If you suspect that a loved one is experiencing symptoms of dementia, you may be unsure what kind of professional to consult. You will definitely want a specialist to get an accurate assessment, but with both psychiatrists and neurologists available, how can you know which one is best?

Psychiatrists And Neurologists: Similarities

Psychiatrists and neurologists follow a similar course of training, beginning with four years of medical school, followed by a residency in their respective specialties. Thereafter, they may elect to pursue a fellowship in a subspecialty within their field.

Thus, both of these professionals are MDs or DOs depending on the type of school they attended; they can both conduct mental status exams, order imagining studies, diagnose dementia and prescribe medications as necessary. Both have been trained to manage multiple medical conditions, and to consult other departments.

And, importantly, both have to earn certification from the American Board of Psychiatry And Neurology. The certification exam requires full knowledge of both psychiatry and neurology, which may seem strange since they are different professions. However, because both disciplines deal with the brain/mind, the reality is that there is a tremendous overlap between the fields of psychiatry and neurology, and knowledge of both is essential to ensuring that all factors are considered in a diagnosis. So what's the difference?

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Psychiatrists And Neurologists: Differences

Understanding the difference between psychiatrists and neurologists is perhaps easiest if considered in the context of the symptoms they treat. The brain is the most complicated, yet least understood organ in the body; and central, as it is ultimately in charge of our bodies, including both voluntary and involuntary functions.

This analogy, although imperfect, may help in understanding the difference: Psychiatrists focus on and treat symptoms originating in the brain that lead to abnormal voluntary functions, i.e; human behaviors, whereas neurologists focus on and treat symptoms originating in the brain that produce abnormal involuntary functions.

In the case of depression, for example, the patient will present with voluntary (meaning that the patient technically has physical control, although they choose not to engage in these behaviors if healthy) symptoms, like social isolation, increased or decreased sleep or weight and stopping activities they once found enjoyable. By contrast, a stroke patient will present with involuntary (meaning the patient could not physically stop these behaviors, because the body is in an “automatic" mode) symptoms, such as blurred vision, paralysis, headache, inability to communicate verbally and involuntary movements.

So Which One Should You See?

Making an appointment with either a psychiatrist or neurologist would ultimately lead to a correct diagnosis, even if they end up referring you to the other specialty for a more specific evaluation.

If a dementia patient is hallucinating or becoming aggressive, for example, you may want to discuss the problem with a psychiatrist who specializes in geriatrics; they may be more comfortable prescribing antipsychotic medications, which are typically used to treat these symptoms. A neurologist may be a better option if other neurological symptoms beyond changes in memory, mood and behavior emerge (like involuntary movements). But the bottom line is that either will be able to provide a preliminary diagnosis of dementia, and guide you in the best direction.