Can you fire a psychiatrist and get a referral?

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Mine doesn't really believe that Nonverbal Learning Disorder exists, so I don't think it's a very good fit, and he won't prescribe adderall because he thinks I'm bipolar. Can I ask for a referral to a learning disability specialist? Will they usually give referrals if it's clear you just don't like their approach? Will they understand the importance of forwarding their patients in-network?

He said that bipolar depression can cause my NLD, but this is BS. It took me 2 minutes to find a study on the effects of depression on cognitive performance, and it appears to affect verbal and nonverbal performance equally:



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Or, I could give him a brochure, but it's unlikely he would like to have his professional judgment questioned, even though he's clearly incompetent (diagnosing bipolar without observing a manic episode, for example):

"NLD may be first misdiagnosed as attention-deficit/hyperactivity disorder (ADHD), bipolar disorder (BD), or Asperger’s disorder. NLD patients may experience chronic low self-esteem, anxiety, and mood symptoms because of their limited ability to express their feelings within an appropriate social context. "

http://www.currentpsychiatry.com/pdf/10 ... ticle3.pdf

If you don't click with your doctor or psychiatrist there is no reason to persevere with them.
It's a pain in the rear, but if I were you, I'd go back to my GP, get a referral to another psychiatrist and go from there.
There is no point trying to get someone to take you seriously if they won't validate you or take your concerns seriously.

Though it may be tempting to try to educate them, it will probably be taken the wrong way if you try giving them a brochure or whatever, and it will only make the process of getting what you want, diagnosis and treatment more difficult. You want help, and showing you're more intelligent or aware of something will only make the doctor think you're being a smartass.

What I've found is doing it "backwards" seems to work better.
Go online and check out the websites and write ups about psychiatrists, psychologists, and clinics in your area, make some enquiries, then see your GP and ask them to write you a referral to the clinic or therapist or whatever you think will work better for you.
You will find some organisations like registration bodies and associations will have lists and brief bios of clinicians, that can be helpful too.

GP's otherwise just refer you to people they know or that other's have told them about and this is not the best way to find the right fit.
Never stick with a medical professional you don't think understands, respects, or cares about you as a patient; you're the patient and you're the one who can figure out the best treatment to suit you; it's about you getting the help you need, not about them getting more patients on their books!

GP is old-fashioned shorthand for primary care provider.

If I called my insurance company and asked for a specialist in Nonverbal Learning Disorder (or learning disabilities, or autism, or whatever), is that an alternative way to do it?

They'll ask "who referred you?"

"I'm new here [true], and my insurance company located you for me. "

I think it's fine to call up your insurance company and ask for an NLD specialist in your new area.

Wait, I have a letter explaining the diagnoses given? Is that enough?

Exactly, instead of endlessly discussing this in a forum get to it and make some calls and arrange something.
Only you and the treating doctor or practitioner can work out the strategy that works for you.
All this discussion is just speculation and people sharing their experience and trying to give you advice.
Only by taking some action can you resolve this, so less posting and reading, more action!

I myself have a very difficult time calling up banks or insurance companies, really calling any kind of officialdom.

In fact, I'd like to tell a story. In 1992, following the acquital of the four officers involved in the beating of Rodney King and the resulting riots, I called up and made an appointment to speak during the public comment period before the Houston City Council. I did some research, made some phone calls (stressful), found that the Houston Fire Department used to have 'Kelly Days,' which was basically a day of personal leave for a fire fighter, which he or she could take without feeling pressured to give further explanation. I thought this would be a good idea for Houston police officers as well. I included some other positive suggestions. I practiced giving the speech from my messy notes, which I were very familiar with and that's important. So, it was partially memorized, partially read, and I felt very effective. I'm glad I did it and felt I did a good job.

I find calling an insurance company just as stressful ! ! !

I have to be ready to talk to someone not understanding, or pretending not to understand. Someone categorizing me in a tricky way, or brushing me off in a tricky way. It is not an easy situation in any way.

I can see why your doctor is leery of prescribing Adderall to you if he suspects you're bipolar. If you are bipolar, then that could send you into a mania, which is dangerous and embarrassing. Depending on how bad it is, you could exhaust yourself working on a new project for a month on two hours of sleep, or end up clothesless and thinking you're the Virgin Mary.

So, first things first: Yeah, you can get a new psychologist, someone who is willing to examine carefully to see whether you are bipolar or not. If you have just depression, without any manias, then it might be safer to use a stimulant. If you have bipolar disorder, you'd have to be carefully monitored. There's the option of Strattera, which is a non-stimulant and works for some people with ADHD, if you do turn out to have bipolar disorder.

NVLD isn't an official diagnostic category; Asperger's or autism is roughly the same thing, though, and you can usually get whatever you need for NVLD with an Autism label. Finding someone who can evaluate you properly could be a good first step.

But do make sure you're right about not having bipolar disorder. I've had a few friends with that, and one of the most important things they learned was how vital it is to keep it under control.

I wish we had a Spectrum resource center where we could check the references of volunteers, and then a volunteer could come over to my house and make some of these phone calls for me, maybe while I stayed and listened in the same room as I read a book or did something else

Yes, I can do it. But it takes enormous energy. And I can find myself putting off a needed phone call for weeks. If I was a rich person, I'd just hire a person to do some of this. I wish we had volunteers who could help in the same way.