That depends. The important thing is that you make an informed choice. Consider the advantages and disadvantages of both. Most of what I present is factual, however, some is my opinion. (Please see my previous post on the differences between psychologists and psychiatrists)

When it comes to anxiety disorders, regardless of the anxiety disorder, cognitive-behavioral therapy is superior to drug therapy. So whether you suffer from OCD, PTSD, Social Anxiety, Panic Disorder, Phobias, or Generalized Anxiety Disorder, the results are likely to be better if you find a therapist who is trained in the cognitive-behavioral treatment (CBT) of anxiety.

Mild to moderate depression fares better with cognitive-behavioral therapy (CBT) as compared to medication. For moderate to severe depression, medication has a slight edge in the short run, but therapy is better in the long run. When depression is severe and significantly hampers motivation to engage in therapy, seeing a psychiatrist for medication is often needed to motivate the person to engage in therapy. I will suggest both therapy and psychiatry when someone is severely depressed as they have a better chance of ending the suffering. This logic does NOT apply to anxiety, however, as medication can interfere with the success of CBT and side-effect can worsen anxiety symptoms (see my previous post on Panic Attacks)

Primary Insomnia (having no medical cause) and issues with anger are often related to anxiety and depression and typically respond best to therapy. (Of course, organic disorders like narcolepsy and sleep apnea should be treated medically). With insomnia, people respond best to medication for 2 weeks ad then the positive effects tend to wane (wear off) and CBT works best after 2 weeks of practicing it.

In my opinion, when it comes to anxiety and depression, medication typically treats the symptoms while CBT can change your habits for life. (It has been proven that low seretonin can result from grief, negative thinking, and sedentary life style – so it is not usually the cause of depression and anxiety). Schema therapy, which includes CBT with experiential and more traditional therapies, gets to the root of the issues.

Psychologists are psychotherapists, but not all psychotherapists are psychologists. Unless grandfathered in, psychologists almost always have a doctoral degree (Usually a Ph.D. or a Psy.D). However, many psychotherapists with master’s degrees are very gifted and often just as good as a psychologist. It is more important that the therapist specializes and has a good reputation for treating the problem that you have.

The main disadvantage to CBT is that it can be time consuming and costly in the short term. However, in the long run it is often more affordable as the positive benefits can last a lifetime. The advantage to medication is that it’s much easier to take a pill than to change your behaviors in therapy. The disadvantages of medication include side-effects (particularly with anxiety, side-effects often make anxiety worse), staying in unhealthy situations because the medications numb healthy feelings, and in the long run, not knowing whether you’re better because of meds or other reasons.

While people suffering from ADHD often respond to therapy, medication is of greater help especially if ADHD is moderate to severe. Bi-Polar disorder and psychotic disorders such as Schizophrenia respond better to medication, so people with these disorders should definitely see a psychiatrist. However, individuals with these disorders can benefit from psychotherapy and may choose to see both.

So, if I were advising a friend or family member on whether to see a psychotherapist or a psychiatrist. I might recommend both in some instances. However, by and large if the person suffers from Bi-Polar Disorder, ADHD, or Schizophrenia I would recommend a psychiatrist. If they are suffering from Generalized Anxiety Disorder (GAD), Post-Traumatic Stress Disorder, Social Anxiety, Panic Disorder, Agoraphobia, Simple Phobia, Insomnia, or Depression without cycles of Mania I would recommend a therapist who specializes in the field. There are individual differences though. So, for instance, some people do respond better to medication for GAD, while some people with ADHD may respond well the therapy, and so forth.

Also, remember that there are alternatives to psychiatry and psychology such as exercise, nutrition, homeopathic medicine, and other life-style changes. It is also very important with all of these disorders to rule out medical factors such as hypo or hyper-thyroid, hypoglycemia, low levels of Vitamin D, hormones, Iron etc. as they can all contribute to depression, anxiety, irritability, and insomnia.

by Dr. Jennifer L. Abel
author of: Active Relaxation: How to Increase your Productivity and Achieve Balance by Decreasing Stress and Anxiety.

Good light!  Most of you know we get Vitamin D from the sun and that it helps our mood.  What you may not know is that we get more Vitamin D from morning sun, so consider a morning walk or eating your breakfast near an east window even when it’s overcast. You can also purchase light panels for around $100  to improve your mood (Try Verilux.com).  For a less expensive option – purchase full spectrum light-bulbs which are readily available.  Altho, they cost 2-3X as much as regular bulbs they’re still pennies/day.  Vitamin D and vitamin D3, in particular, helps mood during shorter and darker days.

Tune in later this week to learn about “Bad Light.”

Jennifer L. Abel, Ph.D. author of “Active Relaxation: How to Increase Productivity and Achieve Balance by Decreasing Stress and Anxiety.”

Cognitive Therapy is based on the fact that what we think affects our mood.  Thinking negative thoughts can lead to depression, anxiety, guilt, and other unnecessary and uncomfortable emotions such as frustration and embarrassment.

Many psychologists have designed elaborate programs of identifying the type of negative thought, looking up a specific anecdote thought, and writing out the new thought. These methods can be cumbersome enough to cause someone to give up on trying to change their thoughts.

When people try to change their negative thinking, the mistake most make is to think the most positive thing they can imagine. Positive thinking, in and of itself, is often useless, even frustrating.  WHY?  Because the most positive thought typically isn’t true.  Trying to change the thought creates more tension and when it doesn’t work it can cause frustration. So for instance, someone is worried about getting laid-off and then they think “I’m sure I won’t get laid off.” That won’t help them feel better because there is no guarantee that a job is completely safe.

My solution…A method of cognitive therapy that is both simple and effective.  When having negative thoughts, think of something Better But Believable (B3). So in the case of the worried employee this is just one example of a string of thoughts that are better but believable:  “Worrying won’t help me to keep my job and if I am laid off I can collect unemployment and catch up on some personal stuff until I find something else. I will survive. It’s even possible I’ll find a job that’s better.”

by Dr. Jennifer L. Abel

author of: “Active Relaxation: How to Increase your Productivity and Achieve Balance by Decreasing Stress and Anxiety.”