Do I Need a Psychiatrist or Just Therapy? How to Decide What Kind of Mental Health Care Is Right for You

If you’re struggling with depression, anxiety, or emotional burnout, one of the most common — and confusing — questions people ask is:

“Do I need therapy, a psychiatrist, or both?”

Many people delay care simply because they don’t know where to start. Others stay stuck in treatment that isn’t fully helping, unsure whether they should try something different or more comprehensive.

This guide walks through the differences between therapy and psychiatry, how to recognize what you may need right now, and how care can evolve over time as your symptoms change.

Therapy vs. Psychiatry: What’s the Difference?

Although therapy and psychiatry often work best together, they serve different roles in mental health care.

Talk Therapy (Psychotherapy)

Therapy focuses on:

• Understanding thoughts, emotions, and behavior patterns

• Developing coping skills and emotional regulation

• Processing trauma, stress, relationships, and life transitions

• Building insight and long-term resilience

Therapists do not prescribe medication. Therapy can be incredibly effective, especially for people experiencing:

• Mild to moderate depression

• Anxiety related to life stressors

• Relationship or work-related distress

• Grief, burnout, or adjustment issues

Many people start with talk therapy and make meaningful progress.

Psychiatry

Psychiatry focuses on:

• Diagnosing mental health conditions

• Prescribing and managing medications

• Addressing biological and neurochemical contributors to symptoms

• Treating more persistent, severe, or complex presentations

Psychiatrists can help when symptoms feel overwhelming, long-standing, or resistant to initial treatments.

When Therapy Alone May Be Enough

Therapy may be an appropriate starting point if:

• Symptoms are situational or recently developed

• You’re functioning day-to-day but feel emotionally stuck

• You haven’t tried therapy before

• You notice steady improvement with therapeutic support

• You want to build skills before considering medication

For many people, therapy alone is enough — and that’s completely valid.

Signs You May Benefit From Seeing a Psychiatrist

You may want to consider psychiatric care if:

• Depression or anxiety hasn’t improved after several months of therapy

• Symptoms interfere with work, school, or relationships

• You feel persistently low, numb, or hopeless

• Sleep, appetite, motivation, or concentration are significantly affected

• You’ve tried medications before without much relief

• Symptoms feel “biological” rather than purely situational

Needing psychiatric support does not mean therapy failed. It often means your nervous system needs additional help to stabilize.

Is It Better to See a Therapist and Psychiatrist Together?

For many people, yes.

Therapy helps you process and understand what you’re experiencing. Psychiatry helps reduce symptom severity so therapy can be more effective.

This combined approach is especially helpful for:

• Moderate to severe depression

• Long-standing anxiety disorders

• Treatment-resistant symptoms

• Periods of relapse after improvement

Mental health care doesn’t have to be one-size-fits-all.

What If Depression Doesn’t Improve?

When symptoms persist despite therapy and standard medication approaches, it may be time to explore advanced psychiatric treatment options.

This doesn’t mean something is “wrong” with you. Depression can be complex, and different brains respond to different treatments.

Psychiatric care allows for:

• Careful diagnostic reassessment

• Medication optimization

• Monitoring symptom patterns over time

• Discussion of FDA-approved options for treatment-resistant depression

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What Comprehensive Mental Health Care Looks Like

A thorough mental health evaluation typically includes:

• A detailed symptom history

• Review of past treatments and responses

• Discussion of goals, concerns, and preferences

• A collaborative plan that may include therapy, medication, or both

Care should feel thoughtful, individualized, and paced — not rushed.

Accessing Care: In-Person and Telehealth Options

Mental health care today is more accessible than ever.

In-person care can be helpful for those who prefer face-to-face visits, while telehealth allows individuals to receive psychiatric care and talk therapy from home.

We provide:

• In-person mental health care and Spravato services in Brooklyn and White Plains

• Telehealth psychiatric care and therapy for individuals throughout New York State

This flexibility allows people to access consistent care regardless of location or schedule.

Where Does Spravato® Fit In?

For individuals with depression that has not responded to standard treatments, psychiatry may also involve discussing FDA-approved options such as Spravato® (esketamine) when clinically appropriate.

Spravato® is used as part of a structured treatment plan under medical supervision and is not a first-line treatment. It may be considered when other approaches haven’t provided sufficient relief.

Final Thoughts

If you’re unsure whether you need therapy, psychiatry, or both, you’re not alone — and you don’t need to have the answer before reaching out.

Mental health care is a process, not a single decision. Many people start with talk therapy, add psychiatric support when needed, or adjust care over time as symptoms change.

At Aurora Wellness, we offer talk therapy, psychiatric medication management, and advanced treatment options, with both in-person and telehealth availability. The most important step is starting a conversation and finding support that meets you where you are.