Genetic, both times I was dx'd ten years apart I was reffered to a psychiatrist immediately. However both times the gp's I saw did up blood work first and the psychiatrists did as well. However they are only looking at a few things..anemia..thyroid..

There are many many physical illnesses or conditions that can contribute to mental illness symptoms they never bother to look at. Food allergies is often just overlooked as well as other rather common problems. You'd think dr's realize the brain is an organ in the body yet for some reason always try to seperate and treat it as if it stands alone.

In Canada tho yes you have to see a gp first to get reffered to a pdoc, you cannot just pick one and make an app. Unless conditions like Cocoabeans mentioned where you would immediatly be seeing one. But I never had to exhaust a GP either.