Despite psychiatry recognizing the importance of a good fit, you and your doctor still might not get on. Nonetheless, if you're itching to "break up," talk about it in your session. Your hunch may be right. Or not. In any case, it won't offend your doctor (if it does offend, your doctor is definitely not the right one for you).

Early departures are tricky. Let's say the side effects of a new medication kick in before the medicine itself takes effect. You don't like it, but your doctor hopes you'll hold on. Should you hang on or not? In most cases, communication leads to a win-win solution, but not always.

Dr. Stephen Bishop, a Denver-based psychiatrist, says he sometimes experiences "a tension in the first meeting that might be hard to describe," which may lead to early termination. He points out that some people simply leave with no explanation. "Most of my patients who terminate abruptly simply cancel or no-show for their next appointment," he says. He suspects that it "usually has to do with that intangible 'chemistry' between doctor and patient."

In 1996, Congress passed the Health Insurance Portability and Accountability Act (HIPAA) to strengthen patients' rights. The Department of Health and Human Services appended a "privacy rule" to specifically protect the security and privacy of health data from things like unauthorized disclosure of your medical records or notes from your therapy sessions.

Despite HIPAA and the strict guidelines of psychiatry's own code of ethics, a surprising number of practitioners still lose their license every year. However, abuse is not the norm. Most psychiatrists are highly motivated, deeply empathic professionals. Their ultimate goal, uncertain as it is lofty, is to help people make profound, long-term, transformational change.

As in all professions, some people over time prove unfit, but it works both ways. Patients get fired, too. For example, were you to steadfastly refuse your meds, your doctor would stop treatment, at least temporarily.

That said, the following ten warning signs mean treatment has gone south and it's time for you to move on. These examples involve disrespect, insensitivity and betrayals of trust, confidentiality and other ethical principles by a doctor and are never your fault.

The top ten warning signs you need a new shrink

No. 10 -  Distraction: You no longer feel focused in session. Your doctor takes phone calls while talking with you. Is it an emergency, or is it a stockbroker?

No. 9 -  Lack of connection: Your doctor seems disinterested, hardly speaks, or types session notes without making eye contact with you.

No. 8 - Arrogance or disrespect: Your doctor is less interested in how you see things than in the brilliance of their own interpretations and focuses on concerns that are not your priorities.

No. 7 -  Judgment and criticism: Your doctor encourages you to open up and share, but seems horrified by what you say, puts you down or is critical in some way.

No. 6 - Your psychiatrist assures you of after-hours availability in an emergency, but is not there when needed.

No. 5 - Your psychiatrist yells at you for any reason at all.

No. 4 - Your psychiatrist falls asleep in session and blames you for speaking in monotone.

No. 3 - Your psychiatrist calls you at home asking for any advice.

No. 2 - Your psychiatrist breaks confidentiality, commenting to you about another patient.

No. 1 warning sign that you picked the wrong therapist -  Your psychiatrist tries to exploit you sexually, in the guise of treatment.  This behavior may be illegal and is certainly in violation of any medical professional's code of ethics.  A patient can and should report unethical behavior to the American Psychiatric Association.

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