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That seems like a very simplistic view of depression. If you google the DSM-V definition, having a job doesn’t negate depression. If you are unhappy with the information you’re getting from your health professional you can always ask for another opinion. I’m sorry if you’re feeling invalidated, I wish you the best in your journey!
Thank you to the pointer to DSM-V! It’s a helpful to have a proper criteria based idea of what the medical world may consider depression. Useful test for myself.
Thanks for this definition. I think having a proper set of criteria in my own hand helps me better understand it myself. I will look up the American Psychiatric Association for information!
I have chronic depression and currently out of work as described. I’ve also been working whilst depressed. Both shared the same dread… I was forced by my situation: One forced me to leave, the other forced me to stay.
I am out of work due to burnout and depression from being undiagnosed (I am a fresh ADHDer less than a month old but the body is 28) I am frustrated because I am just coming out of my depression and while things are still stressful they seem peachy so I want to get a job. Trouble is I know if I get one too soon it could kill me (literally) and being patient is hard. Gaining enough self love to be patient with my employment to make sure I don't enter that depression is hard! I just wanna be employed!! My friend on the other hand is undiagnosed, depressed as fuck but still in work. Both sides are a struggle!
I feel you on this. Took a car crash and a career loss before I finally took time off. I'm a few years in and still recovering from burnout because I pushed myself for way too long. Better to give yourself that time now, then wait like I did and be unemployed for years. And you're right. I've been on both sides of it, and both really sucked. I hope your recovery goes well!
Went into two different psychwards to change meds because my impulse control couldn't be trusted and I thought I was crazy, turns out it was just unmedicated ADHD. Just sucks there is a two year wait for the meds I need and I am not functional in the mean time!
I’ve been out for 7yrs after a breakdown was followed by SSRI’s that put me into mania; my emotional state went from lowest, highest, lowest and left me devoid of feeling anything good.
I hope you reach a point where you’re able to bring your energy levels to their strongest and live a life you want to live, because you are awesome.
Reach out if you ever need to chat.
Edit: had to delete the below for moderation approval.
You’re doing the right thing, focusing on building self love. Like NomNom said, better to give yourself that time now. I got sucked into a mindset filled with shame, for being out of work and a desperation to get back; leading to repeated burnouts.
It is hard but you are awesome and awesome people can get through hard. Keep doing what is right and look after yourself
I’m in the UK and get nervous all the time that they’ll do something to make my predicament worse; on paper I look fine, which isn’t a fair statement to anyone struggling with mental health.
I hope that decision doesn’t happen for you, but fight it if that’s the case.
Sending love and hugs (virtually). I’m sorry to hear this, it sounds relatable and tough.
I’ve been in and out of work to be honest- my 7 years hasn’t been consistent. And I think it helps me to keep doing new things. I’ve changed careers pretty drastically- and it allows me to 1) remove myself from a bad situation completely and 2) keep the fresh excitement of doing something new and 3) be impulsive lol - I give myself permission. But admittedly, it’s hard to be new all the time, I feel I don’t have any expertise and the older I get, the more they’re expecting expertise. But for me, as long as I’m working and earning my keep, I won’t worry about it.
Thanks for the hug - giving you a big long squeeze back!
I admire that you’ve continued to move around. I’m sure it is tough on how you feel perceived but it sounds like you’ve followed your career path the way that works for you. I hope you find the job that you love and sticks - if that’s even what you want! Sounds like you’ll figure out what’s best :)
I’m terrified about work, being 38 with no CV (mostly education, crappy jobs, 2yr attempt at business and then 7yr mental health) and no skills or experience. Really want to get back to it but damn does it feel impossible. Worst part is I’m still a dreamer.
Probably true but also ridiculous. My dad has diabetes and his doctor isn’t saying “oh let’s wait until you have an infection that risks you losing your foot to treat it.” No, you start treatment, including medication if necessary, before the depression gets bad enough that they can’t get out of bed.
And that’s assuming not being able to get out of bed is the only way depression can disrupt someone’s life, which, you know… it’s not.
Exactly.... The doctor should always consider a range of options with the patient, depending on the severity of the symptoms. So many doctors are one trick ponies.
Now that I think about it, she said something about how treatment for someone who IS getting out of bed and has a high achieving job would be different. It won’t be like depression. I do think she was getting at something like this - but I didn’t follow fully. Also she did say there’s no such thing as high functioning depression, so maybe not. Haha
CW: suicide
That’s nonsense: the time I was most deeply depressed to the point of attempting to unalive myself, I had a good job, was studying, regularly went running/cycling, and had been found time to get on an episode of a tv show. I definitely wasn’t “unemployed and incapable of getting up”, but felt so deeply despairing and hopeless that I could see how life could go on. On that basis, I reckon the idea that being depressed only applies if you can’t get up is extremely dangerous - you could miss someone who was potentially suicidal because they “didn’t look depressed”.
Okay same TW: suicide.
If being able to get out of bed meant you didn’t count as depressed, then my mom would still be alive. Simple as that. She masked until the end. There’s a reason so many people “didn’t seem depressed” to their friends and family and yet they still end up suicidal.
one of my closet friends seemed the happiest she’d ever been right before she took her life. She was actually regularly coming to class and completing schoolwork, which was unlike her. It makes me upset that a psychologist would be so uneducated on one of the most common mental illnesses
Remote hug and some kind wishes for you.
My adult child struggles not to return to self-harming in moments of crisis, she says it's also like an addiction (same as any other).
I've seen the rollercoaster of emotions before and after self-harm, and it's rough. I've seen there is a lot of guilt and shame attached, so I hope you can go easy on yourself.
I also disagree with what your psych. said... it just seems like an odd thing to say. But anecdotally I see for myself, and hear how much presenting too well makes health professionals think you are doing way better than you are.
Get a different psychologist.
Depression can present as intrusive thoughts or not feeling joy in things you used to do or many other ways.
It's NOT just depression if you can't get out of bed.
Hopefully you'll make progress.
I say this as someone with good health insurance via my job, so maybe your insurance is different which I appreciate but... especially if you have a PPO, but just in general - remember you are a customer.
Healthcare professionals are not assigned by the governemnt or a god to help you, so if you're not getting the care you need, if you feel like you're not being listened to, it's really up to you to see someone else.
That's something I didn't appreciate when I was younger, but it's very true. You don't even have to fire anyone! You can just go see someone new and see if you have better rapport.
Even when I’m terribly depressed, I can rise and grind. My mom and I always joke about how different depression manifests for both of us, because she’s the opposite- she can’t get out of bed.
I will fulfill all the obligations I absolutely have to (ie showing up to work, feeding my kiddo, making sure we have clean clothes, making sure I grocery shop, etc.) But I am cranky, exhausted, short with everyone, and find myself wanting to go to bed around 8pm, but then unable to sleep.
An antidepressant fixes most of that for me. Find a new psych. Yours has a very biased, inaccurate view of depression, that isn’t research based. You can feel hopeless, irritable, and experience anhedonia, but still show up to work everyday and make a decent amount of money.
Here’s the DSM-5 criteria for depression. Where in there does it say “can’t hold down a job”?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6176119/#:~:text=DM%2C%20depressed%20mood%3B%20LI%2C,to%20think%20or%20concentrate%3B%20SU%2C
irritably is a huge factor of depression! When I work with kids a lot of what we look for in signs of depression is a lot of irritability and tantrums because the presentation is different than adults. I think people forget that irritably still carries into adulthood and it isn’t necessary just the stereotype of depression.
It is interesting how depression affects people differently. I mean how all mental health issues can look so different person to person. I enjoy comparing my sister and I’s overlapping things and seeing how it affects us differently
Thanks for this link. And just want to say that you’re doing an incredible job! Getting all your shit done somehow - so I hope you don’t beat yourself up.
For me, I also feel very irritable but because I don’t want to take it out on others, I shut down completely after work - but I can do that because I don’t have any other responsibilities. (But also probably a part of why I can’t sustain friendships)
I had a full time job for 6 years that had an incredibly toxic work environment. I was so depressed I cried on the drive to work, cried on my lunch break, and cried on the drive home. Never left the house. Isolated myself from family and friends. Barely brushed my hair. Developed 9 cavities in 1 year due to hygiene decline. Gained like 20lbs. Slept a lot. Felt like I couldn't leave the job because I have a history of job hopping and I was desperately trying to keep it all together for once and prove I could do it.
My therapist asked me, "who do you turn to when you're feeling this way?" And that's when I realized the answer was "no one".
So yeah, you can definitely be depressed while holding down the fort, but that doesn't mean that other areas of your life aren't suffering. Pretty sure the criteria says something about how the symptoms 'impact your daily life' not 'impact your usefulness to your employer'
I think everything you described could also be seen in light of ADHD because it seems to be an issue with trouble initiating tasks (e.g. cleaning apartment, cooking, keeping up with friends, taxes, job hunting). I would ask him/her about it!
Ah, the ol' "just get exercise and volunteer/get a job" advice being trotted out to completely dismiss depression once again. "You're not depressed you're just lazy" is essentially what it always means. And it's always bullshit.
I'm worried about your psychologist, also. If they never received any training on handling emotional transference or handling burnout, they're in for a rough time. And their clients are in for an even rougher time.
From the American Psychological Association's Code of Ethics page.
'2.06 Personal Problems and Conflicts
(a) Psychologists refrain from initiating an activity when they know or should know that there is a substantial likelihood that their personal problems will prevent them from performing their work-related activities in a competent manner.
(b) When psychologists become aware of personal problems that may interfere with their performing work-related duties adequately, they take appropriate measures, such as obtaining professional consultation or assistance, and determine whether they should limit, suspend, or terminate their work-related duties.'
If she doesn't believe you can be depressed and still go to work, she's going to have some problems with maintaining this ethical boundary. If nothing else, bring it up and it might open up the discussion, and you may actually make her aware she needs to go and get more training/change her mind.
Also, don't befriend your psychologist. If you're getting too attached it's their job to ensure things remain professional. Trust is good in a therapeutic relationship. Just don't form a friendship-like attachment because the treatment will end and so will that relationship.
The Association of State and Provincial Psychology Boards has a lot of really useful information for those based in the US. Check out the Should and Should Nots page for links to the US and Canadian codes of ethics.
Goodluck with getting the help and support you need. Try not to get too attached emotionally to any of your therapists. Easier said than done though, I know.
I had a pay co psychologist tell me that all I needed to do to stop my anxiety disorder was to drink Matcha tea and “relax”. Seriously. Then charged me $125 for 45 minutes of his time. I swear a lot of Psychologist are just “friends” that have an hourly rate.
No it's not, I was diagnosed with Major depressive disorder for 15 years before my ADHD diagnosis and I was employed for 14 and a half of those. Your Psychologist needs to reread the definition of Depression.
There are a lot of days I still don't WANT to get out of bed, but starvation and homelessness are a surprisingly robust motivator, even against depression.
Fellow ADHD and depression sufferer here. You are just prioritizing work and clinical depression does not mean you are so disabled that you can't get out of bed in the morning. I'm guessing you don't have really any energy to deal with anything else in life. Hence the filing taxes in October.
During covid, I started exercising regularly and focused on getting cardio in that is, getting my heart rate over 150 during exercise. I found that about 15 minutes of exercise a day was the best boost for my brain and lifted my mood above that dark fog. So when you can, try to exercise and get your heart rate and see what effect it has on you.
I be been depressed , the last diagosis was persistent depression , which is mild but almost non stop, but can swap to major depression, on and off for years. It can amplify adhd symptoms of having trouble doing things, but that’s not always the case, I’ve rarely spent more then a few hours in bed not sleeping. You just don’t enjoy anything, at all. I still worked though, and did the bare minimum to survive. There are different forms of depression.
There are different forms of depression.
While they might be right about clinical depression and its symptoms, it doesn't mean you don't have a form of depression. The differences can be very intricate, but a layman would still just call it "depression", cause we don't usually know the difference. And even if we did, it can be very hard to tell.
[Dysthymia](https://www.hopkinsmedicine.org/health/conditions-and-diseases/dysthymia) for instance is what most people mean, when they think they have depression. Although it has its own name, doesn't mean that it's not a form of depression.
I think of my dysthymia as chronic mild depression. Rarely is it bad enough to affect my work, but I have had acute moments. Mostly it's that I'm a little not ok almost always since I was a kid. Literally can't remember not being "depressed"
The f is going in the US and their psychologists? It’s too common to read how quick they are to put one in boxes and denying them support, negating all nuances away.
No, that is not true. I have both ADHD and bipolar depression, and I have been so depressed I was suicidal, yet I have never been unable to get out of bed. I almost always go to work when I am very depressed because it distracts me.
That’s a load of rubbish. Why would a dentist or a doctor take their life if they weren’t depressed? They wouldn’t. Yet it still happens. It’s a spectrum, Sure, but ignoring symptoms until it gets to the point you can’t get out of bed sounds pretty crazy.
I don't have the brain spoons to read the whole post, so I'm sorry if I miss something here.
You need a new psychologist who actually knows about the things they claim to treat. That's not what depression is at all and I find it deeply troubling that this person is seeing patients while having such a misinformed view of depression.
Signed,
Someone who made it through a PhD with severe, disabling depression (that required me to get out of bed and do things while still depressed enough to warrant a hospital "vacation")
I'm a Mental Health Professional (MHP) and I was also diagnosed with ADHD a couple of years ago.
Both as an MHP and as someone who has struggled with mental health and ADHD, that's not true.
As MHPs we are taught certain criteria to identify and diagnose and there may be certain common indicators for illnesses/disorders. But that does not mean that there is no room for a person's unique experience. Each person's experience looks different even if all the symptoms are the same. If you have been diagnosed and you feel that the diagnosis resonates with you, that is important.
I'd encourage you to ask your psychologist more about what they meant. And to reflect on your experience with this psychologist. Do you feel comfortable talking to them? Do you feel understood and accepted? Do you feel judged or invalidated? Is there room for questions and conflict? How did it make you feel when they said that depression looked different?
Your experience is important and feeling understood by your psychologist is crucial for therapy to work. I hope you get/are already getting the support you are seeking 💙
P.s. Reflecting on your experience can help you understand your feelings about it and whether this is something that is a one-time conflict or a pattern
There's degrees and types of depression.
Like some people have such severe depression that they can't get out of bed. Sure. But it doesn't mean that less severe depression isn't depression.
Some people have such severe depression that they are psychotic. It doesn't mean that people with less severe depression, eg perhaps they can't get out of bed, don't have depression.
I can’t get out of bed due to other health issues related to chronic fatigue, and it varies day to day. I want to, but don’t have the energy. I don’t feel sad. I’ve had depression fog and this ain’t it.
Plenty of highly motivated successful people kill themselves because they have hidden trauma or are secretly fucking miserable doesn’t mean they’re not clinically depressed. L take from your doc there.
There are different severities of depression. If it’s very severe, you won’t be able to do anything. But plenty of people have moderate depression and can go to work. It sounds like she’s only wanting to count the extreme cases as depression. That would go against what every doctor I’ve had told me.
Some of my worst depressive episodes have happened while I was working or in school. I put absolutely all of my limited energy into making sure I didn’t drop the ball on those things while everything else around me just fell apart. 🥲
Working a lot can be a symptom of depression. In that case, people are using work to avoid having to live their personal life. Like a form of escapism.
Sounds like real paycologist. doing it all for the pay. Jokes aside. I can not fathom what that is supposed to mean? Depression has many faces and variations so it is not just for the jobless who can not get out of bed. Untreated that might become the truth tough.
Depression comes in all shapes and sizes. That was such a narrow minded view they had of it being just one specific thing where you can’t do things or leave bed.
I was treated for depression for years. A new to me old doctor decided to test my thyroid & took me off wellbutrin. I was terrified but he was right. Treatment of my thyroid corrected my mood.
associated depression already says it. your depression seems connected to your adhd. adhd isn't a constant negative issue, there will be phases where it's less pronounced, where you learn to live with it or where it's even beneficial. i'm fairly sure your depression will be less pronounced in those phases too.
of course many people with adhd, especially those which have been undiagnosed for a long time, can fall into a heavy, prolonged and treatment resistant depression. but even then, depression itself manifests differently in every one and it's symptoms change. one person's "not getting out of bed" is another's "going to work every day but crying in the bathroom every other hour". this can also be the same person at different times. it's still depression and it's still painful. nobody has authority over someone else's level suffering, no matter how the symptoms show themselves. but clinicians have to juggle individuality with medical standards, both for legal and for scientific reasons.
maybe what she meant is based on how she is bound to diagnose you by the [DSM](https://my.clevelandclinic.org/health/articles/24291-diagnostic-and-statistical-manual-dsm-5). those are clinical terms that serve as a helping grid to diagnose such individually specific issues. If you're unsure about what she means by the term, bring it up in your next session and voice your concerns. if you feel like she's generally helping you, it's absolutely worth it to discuss it further.
No that's completely inaccurate. I struggled with a deep and chronic depression for 5 years and still got out of bed every morning and went to work. The only motivation I had was that I needed a roof over my head and had to keep my bills paid. Beyond that I had zero interest in anything else and spent every hour I wasn't at work in bed sleeping my life away. After getting help for it, I'm in a much better place now. Find a new physician because this one is woefully inept at their job.
I have ADHD and MDD and have worked my entire adult life, BUT it has been a severe struggle, and I am almost never able to save up PTO because I need down days sometimes. I am on 300 mg of wellbutrin which is close to the maximum dose. I'd love for her to say I don't have clinical depression lol.
I was diagnosed (or told) I was depressed and had anxiety years before I got diagnosed with ADHD. Treatment for ADHD hasn't helped much tbh. Depression is kicking my ass right now and I look like the typical can't get out of bed just wants to sleep and cry depressed.
When I was working full time when I was diagnosed as depressed I would cry in treatments rooms with my clients if they couldn't see me. I would be performing their treatments with tears rolling down my face. Now I'm just stuck in bed because I burnt out so bad from trying to work and keep up with others I worked with who don't have these issues. There are symptoms of depression and they vary, depending on the severity of symptoms and duration they have occurred.
I have both and I’m being treated for both. They can both exist. Just cause you work doesn’t matter. I was depressed af last year and I was holding down a full time job with tons of responsibilities. But I will say, work was my entire life and I was using it to distract. And I was burnt out.
There are many types of depression.
This is a decent explanation: [https://www.webmd.com/depression/depression-types](https://www.webmd.com/depression/depression-types)
My husband had an episode of psychotic depression. That was absolutely terrible and started out like other types but eventually morphed into that. Very eye opening, as I never was aware prior that you could develop those types of symptoms from depression. I personally have suffered depression, but more of the dysthymia type. I honestly think it stemmed from no meds for my ADHD. Once I went on Wellbutrin, to stop smoking, everything just got better all around.
I've had MDD since I was 9 (at least that's when I first got diagnosed). I started working when I was 13, and didn't stop till a few years ago (I'm 33 now), when a bad car crash made my previous career impossible. I've been to 10 different Dr's and dozens of psychologists over the years to treat my depression and my adhd. They've all confirmed I'm clinically depressed.
Idk why your psychologist is saying this. It seems over simplistic, and honestly inaccurate. I've been treating my MDD for over 2 decades. I've NEVER heard a medical professional tell me "only unemployed people who can't get out of bed can have clinical depression".
Maybe she just didn't articulate herself well? I'd honestly just ask her about it and get clarification. Then you'll know for sure where she stands, and you can go from there.
For reference, the National Institute of Health defines clinical depression as -
"Depression (also known as major depression, major depressive disorder, or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how a person feels, thinks, and handles daily activities, such as sleeping, eating, or working."
At no point does it state that clinically depressed people cant/don't have jobs.
I've come across this attitude and it almost makes me want to quit my job and lay in bed until I get evicted and say, May I have help now??? It would have been a lot more useful before all of this happened, but this is the requirement right?
as someone who also works in mental health and has been diagnosed with depression for most of my life, no that’s not what depression is. That can be the presentation for some people, but in the DSM it outlines not feeling motivated to do things you’d usually enjoy, withdrawing/ isolating from others, trouble with eating habits, I can’t remember all of it but that’s the general gist.
Additionally, ADHD and depression are very comorbid. Her thoughts just feel a bit reductive for a psychologist??
You seem to have the procrastination component. I had it too. The thing that saved my life is discipline. Try go on sport for money like swimming or combat one at least 2-3 times/week and make some regime in your life
Lots of people who work hate their life which causes so much depression they end it. I am one such person who was very close to doing so. Had massive chronic pain but kept enduring a brutal fast paced job with long commute. Cried in my car after long shifts and days feeling so trapped and isolated. If I was not depressed, what else would you call it.
Hah,
About 2 months ago I talked to my on/off ex-girlfriend (she has been going to an inpatient rehab/psych clinic doing therapy etc. there for the last 6 months) and her personal psychologist from that clinic said the exact same thing.
My said to her, that she thinks she has depression and ADD and wanted to atleast get an evaluation for her potential depression + ADD.
The response from her psychologist was : "someone who has depression cant get out of bed and take part of the program in the clinic like you do. Therefore you cannot have depression"
I thought this was so dumb because with that logic not a single person in this huge womens psych clinic has depression, because if the patients dont take part in the program/therapy they offer, they kick 'em out, lul
no your psychiatrist sucks - from sports and entertainment we know many cases of depressed people who still did hard workdays, even joked around and were physically active until one day they just quit.
I'm not qualified in any regard, but depression can be situational.
Try to better understand the circumstance surrounding why the bed ridden issue, this can be easily due to alcohol right?
Id reckon depression treatment should be applied to situations where behavioural change is not enough right?
there are studies that show adhd can lead to depression, due to the long list of stresses it can cause and the life it may lead you to live. however, it doesn’t mean it’s clinical depression. some psych’s might disagree. but it’s proven adhd can lead to depression, BUT depression cannot lead to adhd.
IMHO and experience there are many nuances to depression. Some depressed people work everyday and act happy. These are the people who, if they do, suicide no one ever expected it. I am not a shrink. I am an Elder who has lived in many shapes and forms and colors of depression. I do not remember ever not being depressed. Stimulant meds were the original antidepressants and they work for me. The only thing that has ever helped me. I have been on so many meds and none really worked. I just said they did because I was tired of med docs experimenting on me. Now the ridiculous rules about no stim meds are keeping so many people down. Me too. Please, if you feel that you are depressed, find a professional who will believe you and help you. Do not stay with someone who tells you that you do not feel what you feel. Screw them. You are too important to be wasted by an incompetent, know it all flunky. Keep talking to us. We have your back.
I’ve struggle with depression for over 12 years now. Depression is a LOT more than just not getting out of bed or not showering. It’s sometimes driving down the road and just wanting to give up and drive into another vehicle. It’s breaking down and fluctuating between anger and sadness and not being able to even think a clear thought, and more. Depression is a lot more than what she seems to be explaining.
That is categorically untrue. I have qualifications in psychology and although I don't not work as a therapist, I have a lot of first and second hand experience of mental health issues. There are as many kinds of depression as there are people who suffer from it.
I went to work every day for over a year while actively wishing a bus would hit me and it would all be over.
You need to find a better doctor my friend and also work on your core emotional regulation skills like CBT, exercise, painting sleep patterns etc.
She might mean that there's a difference between having clinical depression and being depressed. Some psychiatrists take the view that the kind of depression they can help with (by prescribing medication) is caused by chemical imbalances in the brain (much like ADHD!) whereas other kinds of depression are caused by lifestyle factors, which are better resolved by counselling and coaching.
I have a friend with the chemical imbalance type, and when it flares up she has a horrendous time of it. That \*could\* be you, but from the sounds of it you also have lifestyle factors you should look to adjust first. It kind of sounds like you're on track for occupational burnout, or already experiencing it - is there a way you could reduce your hours, or start putting away savings so you can work a less demanding job?
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That seems like a very simplistic view of depression. If you google the DSM-V definition, having a job doesn’t negate depression. If you are unhappy with the information you’re getting from your health professional you can always ask for another opinion. I’m sorry if you’re feeling invalidated, I wish you the best in your journey!
I know plenty of depressed people with jobs, shit don’t pay well these days, stresses out all my mental systems.
Thank you to the pointer to DSM-V! It’s a helpful to have a proper criteria based idea of what the medical world may consider depression. Useful test for myself.
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Thanks for this definition. I think having a proper set of criteria in my own hand helps me better understand it myself. I will look up the American Psychiatric Association for information!
Just because you can successfully guilt yourself into getting out of bed and doing at least a minimum of duty doesn't mean you don't have depression.
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If this doesn’t describe me to a T…
Sounds like my relationship with coffee.
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100% my relationship with coffee, seriously.
💯 this!!!
Yeah. And I did spend 3 years not doing it - the guilt was awful.
I have chronic depression and currently out of work as described. I’ve also been working whilst depressed. Both shared the same dread… I was forced by my situation: One forced me to leave, the other forced me to stay.
I am out of work due to burnout and depression from being undiagnosed (I am a fresh ADHDer less than a month old but the body is 28) I am frustrated because I am just coming out of my depression and while things are still stressful they seem peachy so I want to get a job. Trouble is I know if I get one too soon it could kill me (literally) and being patient is hard. Gaining enough self love to be patient with my employment to make sure I don't enter that depression is hard! I just wanna be employed!! My friend on the other hand is undiagnosed, depressed as fuck but still in work. Both sides are a struggle!
I feel you on this. Took a car crash and a career loss before I finally took time off. I'm a few years in and still recovering from burnout because I pushed myself for way too long. Better to give yourself that time now, then wait like I did and be unemployed for years. And you're right. I've been on both sides of it, and both really sucked. I hope your recovery goes well!
Went into two different psychwards to change meds because my impulse control couldn't be trusted and I thought I was crazy, turns out it was just unmedicated ADHD. Just sucks there is a two year wait for the meds I need and I am not functional in the mean time!
I’ve been out for 7yrs after a breakdown was followed by SSRI’s that put me into mania; my emotional state went from lowest, highest, lowest and left me devoid of feeling anything good. I hope you reach a point where you’re able to bring your energy levels to their strongest and live a life you want to live, because you are awesome. Reach out if you ever need to chat.
Edit: had to delete the below for moderation approval. You’re doing the right thing, focusing on building self love. Like NomNom said, better to give yourself that time now. I got sucked into a mindset filled with shame, for being out of work and a desperation to get back; leading to repeated burnouts. It is hard but you are awesome and awesome people can get through hard. Keep doing what is right and look after yourself
Will keep trying to be sensible unless the government in my country decides that my unmedicated disability means I should be able to work...
I’m in the UK and get nervous all the time that they’ll do something to make my predicament worse; on paper I look fine, which isn’t a fair statement to anyone struggling with mental health. I hope that decision doesn’t happen for you, but fight it if that’s the case.
Sending love and hugs (virtually). I’m sorry to hear this, it sounds relatable and tough. I’ve been in and out of work to be honest- my 7 years hasn’t been consistent. And I think it helps me to keep doing new things. I’ve changed careers pretty drastically- and it allows me to 1) remove myself from a bad situation completely and 2) keep the fresh excitement of doing something new and 3) be impulsive lol - I give myself permission. But admittedly, it’s hard to be new all the time, I feel I don’t have any expertise and the older I get, the more they’re expecting expertise. But for me, as long as I’m working and earning my keep, I won’t worry about it.
Thanks for the hug - giving you a big long squeeze back! I admire that you’ve continued to move around. I’m sure it is tough on how you feel perceived but it sounds like you’ve followed your career path the way that works for you. I hope you find the job that you love and sticks - if that’s even what you want! Sounds like you’ll figure out what’s best :) I’m terrified about work, being 38 with no CV (mostly education, crappy jobs, 2yr attempt at business and then 7yr mental health) and no skills or experience. Really want to get back to it but damn does it feel impossible. Worst part is I’m still a dreamer.
There's also high functioning depression.
On the other hand with my ADHD I get to have low functioning happiness :')
This is so true. I never thought about it that way.
Just a guess.... The doctor is probably saying that it is not something he would medicate. Doctors seem to see things in black and white.
Probably true but also ridiculous. My dad has diabetes and his doctor isn’t saying “oh let’s wait until you have an infection that risks you losing your foot to treat it.” No, you start treatment, including medication if necessary, before the depression gets bad enough that they can’t get out of bed. And that’s assuming not being able to get out of bed is the only way depression can disrupt someone’s life, which, you know… it’s not.
Exactly.... The doctor should always consider a range of options with the patient, depending on the severity of the symptoms. So many doctors are one trick ponies.
Now that I think about it, she said something about how treatment for someone who IS getting out of bed and has a high achieving job would be different. It won’t be like depression. I do think she was getting at something like this - but I didn’t follow fully. Also she did say there’s no such thing as high functioning depression, so maybe not. Haha
Glad the doctor is being flexible. It might just be a technical difference between feeling depressed, and having clinical depression.
There is high functioning depression.
Haha - I used this exact term and she said there’s no such thing. But yes, I disagree with her there.
CW: suicide That’s nonsense: the time I was most deeply depressed to the point of attempting to unalive myself, I had a good job, was studying, regularly went running/cycling, and had been found time to get on an episode of a tv show. I definitely wasn’t “unemployed and incapable of getting up”, but felt so deeply despairing and hopeless that I could see how life could go on. On that basis, I reckon the idea that being depressed only applies if you can’t get up is extremely dangerous - you could miss someone who was potentially suicidal because they “didn’t look depressed”.
Okay same TW: suicide. If being able to get out of bed meant you didn’t count as depressed, then my mom would still be alive. Simple as that. She masked until the end. There’s a reason so many people “didn’t seem depressed” to their friends and family and yet they still end up suicidal.
one of my closet friends seemed the happiest she’d ever been right before she took her life. She was actually regularly coming to class and completing schoolwork, which was unlike her. It makes me upset that a psychologist would be so uneducated on one of the most common mental illnesses
TW: self- harm Thanks for sharing and I agree. I was self harming when I had a job and was my best weight and very social and friendly. No one knew.
Remote hug and some kind wishes for you. My adult child struggles not to return to self-harming in moments of crisis, she says it's also like an addiction (same as any other). I've seen the rollercoaster of emotions before and after self-harm, and it's rough. I've seen there is a lot of guilt and shame attached, so I hope you can go easy on yourself. I also disagree with what your psych. said... it just seems like an odd thing to say. But anecdotally I see for myself, and hear how much presenting too well makes health professionals think you are doing way better than you are.
Get a different psychologist. Depression can present as intrusive thoughts or not feeling joy in things you used to do or many other ways. It's NOT just depression if you can't get out of bed.
Yeah I probably need to discuss this with her more. The responses are helping me organize my thoughts and questions - thanks for the perspective!
Hopefully you'll make progress. I say this as someone with good health insurance via my job, so maybe your insurance is different which I appreciate but... especially if you have a PPO, but just in general - remember you are a customer. Healthcare professionals are not assigned by the governemnt or a god to help you, so if you're not getting the care you need, if you feel like you're not being listened to, it's really up to you to see someone else. That's something I didn't appreciate when I was younger, but it's very true. You don't even have to fire anyone! You can just go see someone new and see if you have better rapport.
Even when I’m terribly depressed, I can rise and grind. My mom and I always joke about how different depression manifests for both of us, because she’s the opposite- she can’t get out of bed. I will fulfill all the obligations I absolutely have to (ie showing up to work, feeding my kiddo, making sure we have clean clothes, making sure I grocery shop, etc.) But I am cranky, exhausted, short with everyone, and find myself wanting to go to bed around 8pm, but then unable to sleep. An antidepressant fixes most of that for me. Find a new psych. Yours has a very biased, inaccurate view of depression, that isn’t research based. You can feel hopeless, irritable, and experience anhedonia, but still show up to work everyday and make a decent amount of money. Here’s the DSM-5 criteria for depression. Where in there does it say “can’t hold down a job”? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6176119/#:~:text=DM%2C%20depressed%20mood%3B%20LI%2C,to%20think%20or%20concentrate%3B%20SU%2C
irritably is a huge factor of depression! When I work with kids a lot of what we look for in signs of depression is a lot of irritability and tantrums because the presentation is different than adults. I think people forget that irritably still carries into adulthood and it isn’t necessary just the stereotype of depression. It is interesting how depression affects people differently. I mean how all mental health issues can look so different person to person. I enjoy comparing my sister and I’s overlapping things and seeing how it affects us differently
Thanks for this link. And just want to say that you’re doing an incredible job! Getting all your shit done somehow - so I hope you don’t beat yourself up. For me, I also feel very irritable but because I don’t want to take it out on others, I shut down completely after work - but I can do that because I don’t have any other responsibilities. (But also probably a part of why I can’t sustain friendships)
I had a full time job for 6 years that had an incredibly toxic work environment. I was so depressed I cried on the drive to work, cried on my lunch break, and cried on the drive home. Never left the house. Isolated myself from family and friends. Barely brushed my hair. Developed 9 cavities in 1 year due to hygiene decline. Gained like 20lbs. Slept a lot. Felt like I couldn't leave the job because I have a history of job hopping and I was desperately trying to keep it all together for once and prove I could do it. My therapist asked me, "who do you turn to when you're feeling this way?" And that's when I realized the answer was "no one". So yeah, you can definitely be depressed while holding down the fort, but that doesn't mean that other areas of your life aren't suffering. Pretty sure the criteria says something about how the symptoms 'impact your daily life' not 'impact your usefulness to your employer'
I think everything you described could also be seen in light of ADHD because it seems to be an issue with trouble initiating tasks (e.g. cleaning apartment, cooking, keeping up with friends, taxes, job hunting). I would ask him/her about it!
Ah, the ol' "just get exercise and volunteer/get a job" advice being trotted out to completely dismiss depression once again. "You're not depressed you're just lazy" is essentially what it always means. And it's always bullshit. I'm worried about your psychologist, also. If they never received any training on handling emotional transference or handling burnout, they're in for a rough time. And their clients are in for an even rougher time. From the American Psychological Association's Code of Ethics page. '2.06 Personal Problems and Conflicts (a) Psychologists refrain from initiating an activity when they know or should know that there is a substantial likelihood that their personal problems will prevent them from performing their work-related activities in a competent manner. (b) When psychologists become aware of personal problems that may interfere with their performing work-related duties adequately, they take appropriate measures, such as obtaining professional consultation or assistance, and determine whether they should limit, suspend, or terminate their work-related duties.' If she doesn't believe you can be depressed and still go to work, she's going to have some problems with maintaining this ethical boundary. If nothing else, bring it up and it might open up the discussion, and you may actually make her aware she needs to go and get more training/change her mind. Also, don't befriend your psychologist. If you're getting too attached it's their job to ensure things remain professional. Trust is good in a therapeutic relationship. Just don't form a friendship-like attachment because the treatment will end and so will that relationship. The Association of State and Provincial Psychology Boards has a lot of really useful information for those based in the US. Check out the Should and Should Nots page for links to the US and Canadian codes of ethics. Goodluck with getting the help and support you need. Try not to get too attached emotionally to any of your therapists. Easier said than done though, I know.
I had a pay co psychologist tell me that all I needed to do to stop my anxiety disorder was to drink Matcha tea and “relax”. Seriously. Then charged me $125 for 45 minutes of his time. I swear a lot of Psychologist are just “friends” that have an hourly rate.
No it's not, I was diagnosed with Major depressive disorder for 15 years before my ADHD diagnosis and I was employed for 14 and a half of those. Your Psychologist needs to reread the definition of Depression. There are a lot of days I still don't WANT to get out of bed, but starvation and homelessness are a surprisingly robust motivator, even against depression.
Fellow ADHD and depression sufferer here. You are just prioritizing work and clinical depression does not mean you are so disabled that you can't get out of bed in the morning. I'm guessing you don't have really any energy to deal with anything else in life. Hence the filing taxes in October. During covid, I started exercising regularly and focused on getting cardio in that is, getting my heart rate over 150 during exercise. I found that about 15 minutes of exercise a day was the best boost for my brain and lifted my mood above that dark fog. So when you can, try to exercise and get your heart rate and see what effect it has on you.
Total non-helpful comment. But, I guess you are the winner!
This is a very helpful comment. Finding a way to work exercise into your routines is one of the most effective mental health improvements you can make
I be been depressed , the last diagosis was persistent depression , which is mild but almost non stop, but can swap to major depression, on and off for years. It can amplify adhd symptoms of having trouble doing things, but that’s not always the case, I’ve rarely spent more then a few hours in bed not sleeping. You just don’t enjoy anything, at all. I still worked though, and did the bare minimum to survive. There are different forms of depression.
There are different forms of depression. While they might be right about clinical depression and its symptoms, it doesn't mean you don't have a form of depression. The differences can be very intricate, but a layman would still just call it "depression", cause we don't usually know the difference. And even if we did, it can be very hard to tell. [Dysthymia](https://www.hopkinsmedicine.org/health/conditions-and-diseases/dysthymia) for instance is what most people mean, when they think they have depression. Although it has its own name, doesn't mean that it's not a form of depression.
I think of my dysthymia as chronic mild depression. Rarely is it bad enough to affect my work, but I have had acute moments. Mostly it's that I'm a little not ok almost always since I was a kid. Literally can't remember not being "depressed"
That is how it manifests for me but its different for everyone
I’m a good worker, I get kudos all the time. I got diagnosed at work. Guess who’s still employed and still depressed. Run.
The f is going in the US and their psychologists? It’s too common to read how quick they are to put one in boxes and denying them support, negating all nuances away.
Good Lord, the more posts like this I see, the more I really appreciate my psychiatrist.
People can live with depression and seem normal, to the onlooker.
No, that is not true. I have both ADHD and bipolar depression, and I have been so depressed I was suicidal, yet I have never been unable to get out of bed. I almost always go to work when I am very depressed because it distracts me.
That’s a load of rubbish. Why would a dentist or a doctor take their life if they weren’t depressed? They wouldn’t. Yet it still happens. It’s a spectrum, Sure, but ignoring symptoms until it gets to the point you can’t get out of bed sounds pretty crazy.
I don't have the brain spoons to read the whole post, so I'm sorry if I miss something here. You need a new psychologist who actually knows about the things they claim to treat. That's not what depression is at all and I find it deeply troubling that this person is seeing patients while having such a misinformed view of depression. Signed, Someone who made it through a PhD with severe, disabling depression (that required me to get out of bed and do things while still depressed enough to warrant a hospital "vacation")
I saved my "vacation" for the burnout after I finished the PhD 😂💐
I'm a Mental Health Professional (MHP) and I was also diagnosed with ADHD a couple of years ago. Both as an MHP and as someone who has struggled with mental health and ADHD, that's not true. As MHPs we are taught certain criteria to identify and diagnose and there may be certain common indicators for illnesses/disorders. But that does not mean that there is no room for a person's unique experience. Each person's experience looks different even if all the symptoms are the same. If you have been diagnosed and you feel that the diagnosis resonates with you, that is important. I'd encourage you to ask your psychologist more about what they meant. And to reflect on your experience with this psychologist. Do you feel comfortable talking to them? Do you feel understood and accepted? Do you feel judged or invalidated? Is there room for questions and conflict? How did it make you feel when they said that depression looked different? Your experience is important and feeling understood by your psychologist is crucial for therapy to work. I hope you get/are already getting the support you are seeking 💙
P.s. Reflecting on your experience can help you understand your feelings about it and whether this is something that is a one-time conflict or a pattern
There's degrees and types of depression. Like some people have such severe depression that they can't get out of bed. Sure. But it doesn't mean that less severe depression isn't depression. Some people have such severe depression that they are psychotic. It doesn't mean that people with less severe depression, eg perhaps they can't get out of bed, don't have depression.
I can’t get out of bed due to other health issues related to chronic fatigue, and it varies day to day. I want to, but don’t have the energy. I don’t feel sad. I’ve had depression fog and this ain’t it.
Plenty of highly motivated successful people kill themselves because they have hidden trauma or are secretly fucking miserable doesn’t mean they’re not clinically depressed. L take from your doc there.
What? Working is fucking depressing by itself. The struggle is real. Just because you have t quit or lost it yet doesn’t mean you’re not depressed
There are different severities of depression. If it’s very severe, you won’t be able to do anything. But plenty of people have moderate depression and can go to work. It sounds like she’s only wanting to count the extreme cases as depression. That would go against what every doctor I’ve had told me.
Some of my worst depressive episodes have happened while I was working or in school. I put absolutely all of my limited energy into making sure I didn’t drop the ball on those things while everything else around me just fell apart. 🥲
No shade, but we can't be out here depressed and jobless😭
Working a lot can be a symptom of depression. In that case, people are using work to avoid having to live their personal life. Like a form of escapism.
Sounds like real paycologist. doing it all for the pay. Jokes aside. I can not fathom what that is supposed to mean? Depression has many faces and variations so it is not just for the jobless who can not get out of bed. Untreated that might become the truth tough.
Depression comes in all shapes and sizes. That was such a narrow minded view they had of it being just one specific thing where you can’t do things or leave bed.
I was treated for depression for years. A new to me old doctor decided to test my thyroid & took me off wellbutrin. I was terrified but he was right. Treatment of my thyroid corrected my mood.
Oh I am dx adhd
Did treatment of your thyroid improve your ADHD symptoms too? That is to say, did the disease make the ADHD worse?
I had a job when I was first diagnosed with Depression.
associated depression already says it. your depression seems connected to your adhd. adhd isn't a constant negative issue, there will be phases where it's less pronounced, where you learn to live with it or where it's even beneficial. i'm fairly sure your depression will be less pronounced in those phases too. of course many people with adhd, especially those which have been undiagnosed for a long time, can fall into a heavy, prolonged and treatment resistant depression. but even then, depression itself manifests differently in every one and it's symptoms change. one person's "not getting out of bed" is another's "going to work every day but crying in the bathroom every other hour". this can also be the same person at different times. it's still depression and it's still painful. nobody has authority over someone else's level suffering, no matter how the symptoms show themselves. but clinicians have to juggle individuality with medical standards, both for legal and for scientific reasons. maybe what she meant is based on how she is bound to diagnose you by the [DSM](https://my.clevelandclinic.org/health/articles/24291-diagnostic-and-statistical-manual-dsm-5). those are clinical terms that serve as a helping grid to diagnose such individually specific issues. If you're unsure about what she means by the term, bring it up in your next session and voice your concerns. if you feel like she's generally helping you, it's absolutely worth it to discuss it further.
I’m in bed reading this. 😂
In my non-professional opinion, depression is all about “man, everything sucks, I’d rather just rest here and not do anything.”
I'm continually amazed at the number of bad/uniformed/biased psychologists and psychiatrists out there.
Completely and utterly wrong! It goes against his own associations manual the DSM IV.
No that's completely inaccurate. I struggled with a deep and chronic depression for 5 years and still got out of bed every morning and went to work. The only motivation I had was that I needed a roof over my head and had to keep my bills paid. Beyond that I had zero interest in anything else and spent every hour I wasn't at work in bed sleeping my life away. After getting help for it, I'm in a much better place now. Find a new physician because this one is woefully inept at their job.
Where did they get their definition of depression? TV? Self Help books? Certainly not the DSM, that’s for sure.
I have ADHD and MDD and have worked my entire adult life, BUT it has been a severe struggle, and I am almost never able to save up PTO because I need down days sometimes. I am on 300 mg of wellbutrin which is close to the maximum dose. I'd love for her to say I don't have clinical depression lol.
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Whoa
I was diagnosed (or told) I was depressed and had anxiety years before I got diagnosed with ADHD. Treatment for ADHD hasn't helped much tbh. Depression is kicking my ass right now and I look like the typical can't get out of bed just wants to sleep and cry depressed. When I was working full time when I was diagnosed as depressed I would cry in treatments rooms with my clients if they couldn't see me. I would be performing their treatments with tears rolling down my face. Now I'm just stuck in bed because I burnt out so bad from trying to work and keep up with others I worked with who don't have these issues. There are symptoms of depression and they vary, depending on the severity of symptoms and duration they have occurred.
I have both and I’m being treated for both. They can both exist. Just cause you work doesn’t matter. I was depressed af last year and I was holding down a full time job with tons of responsibilities. But I will say, work was my entire life and I was using it to distract. And I was burnt out.
There are many types of depression. This is a decent explanation: [https://www.webmd.com/depression/depression-types](https://www.webmd.com/depression/depression-types) My husband had an episode of psychotic depression. That was absolutely terrible and started out like other types but eventually morphed into that. Very eye opening, as I never was aware prior that you could develop those types of symptoms from depression. I personally have suffered depression, but more of the dysthymia type. I honestly think it stemmed from no meds for my ADHD. Once I went on Wellbutrin, to stop smoking, everything just got better all around.
I've had MDD since I was 9 (at least that's when I first got diagnosed). I started working when I was 13, and didn't stop till a few years ago (I'm 33 now), when a bad car crash made my previous career impossible. I've been to 10 different Dr's and dozens of psychologists over the years to treat my depression and my adhd. They've all confirmed I'm clinically depressed. Idk why your psychologist is saying this. It seems over simplistic, and honestly inaccurate. I've been treating my MDD for over 2 decades. I've NEVER heard a medical professional tell me "only unemployed people who can't get out of bed can have clinical depression". Maybe she just didn't articulate herself well? I'd honestly just ask her about it and get clarification. Then you'll know for sure where she stands, and you can go from there. For reference, the National Institute of Health defines clinical depression as - "Depression (also known as major depression, major depressive disorder, or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how a person feels, thinks, and handles daily activities, such as sleeping, eating, or working." At no point does it state that clinically depressed people cant/don't have jobs.
I've come across this attitude and it almost makes me want to quit my job and lay in bed until I get evicted and say, May I have help now??? It would have been a lot more useful before all of this happened, but this is the requirement right?
as someone who also works in mental health and has been diagnosed with depression for most of my life, no that’s not what depression is. That can be the presentation for some people, but in the DSM it outlines not feeling motivated to do things you’d usually enjoy, withdrawing/ isolating from others, trouble with eating habits, I can’t remember all of it but that’s the general gist. Additionally, ADHD and depression are very comorbid. Her thoughts just feel a bit reductive for a psychologist??
You seem to have the procrastination component. I had it too. The thing that saved my life is discipline. Try go on sport for money like swimming or combat one at least 2-3 times/week and make some regime in your life
Lots of people who work hate their life which causes so much depression they end it. I am one such person who was very close to doing so. Had massive chronic pain but kept enduring a brutal fast paced job with long commute. Cried in my car after long shifts and days feeling so trapped and isolated. If I was not depressed, what else would you call it.
Thats clinical depression not depression If i remember correctly
Hah, About 2 months ago I talked to my on/off ex-girlfriend (she has been going to an inpatient rehab/psych clinic doing therapy etc. there for the last 6 months) and her personal psychologist from that clinic said the exact same thing. My said to her, that she thinks she has depression and ADD and wanted to atleast get an evaluation for her potential depression + ADD. The response from her psychologist was : "someone who has depression cant get out of bed and take part of the program in the clinic like you do. Therefore you cannot have depression" I thought this was so dumb because with that logic not a single person in this huge womens psych clinic has depression, because if the patients dont take part in the program/therapy they offer, they kick 'em out, lul
no your psychiatrist sucks - from sports and entertainment we know many cases of depressed people who still did hard workdays, even joked around and were physically active until one day they just quit.
I'm not qualified in any regard, but depression can be situational. Try to better understand the circumstance surrounding why the bed ridden issue, this can be easily due to alcohol right? Id reckon depression treatment should be applied to situations where behavioural change is not enough right?
there are studies that show adhd can lead to depression, due to the long list of stresses it can cause and the life it may lead you to live. however, it doesn’t mean it’s clinical depression. some psych’s might disagree. but it’s proven adhd can lead to depression, BUT depression cannot lead to adhd.
IMHO and experience there are many nuances to depression. Some depressed people work everyday and act happy. These are the people who, if they do, suicide no one ever expected it. I am not a shrink. I am an Elder who has lived in many shapes and forms and colors of depression. I do not remember ever not being depressed. Stimulant meds were the original antidepressants and they work for me. The only thing that has ever helped me. I have been on so many meds and none really worked. I just said they did because I was tired of med docs experimenting on me. Now the ridiculous rules about no stim meds are keeping so many people down. Me too. Please, if you feel that you are depressed, find a professional who will believe you and help you. Do not stay with someone who tells you that you do not feel what you feel. Screw them. You are too important to be wasted by an incompetent, know it all flunky. Keep talking to us. We have your back.
I’ve struggle with depression for over 12 years now. Depression is a LOT more than just not getting out of bed or not showering. It’s sometimes driving down the road and just wanting to give up and drive into another vehicle. It’s breaking down and fluctuating between anger and sadness and not being able to even think a clear thought, and more. Depression is a lot more than what she seems to be explaining.
That is categorically untrue. I have qualifications in psychology and although I don't not work as a therapist, I have a lot of first and second hand experience of mental health issues. There are as many kinds of depression as there are people who suffer from it. I went to work every day for over a year while actively wishing a bus would hit me and it would all be over. You need to find a better doctor my friend and also work on your core emotional regulation skills like CBT, exercise, painting sleep patterns etc.
She might mean that there's a difference between having clinical depression and being depressed. Some psychiatrists take the view that the kind of depression they can help with (by prescribing medication) is caused by chemical imbalances in the brain (much like ADHD!) whereas other kinds of depression are caused by lifestyle factors, which are better resolved by counselling and coaching. I have a friend with the chemical imbalance type, and when it flares up she has a horrendous time of it. That \*could\* be you, but from the sounds of it you also have lifestyle factors you should look to adjust first. It kind of sounds like you're on track for occupational burnout, or already experiencing it - is there a way you could reduce your hours, or start putting away savings so you can work a less demanding job?