If you’re feeling overwhelmed, stuck, or navigating mental health concerns, you may want support but aren’t sure what type of care you need. When facing mental health challenges, it's common to wonder, "Do I need therapy or psychiatry?" Understanding the distinctions between these two treatments helps determine the best path for your well-being. This article will explore the differences between therapy and psychiatry and help you identify which might be right for you.

Understanding Therapy and Psychiatry

Therapy, also known as psychotherapy or counseling, involves working with a trained mental health professional to address a wide range of concerns. Topics may include emotional, cognitive, or behavioral issues, as well as relationships, transitions, and personal growth. Therapists use various techniques to help individuals manage stress, cope with challenges, and improve relationships. They cannot prescribe medication but focus on providing support through therapeutic interventions.

Psychiatry is a specialty of medicine focused on diagnosing, treating, and preventing mental health disorders. Psychiatrists are licensed medical doctors who can prescribe and manage medication, conduct medical evaluations, and offer a range of treatments, including psychotherapy.

Do I Need Therapy?

If you’re asking the question, there’s likely something inside you that’s ready for support. You don’t need to wait until things are at their worst to seek help. Therapy can be incredibly helpful not only during a crisis but also as a tool for growth, reflection, and developing resilience.

Below are some common signs that you may benefit from therapy.

Emotional Signs

• You’re feeling persistently anxious, overwhelmed, or low.
• Your mood feels unpredictable or hard to manage.
• You’re grieving a loss or going through a life transition.
• You’re having trouble enjoying things that used to bring you joy.
• You feel stuck in patterns—like people-pleasing, perfectionism, or codependency.

Behavioral Signs

• You’re withdrawing from relationships or isolating yourself more than usual.
• You find yourself using substances, food, or distractions to cope.
• Your sleep, appetite, or energy levels have significantly changed.
• You’re noticing increased conflict in your relationships.

Therapy offers a nonjudgmental space to explore what’s going on beneath the surface. It's a place to open up, feel heard, and develop coping strategies to improve your quality of life.

What Does a Therapist Do?

Therapists have different titles depending on their license. These include Licensed Professional Counselor (LPC), Licensed Clinical Social Worker (LCSW), Licensed Mental Health Counselor (LMHC), Licensed Marriage and Family Therapist (LMFT), and psychologist (PhD or PsyD). Therapists help you work through emotional, cognitive, and behavioral challenges using forms of talk therapy. Depending on your needs, they might draw from various approaches such as:

• Cognitive Behavioral Therapy (CBT) helps you notice and shift unhelpful thought patterns.
• Psychodynamic Therapy explores how your past experiences shape your current emotions and behavior.
• Acceptance and Commitment Therapy (ACT) helps you clarify your values and take action that is aligned with those values.
• Somatic Therapy integrates body awareness to support healing from trauma or chronic stress.

Therapy can help you build insight, set boundaries, improve communication, heal trauma, and create meaningful change.

When Might I Need Psychiatry Instead?

If you’re experiencing more severe symptoms—especially those that significantly interfere with daily functioning—you may want to see a psychiatrist. They will be able to diagnose complex mental health conditions and prescribe medications if needed.

Consider reaching out to a psychiatrist if:

• You’ve experienced panic attacks, suicidal thoughts, or psychosis.
• You’ve been diagnosed with bipolar disorder, PTSD, OCD, or major depression.
• You’ve tried therapy before but didn’t get the results you hoped for.
• You suspect a medical issue could be contributing to how you feel.
• You want a professional opinion on whether medication will help.

Questions to Ask Yourself

To help you decide on the right path for you, consider the following questions:

• What are my main challenges right now (e.g., emotional, behavioral, thought patterns)?
• How significantly are these challenges impacting my daily life (e.g., work, relationships, self-care)?
• Have I tried therapy before? What was that experience like?
• Am I open to exploring medication as a potential part of my treatment?
• Am I looking for practical coping skills, a deeper understanding of my past, or both?

Answering these questions can provide clarity and help you articulate your needs when you reach out to a professional.

Do I Need Therapy, Psychiatry, or Both?

Therapy and psychiatry are not mutually exclusive. They work well together—especially when your care is integrated, meaning your provider has a clear understanding of both your emotional and physical needs. For some individuals, medication can help them be more present, engaged, and able to benefit more from therapy.

Benefits of Working with a Psychiatrist Who Also Provides Therapy

If you want to heal and grow and are interested in medical treatments and medications, a psychiatrist who provides therapy can be a great fit. When you work with a psychiatrist who is also trained in psychotherapy, you get the best of both worlds—comprehensive care that bridges mind, brain, body, behavior, and person.

• Holistic Understanding of Your Mental Health: A psychiatrist who also provides therapy can assess how your emotions, thoughts, patterns, and history interact with biological factors. This deeper understanding can lead to more accurate diagnoses and treatment plans.
• Integrated Treatment Planning: Instead of coordinating between two providers, your psychiatrist-therapist can seamlessly combine medication management and talk therapy, adjusting your treatment in real time as your needs evolve.
• Less Fragmented Care: It’s easier to build trust when one provider understands your full picture. This continuity reduces the stress of retelling your story and allows for a more nuanced and compassionate therapeutic relationship.
• No Pressure for Medication: Not all psychiatrists rush to prescribe. When your provider is also a therapist, they can explore non-medication strategies with you and only consider medications if and when it feels appropriate. They can also formulate treatment plans to reduce and/or eliminate medication through the process of therapy.
• Efficient Use of Time and Resources: Scheduling, billing, and treatment can feel more streamlined when you’re not bouncing between providers. This efficiency can lower barriers to care and support more consistent engagement.

It’s Okay to Ask for Help

Asking “Do I need therapy?” doesn’t mean something is wrong with you. It means you're paying attention to your needs and are looking for ways to care for yourself.

Mental health care is not only for people in crisis—it’s for anyone who wants to live more fully, freely, and consciously. Whether you’re facing stress, trauma, relationship issues, or feeling overwhelmed, you don’t have to figure it out alone.

If you’ve tried therapy before and felt like it didn’t go deep enough—or like the provider didn’t quite get you—consider working with someone who can bridge the emotional, relational, and biological sides of mental health.

Find Support at Existential Psychiatry | Seattle Washington

Dr. David Zacharias at Existential Psychiatry offers both psychiatric treatment and psychotherapy. This integrative model allows for a unique and holistic approach to your care. You don’t have to bounce between providers or worry about miscommunication. Everything you share is seen and held by one trusted professional who’s walking alongside you.

Dr. Zacharias has over 20 years of experience working in healthcare with individuals from all walks of life facing anxiety, stress, depression, trauma, PTSD, ADHD, OCD, and more. He offers diagnostic assessment, medication management, and compassionate therapy. If you’re searching for holistic mental health care in Washington State, reach out for a free consultation.

Written by Existential Psychiatry Staff

Sources

• National Alliance on Mental Illness. “Types of Mental Health Professionals.” NAMI, 2020. Accessed April 10, 2025.