What Is A Psychiatrist? Definition And Areas Of Specialization

The field of mental health care relies on a range of different professionals, who have widely varying skills and areas of expertise. One such mental health provider is the psychiatrist, a medical doctor responsible for helping direct the treatment plans of individuals seeking care by providing diagnoses, prescribing medication, and performing a variety of other important functions. In this article, we will take an in-depth look at psychiatrists—what they do, where they work, and the different fields in which they specialize. 

What Are Psychiatrists?

Psychiatrists work in a variety of sectors and can specialize in numerous different areas.

When it comes to treatment in a practice or clinical settings, psychiatrists are often a first point of contact for individuals seeking care for mental health concerns. Typically, a psychiatrist is consulted when a client has reason to believe they’re living with a mental health condition. Often, the individual has been referred to a psychiatrist by a primary care provider, their insurance company, or another healthcare professional. However, many clients also seek care from psychiatrists on their own. 

When a client comes in for a consultation, the psychiatrist can provide screenings and assessments to evaluate them and determine whether a diagnosis is necessary. From there, they can help direct the individual’s treatment plan, which might include medication, psychotherapy, and other modalities. 

Medication management is a primary component of psychiatry. After initially prescribing medication for an individual (if necessary), the psychiatrist may focus on evaluating its efficacy. This often involves setting regular appointments so that they may evaluate the individual’s progress and adjust the dosage or prescribe a different medication, if necessary. 

The ability to prescribe medication is often cited as one of the significant differences between a psychiatrist and a psychologist. Psychologists typically cannot prescribe medication and must refer clients they feel need a prescription for a mental or behavioral issue to a psychiatrist. (Some states give psychologists the authority to prescribe certain medications). Conversely, while psychiatrists can conduct psychotherapy, most refer clients to psychologists or other therapists for that form of treatment. 

Routine parts of the psychiatrist's job include gathering client details and keeping updated records of their medical history. They can also help clients and their families to cope with stress and crises, which may be directly related to the mental concern the individual is living with.

Psychiatrists may also advise an individual’s spouse, parents, extended family, and caregivers on their condition, treatment, and needs. They often consult and work with a client's primary care physician, therapists, and other professionals involved in treatment. The psychiatrist may also refer clients to other healthcare workers.

In addition to providing care in clinics or practice, psychiatrists can perform varying functions in an array of settings. They can assess the competency of witnesses and defendants in court cases, help businesses evaluate their employees, and play a vital role in palliative care. 

What Kind Of Training Do Psychiatrists Undergo?

According to the American Psychiatric Association, to become a psychiatrist, one must first complete medical school. Doctors who decide to pursue psychiatry then typically spend at least four years in residency. At the end of this time, they can apply to the American Board of Psychiatry and Neurology for certification as a psychiatrist. It will usually take a few more years of subspecialty training if they wish to specialize in a particular area of psychiatry.

What Conditions Can A Psychiatrist Diagnose And Treat?

Psychiatrists can treat a range of mental health-related challenges, including:

• Anxiety
• Depression and bipolar disorder
• Neurodevelopmental disorders
• Personality disorders
• Sexual dysfunction
• Phobias
• Post-traumatic stress disorder 
• Dementia and Alzheimer's disease
• Eating disorders, such as anorexia and bulimia
• Sleep disorders, such as insomnia
• Substance use disorders
• Psychotic disorders
• Dissociative disorders
• Elimination disorders
• Sleep-wake disorders
• Gender dysphoria
• Paraphilic disorders

Psychiatrists also have the expertise to determine whether a physical issue, such as a hormonal imbalance or an adverse reaction to a medication, is contributing to an individual’s mental health concerns. Conversely, they can ascertain whether there is an underlying psychological complication causing someone’s physical symptoms.

Where Do Psychiatrists Work?

Psychiatrists can work in the public sectors, delivering their services to individuals, couples, families, and groups in face-to-face or remote formats. Examples of settings in which psychiatrists commonly work include:

• Psychiatric centers
• Practices
• Businesses
• Justice systems
• Nursing homes
• General hospitals
• Emergency rooms
• Military settings

Areas Of Specialization Within Psychiatry

Some psychiatrists choose to practice general psychiatry, while others pursue further training and certification in a particular area of psychiatry. The following are specializations that psychiatrists may pursue.  

Addiction Psychiatry

This type of psychiatry helps individuals manage addiction-related mental health concerns (substance use disorders and behavioral addictions). An addiction psychiatrist may treat clients individually or in groups. They may also work with the family of the individual to come up with a supportive rehabilitation framework. Addiction psychiatrists often work in rehabilitation facilities, though they may provide care in various other public and settings. 

Child And Adolescent Psychiatry

Also called pediatric psychiatry, this type of psychiatry aims to treat children and teenagers with mental health concerns. Common challenges child and adolescent psychiatrists address include learning disabilities, changing moods, anxiety disorders, eating disorders, substance use disorders, and neurodevelopmental disorders.

Geriatric Psychiatry

The mental health concerns that can arise as a result of aging are often addressed through geriatric psychiatry. Among these are sleep disorders, depression, late-onset substance use disorder, and dementia. A geriatric psychiatrist may also address the emotional challenges that can accompany aging, which may be related to loneliness, physical health concerns, or cognitive impairment.

Improvements in life expectancy mean most developing countries now have larger aging populations than in past generations. This has led to the projection of a vast increase in the demand for geriatric psychiatrists in the future. Already, numerous job opportunities are available for geriatric psychiatrists in assisted living facilities, nursing homes, and personal practices.

Forensic (Legal) Psychiatry

Forensic psychiatry involves working within the court system and with government agencies to evaluate the mental health of witnesses, suspects, and inmates. Forensic psychiatrists are often called upon to conduct assessments of inmates seeking probation and help determine whether their release is prudent. 

Forensic psychiatrists are also often used as expert witnesses in criminal cases, responsible for helping decide whether someone is competent to stand trial or provide evidence. They may also help describe a suspect's mental state when they committed an offense.

In civil cases, the forensic psychiatrist's job may involve assessing the extent of medical health injuries and deciding on mental competency for guardianship.

The field of forensic psychiatry has led to the development of further specializations, including:

• Adolescent forensic psychiatry
• Forensic learning disability psychiatry
• Forensic psychotherapy

Biological Psychiatry

Biological psychiatry, or biopsychiatry, deals with the physical basis of mental disorders, focusing on the nervous system and brain chemistry. As such, it is less likely to use psychotherapy and more likely to treat a client's mental disorder with medication or physical approaches, such as light therapy, electrical brain stimulation, exercise, and dietary adjustment. Conditions that biological psychiatrists usually treat include psychotic disorders, such as schizophrenia, bipolar disorder, depression, attention-deficit/hyperactivity disorder (ADHD), eating disorders, and substance use disorders.

Organizational And Occupational Psychiatry

This form of psychiatry is typically concerned with the mental state an individual brings to the workplace—and the effect the workplace has on the individual’s mental health. Organizational and occupational psychiatrists may be required to assess and treat employees for work-related stress and its manifestations, such as hypertension. They may also be asked to determine the mental health of a potential hire or an employee in line for a promotion. Other responsibilities may include performing assessments for disability insurance benefits and contributing to company policy and procedure development. 

Sleep Medicine

Sleep medicine has evolved as an area of specialization within several branches of medicine, including psychiatry. It involves diagnosing and treating sleep disorders like insomnia, restless leg syndrome, narcolepsy, and obstructive sleep apnea. Psychiatrists who practice sleep medicine may look at the amount and quality of a client's sleep and how this affects their mental health and ability to function in daily life. 

Emergency Psychiatry

This area of specialization involves psychiatrists working in various settings, including the emergency rooms of hospitals. One challenge for emergency psychiatrists is working with clients in immediate and severe danger due to their mental state.

Emergency psychiatrists are often called upon in cases of acute withdrawal symptoms in someone with an addiction. They may also address situations in which an individual is experiencing extreme intoxication or medical complications due to their mental health. Unlike most other psychiatrists, who can build relationships with their clients over time, emergency psychiatrists are almost always dealing with a unique client.

Connecting With A Mental Health Professional Online

Research suggests that online therapy is an effective form of mental health care. In a review of 14 studies, which included over 900 total participants, researchers found that online therapy led to, on average, a 50% improvement in symptoms of conditions that included depression, anxiety, and obsessive-compulsive disorder. They concluded that online therapy can have positive long-term impacts when addressing a variety of mental health challenges.     

Online therapy is a convenient and flexible way of connecting with the right mental health professional for you. With a platform like BetterHelp, you can get matched with a licensed therapist based on your needs and preferences, so you’ll have a good chance of working with someone who can address your specific concerns. All BetterHelp therapists have at least three years and 1,000 hours of hands-on experience, along with a master’s or doctorate degree in their field.