Psychiatrists are, first and foremost, physicians. Before ever conducting a psychotherapy session or prescribing a medication, they complete the same rigorous pathway expected of every medical doctor: Four years of undergraduate study, four years of medical school, and then a minimum of four years of residency training dedicated solely to psychiatric medicine. Many pursue additional fellowships—one or two years of subspecialty immersion in fields such as addiction medicine, geriatric psychiatry, neuropsychiatry, consultation-liaison psychiatry, reproductive psychiatry, or neurophysiology. By the time a psychiatrist begins independent practice, they have accumulated a decade or more of structured medical education, supervised training, and direct responsibility for patients with serious brain-based illnesses.

This depth of training is not incidental. Psychiatry sits at the intersection of medicine, neuroscience, and human experience. Conditions like bipolar disorder, schizophrenia, catatonia, severe depression, obsessive-compulsive disorder, and neurocognitive disorders are illnesses of the brain, even if they manifest through changes in thought, mood, or behavior. They require the same level of diagnostic precision and medical understanding that cardiologists bring to heart disease or endocrinologists bring to diabetes. Psychiatrists are trained to differentiate between psychiatric symptoms arising from medical causes—such as thyroid disease, autoimmune disorders, infections, toxic exposures, neurodegenerative processes, or the side effects of medications—and primary psychiatric illnesses. Misunderstanding this distinction is not just an academic matter; it can cost lives.

Yet, in modern Western culture, an unusual and sometimes troubling phenomenon persists. Professionals from non-medical backgrounds—family therapists, counselors, psychologists, social workers, life coaches, and even those without accredited mental-health degrees—often refer to the individuals they serve as “patients,” and in some cases adopt the title “doctor” through academic or honorary degrees. In almost no other branch of medicine would such blurring of roles be tolerated. A nutritionist does not call their client a cardiology patient. A fitness coach does not diagnose lung disease. But within the mental-health space, the distinctions between medical and non-medical practice have been repeatedly diluted.

This is not a victimless ambiguity. When all healers of the human mind are thought to be interchangeable, patients may unknowingly seek help for serious brain disorders from providers without medical training, without the ability to perform a physical exam, order lab tests or imaging, or distinguish psychiatric symptoms from neurological or systemic disease. A person suffering early signs of dementia, autoimmune encephalitis, or severe metabolic derangement may spend months or years in “therapy” while the underlying medical illness progresses unchecked. A young adult in the midst of a first psychotic episode may be told by a non-medical professional that their experiences are merely emotional “blocks” or existential crises rather than emergent symptoms of a life-altering neurobiological illness that requires prompt medical care.

At the heart of this confusion lies an old cultural wound: the persistent illusion that “mind” and “body” are separate. Western society frequently embraces a comforting narrative that emotional suffering can be disentangled from biology, or that brain-based illnesses are merely psychological reactions to stress or life circumstances. This polarization allows society to ignore the medical reality of psychiatric disease and, in turn, to accept a system in which non-medical practitioners are seen as equivalent—or even superior—to medical doctors in addressing problems rooted in the brain.

But psychiatry is not simply “talk therapy” or generic emotional support. It is a medical specialty rooted in anatomy, physiology, pharmacology, and neuroscience. It deals with life-threatening emergencies, altered states of consciousness, and complex interactions between mind and body. Its practitioners carry the responsibility of diagnosing conditions that may require medication, hospitalization, or collaborative treatment with other medical specialists. This is not to diminish the immense value of psychologists, therapists, counselors, and social workers. They are essential partners in mental-health care, and often provide forms of treatment—such as long-term psychotherapy—that psychiatrists alone cannot meet. A collaborative, team-based approach is ideal. The problem arises not from the existence of these roles, but from the erosion of boundaries that protect patients and clarify professional expertise. Just as we would never allow someone without medical training to practice cardiology simply because they care deeply about the heart, we should not allow the treatment of serious brain disorders to be subsumed under a vague, unregulated umbrella of “mental health.” Clarity of professional identity is not about hierarchy—it is about safety, accuracy, and honesty with the public.

Psychiatry is medicine. Its patients are medical patients. And while society may continue to wrestle with its discomfort around mind-body unity, the suffering of real human beings demands that we keep the lines clear, the roles defined, and the care grounded in the rigorous medical training that brain diseases require.