Sounds like you already know it’s not working for you. Try someone new, and if it blows up, your old psych is just a call away, bud.

I think it’s important to understand what is a psychiatrist. I also want to acknowledge that I am speaking in generalities, and there are individual differences among psychiatrists as there are within any groups. With some minor differences based on the country, in general, psychiatrists are physicians that specialize in mental health, often going through all of the training of a medical doctor, plus two years of mental health classes and a clinically supervised mental health internship/residency of some sort. Within the mental health professional community, they are also informally seen at the top of the hierarchy of mental health professions, above psychologists, social workers, mental health counselors, and family therapists. If I am wrong with any of this, someone please correct me.

Their perspective on mental health issues comes strictly from a medical model. They view all issues as diagnostic disorders in which someone is “broken” and needs to be “fixed”. They often see that their job is to get their patients back to “functioning fully”, which means getting the person back to work. In fact, psychiatrist mostly only prescribe meds in the healthcare system I get care from, while they leave therapeutic interventions to the mental health therapists. Moving on, psychiatry patients frequently ask them for help seeking disability benefits with the argument being that the patient is incapable of working. This can cause psychiatrists to develop a sort of resistance to those requests, as sometimes (not many, but enough) their patients exaggerate or even outright lie about their symptoms to malinger. This can make it difficult for those that are truly experiencing remarkable employment barrier to obtain disability benefits.

With that said, I believe that psychiatrists alone aren’t necessarily the best for autism care. They are not truly trained in the latest psychological and social interventions for autistic people. For one, they see autism strictly as a disorder/deficiency, and not a difference. While both perspectives, disorder and difference, have their strengths and disadvantages, I argue that a well-rounded approach that includes both perspectives is a more effective approach at helping autistic people have healthier and happier lives. What I’m getting at is that perhaps it would be helpful to consult with a therapist (not psychiatrist) that specializes in autism so that you could get a comprehensive plan of care from a diverse team of mental health professionals. A therapist could contribute a different approach that may be more compassionate and consider how environments affect your well-being and ability to function.

The last thing is that I have heard that autistic people can learn to override their intuition in order to adapt to an environment that is not autistic-friendly, whether that be the home, school, social settings, or work. While that may temporarily help in certain situations, it is ultimately unhealthy in the long-term across our entire lives. I think that if your intuition is telling you that you don’t fit well with this particular psychiatrist, it could be beneficial to consult with another one. Perhaps, you could ask around among other autistic friends or communities for any recommendations. If anything, you can even ask online in communities based on your location. There are bound to be other autistic individuals in say a community for Atlanta that could have a helpful recommendation. At worst, you don’t like the options you are given and can always go back to your current psychiatrist.