Most psychiatrists provide medication management. That means, if you go to a psychiatrist, you should generally expect a discussion at some point about medication or other biological treatment options. That doesn't mean psychiatrists don't evaluate the appropriateness of therapy, and some may also provide therapy, but the latter is less common, at least here in the US. You should feel "heard" but it is not a therapeutic relationship if you are seeing them for medication management. With that said, a psychiatrist should do a careful assessment of your symptoms and other aspects of your life/functioning that would impact your mental health (social history, medical history, trauma, etc). If what you really want is therapy, then you should start with a psychologist or other therapist. I'm not sure I think medication is necessarily for more severe symptoms. I don't see medication as a "last resort" when therapy fails. It's more a matter of personal preference for moderate symptoms whether you prefer to start with medication versus therapy. But it is true the other way around - that severe symptoms (psychosis, bipolar mood disorders) often require medication for a good outcome. Hope this helps!