Psychiatry and medication: evaluations, prescribers and how medication fits into care

You do not need to know whether you need medication before your first visit. A psychiatric evaluation looks at your symptoms, history and goals, and the plan that follows may include therapy, medication or both.

Medical reviewer: Dr. Ling Lu

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01 / Psychiatric care

Psychiatrists, psychiatric nurse practitioners, psychologists and therapists

Psychiatrists are medical doctors who diagnose mental health conditions and can prescribe medication. Psychiatric mental health nurse practitioners (PMHNPs) are advanced practice nurses trained to evaluate, diagnose and treat mental health conditions, including prescribing medication.

Psychologists hold doctoral degrees and provide therapy and psychological testing. Licensed counselors and social workers, such as LCPCs and LCSW-Cs, provide psychotherapy.

A psychiatric evaluation reviews your symptoms, history, health, current medications and goals, and ends with a discussion of options. Medication management visits then check benefits, side effects and whether changes are needed. Our psychiatric medication management guide walks through the evaluation, follow-up visits and how side effects are reviewed.

In a psychiatric evaluation, expect questions about why you are seeking care now, what you want to change, your symptoms, sleep and daily functioning, your medical and family history, and any past treatment. The provider will also ask about alcohol, tobacco and other substance use, because substances can cause or mimic symptoms such as anxiety, low mood or mood changes, and will ask directly about safety. A diagnosis, if one fits, draws on DSM-5-TR criteria together with your history and circumstances, and the visit ends with a conversation about options.

People often seek an evaluation for persistent sadness, hopelessness or anxiety, mood swings that are hard to manage, trouble functioning at work, school or in relationships, new symptoms such as panic attacks or sleep problems, or a second opinion on a current diagnosis or medication plan. To prepare, bring a list of your current medications and doses, including supplements, any allergies, and records from past providers if you have them.

A psychiatric evaluation is not the same as a psychological evaluation. A psychiatric evaluation is done by a medical prescriber, such as a psychiatrist or PMHNP, and focuses on diagnosis, physical health factors and whether medication may help. A psychological evaluation is usually done by a psychologist and uses standardized testing to look at thinking, learning, emotions and behavior, for example when a learning disability or autism is a question.

02 / Therapy, medication or both

Therapy, medication, or both?

There is no single right answer. For many concerns, including depression and anxiety, therapy, medication or a combination can each be a reasonable place to start. Providers look at what research supports for your concern, then weigh it with your preferences and what fits your life.

When both are part of the plan, ask how your therapist and psychiatric provider will coordinate with your permission, who handles side effects and urgent questions, and how progress will be reviewed. Never start, change or stop a psychiatric medication without talking to the person who prescribes it.

Guides on psychiatric evaluation and medication

Each guide below covers one part of psychiatric care in more depth, from the first evaluation to how specific medications are used and monitored.

Sources