Who Should You See? Psychiatrist, PMHNP, or Therapist?

Let’s be honest—navigating mental health care can feel like decoding a whole new language. You know you need help, but... where do you even start?  Should you see a therapist? A psychiatrist? What’s a psychiatric nurse practitioner? And do you need both?

If your mind is spinning, take a breath—I’ve got you. Let’s break this down in plain language so you can figure out the right path for you.

What Does a Therapist Do?

Therapists (also called counselors, psychologists, or social workers) are your go-to guides for talk therapy.  They help you process emotions, navigate relationships, build better coping skills, and work through trauma or stress.

Types of Therapists:

• Licensed Clinical Social Workers (LCSWs)

• Licensed Professional Counselors (LPCs)

• Marriage & Family Therapists (MFTs)

• Licensed Psychologists (PhD or PsyD)

What They Help With:

• Anxiety, depression, trauma, grief, life transitions

• Relationship struggles, family dynamics

• Building self-esteem and emotional regulation

• Creating fundamental, sustainable coping strategies

• Psychological testing (if working with a psychologist)

What They Don’t Do:

• Prescribe medications

• Diagnose or treat medical issues

• Manage psychiatric medications or offer medical monitoring

What About a Psychiatrist or PMHNP?

Now we’re in the medical lane. Psychiatrists and psychiatric mental health nurse practitioners (PMHNPs) can both diagnose mental health conditions, prescribe medications, and manage your treatment from a medical perspective.

What’s the Difference?

Psychiatrist = A medical doctor (MD or DO) who specializes in psychiatry.

PMHNP = A nurse practitioner (with a master’s or doctoral degree) who specializes in psychiatric care.

Both are board-certified. Both can prescribe.

Why Many People Choose a Psychiatric Nurse Practitioner (PMHNP)

At JMS Behavioral Health, all of our clients receive care from a PMHNP, and here's why this approach is so practical:

Holistic, patient-centered care

Longer appointment times and more space to be heard

Focus on the whole person—mind, body, and spirit

Telehealth access  that’s flexible and private

Shorter wait times than many psychiatrists

Our PMHNP, Gabe Albanese, for example, brings clinical excellence and compassion to every session. You’re not just a diagnosis—you’re a whole human being.

When to See a Therapist

It may be beneficial to consider starting therapy if you are experiencing:

• Life Transitions & Stress: Divorce, job loss, grief, parenting changes

• Mild to Moderate Mental Health Concerns: Anxiety, depression, low mood

• Relationship Issues: Communication challenges, family stress, breakup recovery

• Trauma Work: PTSD, abuse recovery, childhood experience.

• Personal Growth: Building insight, resilience, and emotional intelligence

When It’s Time to See a Psychiatric Prescriber (PMHNP or Psychiatrist)

Some situations call for more medical support, especially if symptoms are severe or not improving with therapy alone:

Crisis Symptoms:

• Suicidal thoughts or self-harming urges (call 988 or go to your nearest Emergency Department)

• Severe panic attacks

• Hallucinations or delusions

• Deep depression that makes it hard to function

Medication Needs:

• You’ve tried therapy, but symptoms persist

• You’re wondering if medication could help

• You’re on meds that aren’t working or causing side effects

Complex Diagnoses:

• Bipolar disorder

• ADHD needing medication management

• Schizophrenia or schizoaffective disorder

• Co-occurring conditions (mental health + medical or substance use)

Why Both Might Be Best

Here’s where the magic happens: therapy + medication is often the gold standard for many mental health conditions.

When you combine

• A PMHNP or psychiatrist who manages the medical side

• A therapist who helps you navigate emotions, relationships, and daily stressors

You get full-spectrum support that meets you where you are and helps you grow.

At JMS, we encourage collaboration—we’re not just prescribing, we’re partnering.

Should I choose a psychiatrist or a PMHNP?

Choose a Psychiatrist if you need:

• Specialized medical consults for complex conditions

• Someone with an MD/DO background for preference or insurance reasons

Telehealth Has Changed the Game

Whether you're seeing a therapist, PMHNP, or psychiatrist, you can now get care from home.  At JMS, we provide comprehensive psychiatric services via secure telehealth throughout New Jersey.

No traffic. No parking. There is no need to spend time in waiting rooms. You can receive compassionate, expert care from the comfort of your couch. (If you require treatment for ADHD with a schedule II medication, you are required to have your initial evaluation and follow-up visits every 12 weeks in person.).

Insurance Tips

Most insurance plans cover therapists, psychiatrists, and psychiatric mental health nurse practitioners (PMHNPs) equally. Things to check before booking:

• Is the provider in-network with your plan?

• Are they accepting new clients?

• Do they offer telehealth?

• Are they specialized in addressing your specific needs?

(And yes—Gabe is in-network with most major plans through Headway!)

The Bottom Line

Mental health care isn’t one-size-fits-all. Whether you start with therapy, psychiatry, or a mix of both, the most important thing is this:

You’re taking the first step toward feeling better. And that is powerful.

You don't have to possess all the necessary skills to seek help. You need the courage to reach out—and we’ll take it from there.