I have worked with nurses who weren't nurse practioners but who had extensive psychiatric training and they were better than some psychiatrists I've had the distinct displeasure to have dealt with professionally. They were kinder, more patient, had a better understanding of the need to LIVE while still taking meds and they worked hard to do whatever it took to get that for their patients. I was always glad to find a reason to bring them into a case because they were so kind to the patients and made it much easier for them to cope with not being able to be as independent as they had been. When a case was mainly open for psychiatric care and I was involved for some reason I could always see the patient making progress with their psychiatric goals and getting good help with whatever they needed. After working in a trio of long-term psych facilities for several years with a psychiatrist who preferred to just sedate people into not acting out without much care for the quality of their lives I was really impressed. They couldn't prescribe but they did work with the drs and usually got appropriate meds in place no matter the situation.

I don't hate your dr but I do think you are in a bad situation with him. I think you haven't had a good chance to see what real stability is like and that's because you've not had a med combination likely to produce stability. I would love to know what you felt like on a more typical set of meds, like an atypical AP, a normal dose of lamictal, maybe an AD that helps balance the sedation and maybe something for anxiety as needed. Something like that. Simple yet often effective.

And the confidentiality thing, well, that's a really serious offense as we've talked about already.

I haven't actually had to change psychiatrists really ever (my first died, the 2nd I graduated and moved away from, the 3rd wasn't worthy of the word psychiatrist, the 4th was just for a clinical trial and the 5th is hitting 12 years this month.) So I'm not full of knowledge but I do know with changing therapists I have needed to make myself commit to several visits (with this one it was 3 months) with someone to hold me accountable before I decided I hated him and walked off, just because the transition can be hard. Sometimes it takes a few tries and if that happens that's ok, you still can be strong and take care of yourself and see someone who is prescribing reasonably and not violating confidentiality. (When I think of that situation I think of a quote from one of the Laura Ingalls Wilder books "A dog that will fetch a bone will carry a bone". True of most people willing to gossip a bit I think.....)

I hope you find a decision you feel at peace with.