How to become a psychiatrist?
Learn about the critical role of psychiatrists, as well as how long it takes to become one and average salary data for psychiatrists in the U.S.
Our awareness of mental health and well-being is more acute than ever, with professionals working hard to recognize mental health conditions such as stress and anxiety as endemic in modern societies.
Within the US alone, 25% of the homeless live with mental illness. Nearly three-quarters of those in the juvenile justice system are found to have mental health conditions. And up to a third of US service members also fall victim to mental illness, many suffering post-traumatic stress disorder (PTSD).
To help address these conditions, the role of the psychiatrist is increasingly important; but what exactly is a psychiatrist?
Psychiatrists diagnose, treat, and prevent mental, emotional, and behavioral disorders using medication, neuromodulation — which utilizes devices to stimulate nerves with pharmaceutical agents or electrical signals — and psychotherapy. Once fully qualified, the average psychiatrist across the US can expect to earn on average between $120,000–$270,000.
Here’s a breakdown of the top eight paying states and the lowest eight paying states as an average.
| Hawaii | $269,800 | Montana | $167,370 |
| South Dakota | $267,520 | D.C. | $167,190 |
| Connecticut | $258,200 | West Virginia | $166,400 |
| Maine | $256,270 | Alabama | $166,220 |
| California | $255,790 | Arkansas | $153,920 |
| New Mexico | $255,410 | Utah | $145,700 |
| Illinois | $251,390 | Idaho | $137,280 |
| Wyoming | $251,070 | Louisiana | $120,090 |
Psychiatrists have studied for four years at medical school and a further four years of residency in psychiatry. After completing medical school, the candidate must take a written examination to gain a state license. The first year of residency training is typically in a hospital, working with patients showing a wide range of medical illnesses.
The psychiatrist-in-training will then spend at least three additional years learning the diagnosis and treatment of mental health, including various forms of psychotherapy and the use of psychiatric medications and other treatments. Training takes place in settings such as in-patient and out-patient wards and within emergency rooms.
Evaluation and Diagnosis
One in five of all US citizens are said to suffer from mental illness at some time in their lives — and less than half of those seek help for their condition.
Common conditions that psychiatrists come across include:
- Anxiety
- PTSD
- Insomnia
- Depression
- Bipolar disorder
- Agoraphobia
Others include:
- Phobias
- Obsessive-Compulsive Disorders (OCD)
- Personality Disorders
- Schizophrenia and paranoia
- Dementia and Alzheimer’s disease
- Eating disorders e.g., anorexia and bulimia
- Addictions, drugs, alcohol
Once an evaluation has been carried out and a diagnosis made, the patient may undergo treatment, such as prescription medications, psychotherapy, or possibly electroconvulsive therapy.
Psychiatrist vs. Psychologist
Both psychiatrists and psychologists treat various mental health issues, and both practice psychotherapy, but there are important differences in the two methods.
While both psychiatrists and psychologists can be referred to as ‘doctors’, only psychiatrists are medical doctors and therefore able to prescribe medication per state law to the patient. A psychologist cannot prescribe medication. Rather than taking a more ‘medical’ route to treatment, a psychologist uses an individual’s history and symptoms to assess what is causing the illness and then designs a treatment plan using an evidence-based psychological approach.
After completing thorough evaluations, psychiatrists can prescribe various medications to help treat mental disorders or conditions associated with mental health and well-being. How psychiatric medication acts on the brain is not completely understood, but it is thought that the compounds may modulate chemical signaling and communication within the brain, reducing some of the symptoms associated with psychiatric disorders. Patients on long-term treatment will need to meet routinely with their psychiatrist to keep track of the effectiveness of the medication and any potential side effects the patient may have experienced. Medication can be prescribed in tandem with psychotherapy sessions.
These medications can include:
- Antidepressants – used to help relieve symptoms of conditions including social anxiety disorders, panic disorder, obsessive-compulsive disorder, depression, PTSD, borderline personality disorder, dysthymia (persistent depressive disorder).
- Sedatives and anxiolytics – used to treat panic disorders, anxiety, and insomnia.
- Antipsychotic medications, such as asenapine, clozapine, and lurasidone, treat psychotic symptoms (delusional behavior, hallucinations), schizophrenia, bipolar disorder.
- Hypnotics, such as Ambien, Butisol, and Estazolam — used to induce and maintain sleep.
- Mood stabilizers – used to treat bipolar disorder by preventing the highs (mania) and the lows (depression).
- Stimulants, such as Methylphenidate — used to treat ADHD.
Other treatments are also used. Electroconvulsive therapy (ECT), a medical treatment that involves applying electrical currents to the brain, is sometimes used to treat severe depression when the patient has not responded to other treatments. Deep brain stimulation (DBS), vagus nerve stimulation (VNS), and transcranial magnetic stimulation (TMS) are some of the newer therapies being used to treat certain mental disorders. Light therapy can be used to treat seasonal depression.
Psychiatrist vs. Therapist
Both psychiatrists and therapists share the same goal to help patients with mental health problems. They will both know the many kinds of issues, behavioral disorders, and syndromes. However, a therapist is a mental health care practitioner and cannot prescribe medication. Both types of professionals have the same goal of helping patients recognize and navigate the issues that may be holding them back in life. Therapists do this by carefully listening to the patient then reflecting back on their life. A traditional psychotherapist will look at the past and early relationships and dissect them to get to the root cause.
A Rewarding Career
Like many doctors, psychiatrists can work in hospitals or clinics. And around half of all psychiatrists in the US have private practices. So, what is the attraction of working in any given particular field of psychiatry aside from the financial rewards? Those in the profession say it is extremely satisfying for a psychiatrist to see the positive results that their work has achieved. Many will tell you of the sense of achievement they get from helping patients improve their quality of life.
Examples include helping patients who once suffered anxiety enter a packed room and communicate confidently with others or support someone with an addiction to kick their habit. A patient’s journey can be long and complex, but it gives many patients great comfort to know that their psychiatrist will be with them every step of the way.
Beyond the satisfaction of helping patients overcome their challenges, psychiatry also offers inroads for doctors to specialize in a particular area of psychiatry. If you qualify as a psychiatrist, you may have the opportunity to work in psychiatric hospitals, prisons, addiction units or even find a career path in psychiatric research.
Often, psychiatrists will work alongside physicians, nurses, social workers, advanced practice nurses, and other therapists in order to serve a patient’s needs. The US is currently facing a psychiatric shortage. Many are nearing retirement age, making it the perfect time to pursue this career path — to help serve the mental health needs of the patient population. The situation is escalating to a level of unprecedented demand. There are currently around 28,000 psychiatrists in the US, though that number is shrinking fast. For the past few years, the US health system has lacked enough primary care providers to deal with the increasing pressure.
If you are interested in completing medical school and helping people living with a debilitating mental illness, speak to someone at MUA for more advice.