Psychologist vs Psychiatrist

While they both offer mental health treatment for their patients, their therapy approaches differ. When choosing which type of mental health professional to see for your postpartum depression, it’s important to understand their critical differences. Find a Therapist Now

Who Treats Postpartum Depression?

Several kinds of professionals treat postpartum depression, and you do not need to find a specialist before you can start getting help. The fastest first step for most people is the clinician they already have.

  • Your ob-gyn, midwife or primary care doctor can screen you, and the American College of Obstetricians and Gynecologists (ACOG) recommends that obstetricians start medication, refer you to therapy, or both.
  • A therapist, such as a psychologist, licensed clinical social worker, licensed counselor or marriage and family therapist, provides talk therapy, which ACOG calls a first-line treatment for mild to moderate postpartum depression.
  • A psychiatrist or psychiatric nurse practitioner manages medication, especially when depression is severe, has not responded to a first treatment, or comes with other conditions such as bipolar disorder.

The best specialist is often a combination: a therapist for talk therapy, and a prescriber who coordinates with your ob-gyn if you need medication.

Find a postpartum depression therapist near you

Types of Postpartum Depression Specialists

Professional Training and license Can prescribe? Best for
Psychiatrist Medical degree (M.D. or D.O.), then psychiatry residency; licensed physician Yes Severe depression, complex medication decisions, bipolar disorder, psychosis
Psychiatric-mental health nurse practitioner Graduate nursing degree, national certification and an advanced practice nursing license In most states, with rules that vary by state Medication management, often with shorter waits than psychiatrists
Psychologist Doctorate (Ph.D. or Psy.D.) in psychology; licensed in every state Only in a few states Structured therapy such as CBT and IPT, psychological assessment
Licensed clinical social worker (LCSW) Master’s in social work plus supervised practice; licensed in every state No Therapy, plus help with practical and family stressors
Licensed counselor (LPC or LMHC) Master’s degree, supervised clinical work and a national exam No Individual therapy
Marriage and family therapist (LMFT) Master’s degree plus supervised practice; state licensed No Depression in the context of a relationship or family
Ob-gyn, midwife or primary care clinician Medical or nursing training; licensed Physicians and most nurse practitioners, yes Screening, starting first-line medication, referrals

What Is a Perinatal or Reproductive Psychiatrist?

A perinatal or reproductive psychiatrist is a psychiatrist with additional training in mental health during pregnancy, after birth and across the reproductive years. They are especially helpful when medication decisions involve pregnancy or breastfeeding. Formal training is growing: since 2021, the National Curriculum in Reproductive Psychiatry has provided a standardized year-long teaching series for psychiatry fellows. They are also scarce, which is why most people start treatment elsewhere.

Do You Need a Psychiatrist?

Often, no. ACOG recommends that obstetricians be ready to start antidepressants for perinatal depression and anxiety and to counsel patients on the benefits and risks. SSRIs are the recommended first-line medication, and ACOG recommends against stopping mental health medication just because someone is pregnant or breastfeeding.

That matters because psychiatrists are hard to reach. In a study of 948 psychiatrists in five states, callers posing as new patients with depression found that only 18.5% could offer an appointment, with median waits of 67 days in person and 43 days by telehealth. Waiting has a cost: in one Texas health system, each week spent waiting for a reproductive psychiatry appointment raised the odds of worsening symptoms by 13%.

The practical takeaway is to start with the clinician you can see soonest, and to see a psychiatrist when your depression is severe, complicated or not improving.

How Your Ob-Gyn Can Get Specialist Advice

Even if you cannot get a psychiatry appointment, your ob-gyn may be able to consult one for you. Perinatal psychiatry access programs give obstetric and primary care clinicians training and real-time phone consultation with perinatal psychiatrists. The first statewide program, MCPAP for Moms in Massachusetts, became the model for others, and about 30 state, regional and national programs now exist. Postpartum Support International also runs a free national consult line for U.S. prescribers. It is worth asking your clinician: “Can you consult a perinatal psychiatrist about my care?”

What PMH-C Means

PMH-C stands for Perinatal Mental Health Certification, awarded by Postpartum Support International. It is the clearest sign that a clinician has specific training in postpartum depression and anxiety. To earn it, a clinician needs:

  • A professional degree or credential in their field
  • Two years of experience that includes working with pregnant and postpartum clients
  • 20 hours of specialized perinatal mental health training
  • A passing score on a proctored certification exam
  • 12 hours of continuing education every two years to keep it

In 2026 the certification was accredited by the National Commission for Certifying Agencies, through June 2031. PMH-C is a certification, not a license: every clinician still needs a state license, and you can check a clinician against PSI’s public list of PMH-C holders. Many excellent therapists treat postpartum depression without it, so treat it as a strong signal rather than a requirement.

Therapy That Works for Postpartum Depression

  • Cognitive behavioral therapy (CBT) helps you challenge and change unhelpful thoughts and behaviors, such as “I am failing as a mother.”
  • Interpersonal therapy (IPT) focuses on relationships and communication during a major life change.

ACOG names both as first-line psychotherapies. They also prevent depression: the U.S. Preventive Services Task Force found that counseling such as CBT and IPT lowered the likelihood of perinatal depression by 39% in people at increased risk, and recommends that clinicians provide or refer them. See therapy for postpartum depression and postpartum depression medication.

Is Online Therapy as Good?

Online therapy is a real option, not a compromise. A 2021 meta-analysis of nine randomized trials found that telehealth treatment lowered depression and anxiety scores in postpartum depression, and a 2026 analysis of 23 trials found the strongest benefit after birth. It also removes the hardest part of therapy with a newborn: getting out of the house.

How to Find a Postpartum Depression Specialist

  1. Tell your ob-gyn, midwife or primary care doctor now. They can screen you, start treatment, and refer you, and they do not need a psychiatrist to begin.
  2. Search a directory for perinatal specialists. Our directory lists licensed therapists who treat postpartum depression by state and city, including PMH-C certified providers and those offering online sessions. Postpartum Support International also keeps a provider directory; it lists trained providers but does not endorse them.
  3. Call Postpartum Support International’s HelpLine at 1-800-944-4773 in English or Spanish. A trained volunteer returns your message and can help you find local support.
  4. Check your insurer’s list for in-network psychologists, social workers, counselors and psychiatric nurse practitioners.
  5. Book the first real appointment you can get, and keep looking for a better fit afterward if you need to.

Paying for Treatment

  • Marketplace plans under the Affordable Care Act must cover mental health care as an essential health benefit, and cannot charge you more for a mental health condition.
  • Parity rules mean limits on mental health care, such as copays and visit caps, cannot be stricter than limits on medical care in plans the federal parity law covers, including large employer plans.
  • Medicaid can now cover mothers for 12 months after birth. From 2021 to 2025, 48 states and Washington, D.C. adopted this extension.
  • Private pay is common: about a third of private-practice therapists do not take insurance, and a large study of listed therapist rates found an average cash price of about $143 per session. Ask about sliding-scale fees, and ask for a superbill if you plan to claim out-of-network benefits.

Questions to Ask a Postpartum Depression Therapist

  • What experience do you have treating postpartum depression and anxiety?
  • Do you have perinatal training or PMH-C certification?
  • Which approaches do you use, such as CBT or interpersonal therapy?
  • How long do you expect treatment to last?
  • Do you offer online sessions, and can I bring my baby to in-person visits?
  • If I need medication, will you coordinate with my ob-gyn or a prescriber?
  • Do you accept my insurance, and what will a session cost?
  • When is your first available appointment?

Treatment works best when you have a good relationship with the person treating you, so it is fine to talk to more than one before choosing.

When It Cannot Wait

  • Thoughts of harming yourself: call or text 988, the Suicide and Crisis Lifeline, free and open 24 hours a day.
  • Struggling and need to talk now: call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262), free, confidential and available 24/7 in English and Spanish.
  • Confusion, hallucinations, paranoia or not sleeping for days: these can be signs of postpartum psychosis, a medical emergency. Call 911 or go to the nearest emergency room.

Frequently Asked Questions

What kind of doctor should I see for postpartum depression?

Start with your ob-gyn, midwife or primary care doctor, who can screen you, start treatment and refer you. A therapist provides talk therapy, and a psychiatrist or psychiatric nurse practitioner helps when depression is severe or medication decisions are complicated.

Can my ob-gyn prescribe medication for postpartum depression?

Yes. ACOG recommends that obstetricians start medication for perinatal depression when needed, with SSRIs as the first-line option, and refer to behavioral health care when appropriate.

What is the difference between a psychologist and a psychiatrist?

A psychiatrist is a medical doctor who can prescribe medication and also provides therapy. A psychologist holds a doctorate in psychology and mainly provides therapy and assessment; only a few states allow psychologists to prescribe.

What is a perinatal psychiatrist?

A psychiatrist with extra training in mental health during pregnancy and after birth, including medication decisions while pregnant or breastfeeding. They are scarce, so your ob-gyn may consult one through a perinatal psychiatry access program instead.

What does PMH-C mean after a therapist’s name?

It means they hold Postpartum Support International’s Perinatal Mental Health Certification, which requires perinatal training, two years of relevant experience and a certification exam. It is a certification on top of a state license.

Does insurance cover a postpartum depression therapist?

Most health plans cover mental health care, and Marketplace plans must. Coverage for a specific therapist depends on whether they are in your network; many private-practice therapists do not take insurance but can provide paperwork for out-of-network reimbursement.

How long does it take to see a postpartum depression specialist?

It varies widely. Psychiatry waits can stretch for weeks or months, while telehealth and therapist appointments are often faster. Because waiting can make symptoms worse, start with whoever can see you first.

Is online therapy effective for postpartum depression?

Yes. Randomized trials show telehealth treatment reduces postpartum depression and anxiety symptoms.

PostpartumDepression.org Team
Reviewed by:Kimberly Langdon M.D.

Medical Editor

  • Fact-Checked
  • Editor

Kimberly Langdon is a Doctor of Medicine and graduated from The Ohio State University in 1991. She completed her residency in Obstetrics and Gynecology at The Ohio State University Hospitals, Department of OB/GYN. Board-Certified in 1997, she is now retired from clinical practice after a long and successful career. Currently, she is the Founder and Chief Medical Officer of a Medical Device Company that is introducing patented products to treat vaginal microbial infections without the need for drugs. She is an expert in Vaginal Infections, Menstrual disorders, Menopause, and Contraception.

Written by:

Jenna Carberg was diagnosed with postpartum depression following the birth of her daughter in 2016. It was a healthy birth but in the following days, Jenna's mood changed quickly. Doctors suggested that it might be the "baby blues", but her husband Chris suggested she seek a second opinion. Jenna was diagnosed with postpartum depression and began a journey that lasted 9 long months with significant ups and downs. Jenna's mental health care and her experiences became a passion for her to share with the world. She and her husband Chris founded PostpartumDepression.org as a support website designed to help women suffering in silence and their loved ones.

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