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Counsellor, psychologist or psychiatrist: Who should be your first stop for help?
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Counsellor, psychologist or psychiatrist: Who should be your first stop for help?

The three mental health professionals often work in tandem.
Psychologist vs psychiatrist |
Representational Image | Shutterstock

“I had been battling with grief and depression for a long time,” reveals Padmashree Pande, a media professional currently working in Bengaluru. “I also had anxiety but didn’t know that it was severe enough to be classified as a disorder. These feelings became too overwhelming and, coupled with a job where I worked only in night shifts, I was constantly on the verge of a breakdown. This triggered a thyroid dysfunction and soon I became unrecognisable to myself,” she adds.  

It was only after returning to Nagpur, her hometown, that she realised that she needed to speak with someone about her concerns, says Pande.  

“I never had the will to reach out for help until a friend confided in me about her struggles with similar issues and recommended a therapist. I immediately consulted the therapist, she clicked for me and I’ve been seeing her ever since,” she adds.  

Like Pande, many have been reaching out to either therapists, counsellors, or psychologists for help. For those newly looking for help, however, the question remains: whom should they see first? Happiest Health tries to get the answers.  

Know your options first. Broadly there are three kinds of professionals to choose from: counsellors, psychologists and psychiatrists.  

 Counsellors   

They are often the first port of call for someone seeking mental health services. They can help people with a wide range of issues and adopt a person-centric approach, listening to problems, providing clarification, and offering perspectives and strategies to cope. Counsellors also treat mild to moderate symptoms of common conditions such as anxiety, depression, stress, substance abuse, eating disorders, and more.   

Counselling services do not only pertain to mental health services, and can include life coaching, career guidance, and other areas. Many countries also do not have strict rules that define who can provide these services.  

India, for example, does not have a licensing system for counselling. Thus, it is recommended that one only visit counsellors who have a master’s degree in counselling or applied psychology, at the least. 

 Psychologists  

This group treats more severe mental health conditions and illnesses. Often working in therapeutic settings, they are trained in diagnosis and assessment and usually operate from within those perspectives, unlike counsellors.  

In India, psychologists must hold either an MPhil or PhD in Clinical Psychology and be licensed by the Rehabilitation Council of India.   

Psychiatrists 

They are medical doctors with an MBBS and MD in Psychiatry. They are the only set of practitioners permitted to prescribe medication, specialise in preventing, diagnosing, and treating mental illnesses. Psychiatrists are trained to differentiate mental health issues from other underlying conditions that could cause psychiatric symptoms. They are less likely to engage in behavioural and psychological therapy and instead focus on the case management, diagnosis and medication side of care.   

According to Rashi Vidyasagar, Director at The Alternative Story, an organisation that specialises in mental health services for people who identify differently from conventional gender and identity categorisations, the most important step is making that appointment. “Beginning the process and making your mental health a priority is most important,” says Vidyasagar.   

Tandem treatment 

Most often these practitioners operate in tandem. Vidyasagar says, “Referrals among our counsellors, external psychologists and psychiatrists are common. Sometimes we determine that a person will not benefit from behavioural interventions alone and requires clinical interventions or medication, so we refer accordingly.”  

The reverse is also common. “Psychiatrists refer people to us for behavioural interventions in case medicines are not required, or in addition to psychological or psychiatric treatment. For example, we may deem that someone suffering from anxiety will benefit from a short-term course of medication, while our longer-term behavioural interventions are being administered. At the end of the day, we’re all trying to find the best outcome for those who reach out.”  

Urmila Biswas, founder of a Bengaluru-based public relations firm, is grateful to the therapy sessions she took and which, she says, improved her mental health and finetuned her perspective on life. In her view, “The rewards from working consistently with a trained professional who understands you and your needs can be life-changing.” 

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