I'm in Canada, so, there are available options for immediate, what I would call 'emergency' needs - in fact, I could walk into the emergency room here and ask for help - and I'm sure I'd get it. I had to take someone I was involved to the hospital, for suicide prevention once, so I do know the drill. If it comes to it, I hope I have the strength to do it.
I've decided to wait on a Dr visit, until I've spoken with my counselor on Monday, and see what they recommend. I made the appointment with my family doctor anyways, as a back up plan, but I would tend to agree with your assessment - regular family Dr's are generalists - I think I'm in need of a specialist. That said, however, about two years ago, I did get a referral to see a psychiatrist - advised him that I have exceptionally unhealthy thoughts, regularly (at that time, once or twice a week) - and after an hour or so, he decided that at best, I was a little stressed, but otherwise fine, and not in need of treatment. It was quite a blow, here I was thinking I was severely depressed - full of constant self loathing, a full and detailed plan on how to end my own life, appetite problems, sleeping problems - but, as it turns out I was "a bit stressed, but otherwise, okay". Hard to reconcile the feelings you have, when the 'professional' tells you you're fine.
In truth, it leaves you feeling like you were an enormous fool, and that you should just 'walk it off' already and quit whining about it. Which, needless to say, had made it difficult to go back and look for additional help. And I should be clear, this was a full PhD Psychiatrist - not a psychologist, or a councillor. I had to wait nearly 3 months to get an appointment with him, and I saw his degrees hanging on the wall. He told me he deals with "the mentally ill" and that I "wasn't that bad off, really, and didn't need any treatment" - And those are direct quotes, I remember them as if they were yesterday.
All in all, 'hopelessness' has been a constant companion through this process. After reaching out again to a psychologist, and being regaled by the stories of her visiting her dying mother, and believing the spirit of her dead brother (who committed suicide) was standing beside the bed, full of remorse (I wish I was making that up), to confiding in a counselor that I had a phobia of confrontation, only to have them promptly get in my face (literally, inches from my face) and shouting at me (again, I wish i was making that up) to show me that what I felt was confrontation, wasn't what she thought confrontation was - and that I needed to clarify my statement. Only to be followed up by another therapist who (after 2 whole sessions) advised me that I should go see a specialist, oh, and there would only be a 2-3 month wait. It also wasn't covered by my insurance, and who wanted me (I kid you not) to try to balance myself on a ball, so she could see where the imbalance in my psyche was...
All in all, a very difficult battle to even keep going back.
I wont even get started on the HORRIBLE experience I've had with medication - sufficed to say far from merely not working, it made things significantly worse.
And to know, that even after all this trouble, all of these hurdles - my wife believes that I just 'gave up' on her, the relationship and myself. It's heartbreaking. But - all that aside, I WILL get better, I WILL keep looking for answers, and not for her, not for the relationship, but because *I* need to be better. For myself, to make sure my daughters have someone to walk them down the isle if they get marri