How to find the right psychiatrist for my adult son

[MEgirl]

DS mid-20's has accepted help in looking for a psychiatrist so he can get a review. He's suffered from depression and anxiety since he was a teenager. DH died at the beggining of the pandemic from Covid and all three of my children were diagnosed ADHD a few months later. Suspect DS is also autistic.

DS has been seeing a psychologist for at least 18 months but I feel that he need more as nothing seems to have shifted in 3.5 years since he graduated.

I'm at a loss on what I should be looking for in a psychiatrist, what questions to ask when contacting someone, is there a particular field of specialisation we should be looking for.

I offered to put together a list of potential doctors which DS could then review. He needs assistance and encouragement to seek further treatment otherwise nothing changes which he accepts.

Does anyone have experience or suggestions on what I an do to help?

He may not have the right diagnosis and that is what a psychiatrist does. I had the incorrect diagnosis but I hadn’t been completely honest with MH services. The assistance from psychologists was what gave me the confidence to tell the psychiatrist eveyrthing. They then changed my treatment plan because they changed the diagnosis. I still have anxiety and depression but my actual diagnosis is bipolar.

He may just not be seeing the right psychologist for him, the relationship between therapist and patient is hard to get right or he may just not be telling them everything. It’s no one’s fault it is the level of comfort required plus the time has to be right, I have seen six psychologists and four psychiatrists. Just wish I had been honest years before but it was locked away in my head.

If it is a clinical psychologist then surely they can advise about a psychiatrist who would be a good fit for your DS character and symptoms. Is there a reason why you haven’t asked them?

I think it’s important to understand what a psychiatrist does - they diagnose and, often, medicate. Is that what DS wants? If so, I found mine by googling!

Edited because I misunderstood your post originally.

That's what I think needs checking. He is on anti-depressants but I'm not sure that they work as well as they should. He refuses to take his ADHD meds because he is scared of side effects. I'm sure that he won't tell them everything.

He's resistant to acting on any suggestions. He very much says that he will act on suggestions and then continues as he is now.

I found the current therapist for him based on a recommendation and I haven't wanted to rock the boat and upset her. I have spoken to her personally in the past and will get in touch with her again this week to ask her how she thinks DS is progressing.

DS is currently medicated. He went through CAMHS and on to the Tavistock when he aged out but then went to univesity. He had a difficult time which wasn't helped by covid or DH dying.

I suggested that he see our GP when he came home but I don't know what was said during the appointment. Eventually it turned out that a referal had been made to an adult ADHD clinic and nothing else. The waiting list in our area is 10 years. I can't be sure that DS would respond to the mental health team correctly if a new referal was made as he often receives phone calls when is sleeping/groggy and then doesn't follow up. He'll end up being discharged before he's even started.

Hence I'm trying to assist him by getting him to a private psychiatrist so we can work out whether he needs differnet anti-depressants/different treatment or whether a psychologist (maybe a different one) is enough.

There is a big difference in level of training between a clinical psychologist and a therapist

I used the term therapist in a general sense as in DS is receiving therapy. She is actually a registered clinical psychologist.

What is it that he's not doing currently that he should be doing as in what should the medication and therapy help him be able to do?

What do you/ he want the psychiatrist to do? Psychiatrists mainly do diagnosis and medication but a lot of general psychiatrists who would treat anxiety and depression would not be ADHD/ ASD specialists. That kind of neurodevelopmental diagnosis tends to be a separate assessment.
What diagnosis is it that you are suspecting aside from depression? What is the main symptom/ problem that he wants help with? These are the questions that should guide your choice then look for someone with experience or a specialism in that particular area.

He's not enjoying his life. He was diagnosed with depression by a CAMHS psychiatrist as a teen. He's been on the same medication and dose since then. he received no counselling at the time of DH's death and was very isolated at uni. I think that he spiralled in to deeper depression and despite the current psychologist he's not making any progress. I would like him to get an assessment to work out whether depression and anxiety are the only problems, whether a different medication would work better.

He is currently unemployed because he can't be in company much. He has a very low tolerance for groups, noise, conversation etc.

I'm just trying to work out how I can help him.

He's already had an ADHD diagnosis but won't take any meds. I suspect that some of the depression is due to the ADHD. He won't engage with an autism diagnosis because he reacted badly to the ADHD diagnosis and is scared to go through a similar experience again. Due to other life experiences, I do wonder whether there is any PTSD or similar going on. I also wonder whether he has treatment resistant depression or if there is an internal barrier to engaging with suggestions made to improve his life.

I just want to try and work out how I can help him live a better/happier life than he currently has.

Hi Op. I sympathise - it’s so hard to see your child struggling no matter how old they are. One of my children was originally diagnosed with anxiety as a late teen and prescribed antidepressants. Now in 20s and has been diagnosed with adhd in the last year and prescribed adhd medication instead. Difference is night and day. If your son can be given the right support and is open to adhd medication it could make a world of difference to him. Not in the UK but we went online and looked for psychiatrists who specialise in adhd, often attached to a dedicated clinic. Hope it works out well.

>Hi Op. I sympathise - it’s so hard to see your child struggling no matter how old they are.<

Thank you. I wish he would try the ADHD meds. They've been sitting on his desk for over a year and he won't touch them. Fingers crossed that someone else will be able to persaude him to try.