I'm sorry that you have not felt supported in your quest to access mental health care. It never surprises me to hear stories like yours, which I've heard a lot of. The whole mental health industry is very disorganized. I've tried it all and don't have much good to say about it.

First of all, you have a "provider" who is a nurse practitioner. She is not a doctor. I'm sure you know that yourself, but I also think you are overestimating her capabilities. That's not your fault because the system has conditioned us to accept nurses and physician's assistants as able to perform the role of doctor. These N.P.s and P.A.s are often in over their heads. I am a nurse, myself, and I have seen patients get poor care because an N.P. or P.A. was in over their heads.

Personally, I believe that N.P.s should not be diagnosing. If you ever apply for disability Social Security, the federal government will not accept any diagnosis that doesn't come from an actual doctor. They have good reason for that. These "providers" who are not doctors, tend to think they just have to check off criteria that they look up in the DSM, which lists all psychiatric diagnoses. They are way too quick to slap labels on clients whom they don't know very well. The health insurance systems encourage this because it's cheaper to pay an N.P. than to pay an actual psychiatrist. Once a "provider" gives you a diagnosis, it tends to get carved in stone, and every subsequent provider may just rubber stamp it.

If the N.P. cares something about you, that might make her better than some others, but it doesn't make her competent to diagnose. Autism and schizoaffective disorder can have features that resemble other disorders. Teasing out exactly what's going on can sometimes take years. It was a psychiatrist who told me that. It really is a guessing game to some extent.

It is good that you are finding 2 meds helpful. The other thing you need is therapy to learn to manage having a mental health challenge. Every human is dealing with some big challenge. In that sense, you are like everyone else.

Therapy shouldn't focus on a psych diagnosis. It should focus on what is not going well in your life and what you can do about it.

I think a psych issue has 2 layers, so to speak. There is how we feel inside. Secondly, there is how we interact with the world around us. A good therapist should help a client see where they may need a different behavioral strategy to get what they want in life. Two clients with the same psych diagnoses may have vastly different problems in working out how to have successful lives. One size does not fit all.

I can believe that you have not been well served in your search for effective help. Don't give up.