stress or sadness may resolve spontaneously, serious mental health disorders such as depression or obsessive-compulsive disorder rarely disappear without treatment. They often require intervention to prevent them from worsening. Untreated mental health issues can lead to more serious complications, such as chronic stress. Studies indicate that early diagnosis and treatment are crucial in preventing the progression of mental health disorders.

Myth 4. Mental health disorders are rare.

In reality, mental health disorders can affect anyone, and the number of people struggling with them is constantly growing. For example, in 2017, as many as 264 million people worldwide suffered from depression.

Myth 5. Medication changes your personality.

In some cases, treating mental health disorders requires the use of medication. Antidepressants or mood stabilizers are designed to alleviate symptoms. They help balance chemicals in the brain, thereby improving mood and relieving anxiety or psychosis without changing your personality. For example, SSRIs (selective serotonin reuptake inhibitors) are commonly used to treat depression and anxiety, and research shows that they do not alter personality traits.

Myth 6. Psychiatric treatment is something to be ashamed of.

It is important to understand that mental health problems or mood disorders often stem from brain dysfunction. Impaired neurotransmitter secretion or deep-seated, unhelpful beliefs can significantly lower our quality of life and cause suffering. This is not our fault, which is why it is important to view psychiatric treatment the same way as any other form of medical care.

Psychologist, psychiatrist, or perhaps a psychotherapist?

Mental health is cared for by psychologists, psychiatrists, and psychotherapists. Here are the key differences between these specialists and information on the issues they address: 

Psychologist is a specialist trained in psychological testing, therapy, and counseling. They do not prescribe medication. Their scope of practice includes:

• Counseling. For mild to moderate mental health concerns, such as thought pattern or adjustment disorders, a psychologist may suggest short-term, evidence-based intervention.
• Behavioral and cognitive disorder assessments and testing. Psychologists are trained to conduct comprehensive testing for conditions such as learning disabilities, ADHD, autism spectrum disorders, and personality disorders, as well as personality trait assessments. These evaluations support the diagnosis of disorders and assist in developing treatment plans.

Psychiatrist is a medical doctor who specializes in diagnosing and treating mental illnesses, combining a medical approach with a psychological one. Psychiatrists are the only mental health professionals who can prescribe medication, which is often necessary for severe disorders. Areas where a psychiatrist can help include:

• Medication management. Patients suffering from conditions such as schizophrenia, bipolar disorder, clinical depression, or anxiety disorders may require pharmacological treatment, as it is often essential for stabilizing symptoms. Psychiatrists specialize in monitoring the effects of medication and adjusting dosages.
• Severe or complex symptoms. Individuals experiencing psychosis, suicidal thoughts, or severe mood disorders should seek help from a psychiatrist, who is better equipped to provide immediate medical interventions, including hospitalization and intensive treatment.
• Medical complications. Mental health issues related to other medical conditions, such as neurodevelopmental disorders, dementia, or post-stroke depression, often require additional psychiatric care.

Psychotherapist is a person who has completed professional training (typically lasting 4 years) and is licensed to treat mental, emotional, and behavioral disorders using psychological techniques. A psychotherapist does not prescribe medication; their support consists of regular, weekly sessions with the patient, lasting approximately 50 minutes.

During these meetings, the psychotherapist helps the patient understand the difficulties they are facing and works with them to develop more supportive ways of thinking and behaving. Psychotherapy can take various forms, depending on the approach the psychotherapist uses. These include, among others, cognitive-behavioral, psychodynamic, systemic, Gestalt, and humanistic therapy.

If you are experiencing severe symptoms that may require pharmacological treatment, a psychiatrist is usually the best choice. If you are looking for therapeutic interventions and long-term support without the need for medication, a psychotherapist would be more appropriate. If you need counseling, want to take psychometric tests, or are unsure who to turn to with your problems, it is worth scheduling a consultation with a psychologist. This specialist will provide professional advice on where best to seek help. It is also worth remembering that in many cases, it may be necessary to combine psychiatric treatment with therapy, for example, in the case of a severe depressive episode.

Bibliography:

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.}