employment, careers, depression, and inpatient psychiatric care
September 1, 2011 7:02 PM   Subscribe

Am I depressed because I hate my job? or do I hate my job because I'm depressed? Quitting is a bad idea, right? What about going to a psychiatric hospital? (warning: long)

For a few months now I've been futzing with my brain trying to get depression and medication side effects/tiredness under control. Thanks to the hospital I get care from, I received a new psychiatrist a month+ ago and I think I've decided he's not really helping, even though I don't really have any solid reason for saying that. I tried Cymbalta and Celexa in the past but I blame them for shitty misery-making side effects. My new psychiatrist prescribed me wellbutrin which had potential but now it seems like all of my rational emotions have disappeared. I've become complainy, crabby, an asshole, apathetic, more anxious and more depressed.

This sort of coincided with a downturn in my enjoyment of my job. I got extremely lucky after graduating last year and was hired as a web developer with a major role in designing and developing a database-based website for researchers. It was exactly what I wanted to do (in theory), paid well, had job security, was within my skill set, was fun, interesting, and so on. Within the past month or so it's been finalized that year 2 of funding and development is going to start and it's sort of just assumed that I'm staying on. In school all I only ever really did was short term projects that I could put away after a while. This is now such a big clunker of a project that I don't even want to look at it anymore. I'm sick of it. the data being stored doesn't interest me. Appeasing the users doesn't interest me. All the features that are desired for the second year of the project don't involve much creativity and I'm not even sure I can do them and I certainly don't give a shit. Every time we have to put together any sort of schedule or timeline I just want to cry because I don't want to BE there tomorrow, or in 1 month, 3 months, 6 months. This is especially painful because this was my dream job. this was my ideal job that I was so happy to get and I don't really know what else I can do other than this. And even if I did quit, which I shouldn't, I'd be leaving my coworkers in the lurch and would probably not be able to get any recommendations for just ditching the project like this.

I started really feeling this way 2 weeks before my previously planned vacation break. It got harder and harder to go to work or be at work without wanting to just cry. I would waste a lot of time on the internet in order to avoid the tedious-as-fuck tasks I should have been doing. I would count down the minutes until I could go home (like always) and then once I got home I would do essentially nothing. I left on my glorious 10-day vacation hoping that it would solve all my problems. I was with my boyfriend and I absolutely ruined a couple of days of it for him because I was being so crabby, fighty, and when any discussions veered towards my job or friends or "how great this city is, I want to move here!", cry-ey.

I went back to work on Tuesday. All I can think about when I'm at home is having to go to work and sit at that desk all day. When I'm at work all I can think about is how much I don't want to be there. I try and convince myself that it's only because I'm depressed, and it doesn't *really* make sense to quit because of money and job security all that bullshit that I really don't think i care about anymore, except the insurance I guess. My boyfriend thinks I'm being immature and ridiculous when I say I want to just quit without other plans. I'm sure he's right, but just being at work, just sitting at my desk is so. hard. And the thought of staying there and at the same time looking for jobs until I find something better is mostly what's making me do so many web searches for local inpatient psychiatric care.

Today my project manager called me into her office and basically said she noticed that something was wrong, I should try and show some "more enthusiasm" for the project, I could take a day off if necessary but that it's not worth it to come in to work if I'm not going to be enthusiastic because there's a lot to do. This was probably because I spent the whole meeting daydreaming about my lucky friend whose job is to take care of experimental rats in a research facility. I told her I had considered taking today and yesterday off as sick days but felt too guilty to do it after taking such a long vacation. I sneaked out an hour early after that conversation so I wouldn't be seen crying at work.

Since i got back from my trip I've been googling inpatient psychiatric care in my city (Boston). I really just want to go somewhere and stay there away from people, fix my problems and not have to think about going back to work. My current psych is on vacation until next week and I don't have an appointment until thursday which seems like an eternity. I don't think he's much help anyway. I stopped taking the wellbutrin after my third vacation breakdown. I tried to set up a new psychiatrist appointment elsewhere but the organization I wanted to go to doesn't accept my insurance, and all the ones on my insurance list near my workplace have lousy reviews or are too far for me to travel during a lunch break or have the wrong specialty or i just don't want to be cold calling these people. I'm not suicidal at all but I'm just miserable in my own skin and want to sleep until the next ice age. I bought both "feeling good" and "what color is your parachute" but I can't get myself to read anything except blogs, or do anything except sleep or maybe play minecraft. and the thing is, it comes and goes too. when I got home and ate dinner, I was fine. writing this post and thinking about potentially having to go to work or see friends tomorrow is turning on the waterworks. I'm dreading having to interact with people I know this weekend. I'm ruining this long weekend before it even starts, and no matter what I'll just have to get up and go to work afterwards.

anyway, okay, there it is. I'm so sorry that's so much text and it's all over the place. I feel ridiculous when I compare this to real world problems but I still just have no idea what to do. I want to check myself into a facility but that seems drastic, expensive, and will cut into the only not-at-work time that I have. What I really want is a psychiatrist appointment NOW but that's unrealistic. Can anyone offer any advice or cambridge/somerville/boston area resources? Should I quit my job? that's immature, right? can I quit by phone and just not go back? is there an urgent-but-not-really-emergency psychiatric facility I could check myself into, or some 24-hour miracle psychiatrist I could visit? What would that be like?
...once again I'm so sorry this got so long. I really appreciate any advice.
posted by sarahj to Health & Fitness (29 answers total) 8 users marked this as a favorite
I'm not a doctor, but you sound like you have really, really bad depression. It's got jack shit to do with immaturity, morals, or character. Try getting your psych paged while he's on vacation. You're doing really poorly and your judgment is completely fucked because of the depression. PS: one thing you will learn when you've been around a little longer is that somebody minimizing their problems and saying they're not "real world problems" is a gold-plated, never-fails, 99.99% accurate symptom of depression. Of course it's a real world problem - you're about to lose your dream job because you're sick. Get your psych on the phone, and if you can't, call one of the psychs in your area who's not exactly perfect. Talk to somebody right away. This is a serious situation.
posted by facetious at 7:26 PM on September 1, 2011 [3 favorites]

Too Much Information. No, seriously...there's so much here I don't know where to begin and I'd be interested to see if anyone else can make a go. Here's what really comes through to me:

1. You hate your job - possibly your profession.
2. You've had trouble with depression in the past.
3. You seriously hate what you do.
4. You are worried about the state of your mental health.

Go see a psychiatrist (sorry I don;t know anyone for referral i your area but someone else here likely can help) . See him tomorrow if you can. Tell them it's an emergency. Trust me here - it is. You need to talk this all out with a real professional. Tomorrow morning - early just call in sick, park yourself in the E.R. and tell them you need to see a mental health counselor - it's an emergency.

As to quitting your job I can give you only two pieces of advice fro personal experience.
a) If you're miserable where you are no amount of money can make up for that. Better to work in customer service at a Walmart if that's what makes you happy to go to in the morning.

b) You need a job to pay the bills so if you leave - have something lined up first. Maybe a different field. Maybe pumping gas. Just make sure it pays the bills (and you can always downsize your lifestyle). Without a job you may become homeless. I have been in jobs that I have absolutely loathed and I have been homeless. Homeless is worse. Much, much worse. Choose wisely.
posted by Poet_Lariat at 7:28 PM on September 1, 2011

I assume, from your previous questions, that you are in the US. If your employer has over 50 employees within a 75 mile radius of your work location, you've been there 12 months, and you've worked 1250 hours in the last 12 months, you are almost certainly protected by FMLA. So I suggest putting off worrying about your job.

I know this because I've got all the forms right here to turn in to my case manager at the partial hospitalization program which I, ironically enough, started on Tuesday. I was having tons of trouble liking my job, getting anything done, etc., too. At my intake they seriously were like "you can start right now." A couple of people this morning started a few hours after they walked in.

But, if you're trying to avoid people this is so, so not the place to do it. I'm learning to cope with my social anxiety by being immersed in an environment where I constantly interact with between five and fifteen people for six hours a day. And the folks coming over from the inpatient side are talking about all the other people who were over there still, which makes me think you can avoid them even less in inpatient, since at least with the PHP program I'm allowed to go outside if I need a break. And I don't see how you can look for a job from inpatient. You get ten minutes on the phone at a time and there's a person screaming about how he's going to get his lawyer and get out, or whatever (I now know exactly enough to know I never, ever want to be in the inpatient ward.)

Having said that, I think you should start by calling these people. Let them know you're close to walking out on your job and in despair and unable to function (like you said above) and if they're anything like my local urgent psychiatric services, they'll try to help you get stabilized. Though that really is more like when you go to the ER and end out talking to the psych resident and they give you seven days of medication and a referral. And I don't think anyone except the ER will let you come in till tomorrow.

Your doctor should also have a backup, by the way. Mine always have, except the one I totally stopped seeing because he didn't do things like have a freaking backup.
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 7:29 PM on September 1, 2011 [5 favorites]

Do not quit. However, you are sick. For real, so call in sick. You can honestly tell the PM that you realized you were so under the weather because you actually were sick, when this evening you started to feel even worse. All true!

Then ask for an emergency appt with one of those psychiatrists that's just a little too far from your work to get to on your lunch break (or on preview, with that program linked just above).

Hang in there. In my opinion, your dream job is still intact. It may or may not be this one. But it does sound like you liked the non-tedious-as-fuck Year One of the project: true? There are tons of people who can't deal with building something out of nothing and would love to tie up tedious loose ends. Once you feel a little better you can go look for another Year One kind of job, or get moved to a Year One project at your same job, or get an intern, or discover podcasts that distract you. Those answers may not work perfectly, but you will be able to figure it out once you start to feel a bit better.
posted by salvia at 7:37 PM on September 1, 2011 [1 favorite]

I would advise you not to think about your job at all at the moment -- or, more to the point, don't take your thoughts about your job seriously until your depression is better managed. You sound very depressed (been there, I know what it looks like!). All your thoughts about your job situation and what to do about it are currently too distorted to be of practical value. Take sick leave -- just tell your manager you are sick, because you are, and stay out as long as you need to. Call your psychiatrist -- he almost certainly has someone covering for him; tell that person you need an appointment right away. And just keep going with the medication trials, even if it seems that none of them work. It is not unusual to cycle through a whole bunch of antidepressants until you hit on the right one. Once you're feeling better (and you will!) you'll be in a position to evaluate whether or not to quit your job and what to do about your career. Also, know that if things start feeling really really bad, you can go to any emergency room for psychiatric care. Hang in there! You will be okay.
posted by Wordwoman at 8:06 PM on September 1, 2011 [1 favorite]

I think many many people become disillusioned with their jobs within a year- especially their first year. So that may be a factor. Also, all those medications have SO many side effects- I didn't know that celexa gave you muscle aches until I read it here..I thought I was just SO TENSE. Also the pill (birth control pills) can make you LOSE YOUR MIND. Especially on romantic vacations. You do sound like you are at the end of your proverbial rope though...is there anyway you can take sick leave until you feel more emotionally stable? Either through medication, or whatever else your psychiatrist may recommend? You will get through this though. I'd imagine your psychiatrist definitely has an 'in case of emergency' 24 hour number- it might be time to use it. Actually on preview Fee Phi Faux..has given you some pretty good advice!
posted by bquarters at 8:17 PM on September 1, 2011

About FMLA - be sure to follow your standard call-in procedures, and realize that you have 15 days, from the day you notify your employer about the need for FMLA leave, to get the first certification paperwork in. You can get the paperwork here (PDF.) And be ready to have to pay a bit - usually between $25 and $50 - for the doctor to fill out the forms.

It is really important that you call in the way you're supposed to - this is one spot that a lot of employees have had trouble with, and the latest guidelines clearly state (PDF) the employer can impose discipline for failing to follow the established rules when it was "practical" to follow them (it's about halfway down on page 6.) As an employee I'd pretty much want to follow the letter of the rules unless I was, like, unconscious.
posted by SMPA at 8:21 PM on September 1, 2011

nth-ing that your depression seems to be pretty bad at the moment, and nth-ing the advice not to leave your job, at least not until you are in a better position to work out what the next step is and act on it.

Your feelings of despair and overwhelmedness about your job sound to me like classic depression symptoms. I suspect if you can get some improvement happening in the depression, the job will feel more manageable.

You menioned seeing a psychiatrist - what does your psychiatrist do when you meet? I ask because some psychiatrists do therapy, and some psychiatrists really only prescribe meds and monitor [or at least this is the case in my part of the world, possibly different where you are]. I am wondering if some brief, focussed therapy (e.g. cognitive / cognitive behavioral therapy*) might, in combination with medication, help with some of the thoughts and feelings you are having - particularly that sense of mingled panic and despair at looking at the next year's work. Learning to break down big tasks into what you're going to do now and what you're going to do next would, I suspect, make the boredom and overwhelmedness more manageable. As well as this, I suspect you're labouring under some big expectations of your job, esp. when you describe it as your "dream job", and coming to accept that most jobs will have parts that suck, or failing that, that a job which initially seemed like your dream job may turn out not to be ideal for you (and that's ok!) might lift the guilt/disappointment/ennui a bit.

I agree with the posters above advising you to get help as soon as possible. You are miserable, and you deserve to feel better - do whatever you need to do to get the help you need.

[I am a mental health professional, but not your mental health professional, and I have never met you, so this is not professional advice from me.]

*I almost hate to mention CBT given the extent to which people I encounter (unrealistically) view it as a magic wand - but these kinds of issues are really right up the CBT alley.
posted by Cheese Monster at 9:15 PM on September 1, 2011

According to research the Australian National University has recently published research in Occupational and Environmental Medicine, a bad job is worse for your mental health than unemployment.

The study analysed seven waves of data from the HILDA Survey and found that the mental health of respondents who were unemployed was comparable or superior to those in jobs of the poorest psychosocial quality. Further, while moving from unemployment into a high quality job led to improved mental health, a transition from unemployment to a poor quality job was more detrimental to mental health than remaining unemployed.

she noticed that something was wrong, I should try and show some "more enthusiasm" for the project

I'm so, so, so sorry that this happened to you. It's like we still live in the fucking Dark Ages. There are employers and managers who know about depression, often from personal experience, who are only too happy to give people a chance to work through it while still holding down a job. I hope you find them.
posted by obiwanwasabi at 9:31 PM on September 1, 2011 [1 favorite]

Please do what salvia said: call in sick, and see a doctor as soon as you possibly can.

Anti-depressants can be dangerous and it sounds like the wellbutrin has been making your existing depression significantly worse. It's good that you're not suicidal -- but if you don't already know it, you should be aware that wellbutrin and other anti-depressants will often cause suicidal feelings. If you start feeling that way, please know it's not 'real' -- it's caused by the drug, and it will go away. With wellbutrin, I think side effects persist for a few weeks after you stop taking the drug -- if I'm right about that, you will start to feel better, but it may take longer than you would expect.

IANAD and have no medical training; I have plenty of friends taking anti-depressants. Typically their doctors seem to prescribe them some random thing and assume it's fine until/unless their patient makes a serious complaint. So you may need to be forceful in saying that the wellbutrin is not working for you, and that you need to cycle through other meds together until you find something that works, because your situation right now is not sustainable.

Don't think about your work at all right now -- you're in no condition to be rational about it, and you have no way to know if you want the job or not. Just get healthy, with a leave of absence if you need to, and then afterwards you can sort out your job. It sounds from your previous AskMe like your PM is actually sympathetic and clueful, so with luck she will support you in getting a leave if you need one.

Good luck. Try not to blame yourself -- this isn't your fault, and you can get it fixed.
posted by Susan PG at 10:21 PM on September 1, 2011

You sound like me last December. Here's a good rule of thumb, and how I wish I'd handled it: don't make major life decisions while you're depressed. I know going to work sounds like the worst thing in the world, but being employed gives you access to a lot of resources that can help. So don't quit your job - yet. Right now, your bills are getting paid, you have access to health insurance, therapy, prescriptions and paid sick time.

Take advantage of that.

Make getting treatment your first priority. If that takes inpatient care, so be it. Once your depression is under control, then you can decide whether a career change is in order. And if it is, you'll be much better equipped to handle it. Best of luck, and I hope you feel better soon.
posted by Space Kitty at 12:20 AM on September 2, 2011 [3 favorites]

It's hard to understand what is really motivating your malaise. If you ask your mother (and she's anything like mine) you should be happy to have a job that is consistent and pays well. But we all know that's not necessarily the case.

I recall the first few years at my job, when it was a challenge, before things stagnated. Promotions stopped, raises stopped, and you're pretty much taken for granted. Being taken for granted, even as a valued part in the operation, is pretty saddening.

Don't sweat that it WAS your dream job. If it's not what you want to do, then it's not your dream job anymore, you might have beaten whatever challenge it had for you before.

I was talking to a friend about the Lion King musical. Apparently there are people that have worked on that show for 10 YEARS in a row. So you can bet that job, working in a high level production, is a grind for someone.
posted by Napierzaza at 4:35 AM on September 2, 2011 [1 favorite]

I would call in sick and see the psychiatrist, but I would seriously consider actively looking for a new job because the problems you mention will not go away just because you go on meds. I had a job as a grad student where a lot of days I did nothing more than surf the internet(people told me how lucky I was, and I felt somewhat lucky because the job paid tuition, but 8 hours of doing next to nothing gets OLD). I really liked the people I worked with, so that made it somewhat bearable, but doing nothing was actually very taxing and I was exhausted by the end of the day. At work I would basically go into a stupor and was constantly asked if I was okay, or told that I looked tired.

At the same time I was in grad school and was pretty bored with my program, so sitting at work doing nothing and then going to sit through 3 hour seminars that I found pretty tedious did not make a great combination for me.

It kept getting worse until I was basically in a stupor all of the time.

I am done with all of that now, and feel SO MUCH BETTER. A fog has lifted....hell, I'm currently unemployed(all of this ended a week ago) but I feel so great now that I have control over my life, that I am much calmer about pursuing employment and moving forward with my life. I also realized that I don't want to work in the field I was in grad school for, but now I have the energy to pursue what I really want to do.

I would also suggest getting into a regular exercise routine. It really helps.

Note: I've taken anti-depressants and nearly failed out of school b/c I became so apathetic on them, so I didn't want to risk it again. Otherwise I probably would have gone to a psych long ago.
posted by fromageball at 6:18 AM on September 2, 2011

See a doctor ASAP and also get a blood test for any vitamin deficiancies. Also, your job, I believe might be hurting you. See, some often think that just because your job is not putting you in physical danger, doesn't mean your brain isn't computing it as such. You can do this. You can switch a lot of things that have become terribly boring and meaningless to you. It takes time but I believe with the right resources and help you can do this.
posted by InterestedInKnowing at 7:54 AM on September 2, 2011

Hey, you're the former me. How about that. Here's a report from your future. I've been where you are and have been a very long time coming out of it. I've learned some lessons along the way. So here's my story and associated advice.

I agree with those who say to bite the bullet and get immediate help from someone who isn't your primary psych, whether it's his backup or an emergency person or whatever. Psychs know meds and it doesn't have to be the same one as long as they know for sure what you're on and why. As horrible as things seem, you can get some temporary and partial peace with the right meds, at least enough to take the edge off. Sounds like the ones you're on are making it worse and should be changed anyway. When I was on Wellbutrin, they also put me on Buspar (buspirone) for anxiety because Wellbutrin is known to exacerbate anxiety. If you're taking that and do nothing else, try dropping down to a half dose or even skipping a day and see if it makes a difference. Something has to give and you'll be seeing someone soon to straighten out the med situation anyway. Help yourself if you can't get help from someone else right away.

I also agree that you should not make big decisions while you're in the grips of this acute misery. Whether you're depressed because you hate your job or hate your job because you're depressed, here's what I know: you can't trust your feelings. This is a strange thing, like going blind or losing your limbs. In the past, if you felt bad and pessimistic it's because you had a reason, because something happened. Now, maybe you have a reason on a given day or week but it doesn't matter because you have this underlying thing that's going to make you feel bad regardless. So you can't know what other reasons there might be. If those other reasons go away, you'll still feel bad. So try not to make big decisions based on how you feel. Get some help. Take a break if you need to.

I was exactly where you are in my first job out of school and then again at the place after that, which lasted a lonnnng time. In the first one, I was so miserable that I had to get out. It was like I had been born into the adult work world without any skin. It hurt. Luckily I had my parents and retreated back to their place and lived with them while applying for grad school. I went, but that didn't go well either, again because of the disease. So it was back home again. Finally therapy, tried Prozac, made me rage, lost me a temp job. Retreat. Back out temping and finally temp to perm. I knew it wasn't right for me but it was something and I had to do something. Different meds, a better mix, a little stability. Still not happy, still very much affected, but some stability and even advancement careerwise.

Still, within that stability I began to ask the question you've asked. Am I depressed because I don't like my job/life or do I not like my job/life because I'm depressed? Stay or go? See above, no way to know. I limped along for years and years that way. I looked at thousands of job descriptions during that time, but nothing appealed. Nothing. So I made do, because if I left, what else would I do? Nowhere to fall back this time. Not going back home, not at this age. All options seemed sure to deliver the same misery.

I faked it fairly well at work and in truth found ways to live with the depression as a permanent fixture (this doesn't happen to everyone, btw). I quit the meds because being numb and without feeling (which also doesn't happen to everyone, btw) was worse than the depression for me. And they had served their purpose, giving me a stable platform from which to rethink things. And it wasn't so acute anymore, less of a tiger and more of a tumor, inextricable but stable. But eventually my apathy caught up with me and the whispers said they were wanting to find an exit for me. Then a friend offered an opportunity elsewhere and I jumped. It was somewhat better but I still knew I wasn't doing the right thing. And then that went south too, due in part to the economy and maybe in part to not the right fit, and I was laid off. And then I faced the dread of signing up with another company in the same field and I just couldn't do it. I knew it would be the same. I knew I couldn't fake it. I knew I'd still be lost and in the wrong place. I felt like I had cement shoes and couldn't lift my feet.

So I went out on a limb and used my accumulated skills to start my own company doing the same kind of work independently from home, just me and a computer. And suddenly after all that time I was finally where I was supposed to be. It was an epiphany. Things even fell through right after I started - the big money job that justified me starting the company in the first place fell through and I had nothing but dwindling savings. So I should have tucked my tail and skulked back into employment but I didn't because I knew that this was finally the place for me. So I scrapped and am scrapping still and so far have been able to keep the lights on. All this time, I needed to be my own boss and I didn't know it, had never thought much about it, and yet I know that was the answer all along whether I was ready for it or not. Seemed too scary and risky to go out on my own and besides, what would I do? It took this long for me to build up a particular skillset that people wanted and would pay me for just as soon as paying some other company. I was qualified and somewhat in demand. I had been wary about staying in this industry because it's got some really wearing downsides, but suddenly when it became my ticket to living how I wanted to live, I didn't care at all. I'll do it I'll do it I'll do it. It was an instant perspective shift in my head. Suddenly it was a means to an end - the end being the kind of life I want to lead. It feels scary and it feels great and it feels right.

I say all of that just to touch back on the question of whether you don't like your job/life because you're depressed or whether you're depressed because you don't like your job/life. I'm sure it's some of both, and you have to deal with both, but I wanted to present myself as an example of someone who wondered and wandered for 16 years and finally found that there was in fact an answer, that there was in fact a right thing out there for me. So expect to do some living and some fighting and some crying and a lot of waiting, hopefully less than I did. A healthier way to look at that would be the quote, "Life's not a struggle, it's a wiggle!" Silly but true, particularly in the work world. Wiggle until you fit right. Patience sucks but that's all there is for it. Keep adjusting and considering other options until you find a fit. Keep zeroing in on it, each one closer to the true you than the last. The second thing might not be right or the third or eighth, but your fit is out there so keep wiggling.

I was thinking that you're in a particularly great field for doing your own thing sooner or later. Health insurance is important, particularly if you have mental health needs. And steady income is important. And the skills you learn as an employee gaining experience are very important. But web designers/developers are in demand and will remain so, whether at companies or as freelancers or independent businesspeople. I'm just saying you have options, though maybe you could use some more experience first.

You know how whenever somebody loses a job, they say, "Buck up, Steve, when one door closes, another opens"? That's right but only partially. That other door, many other doors, were always open, but you couldn't see them because you had no need to look. Once you get hungry, once you have need, once you have nothing else to cling to, you see them. They're there for you right now. It's hard to truly see them and go for them while you're supported by something else, but it can be done if you go ahead and commit to getting out of there and into something more workable. When you lose your job you have 24 hours a day to work towards something else and you're very open to new and different things. When you have a job, you have a lot less time, but you can make some time each day if you're committed. And meanwhile slog away and get your work done.

I thought I was at a great job once and it made me as miserable as you are now. The first thing I said every morning was "fuck," and on Monday mornings it was "FUCK" and on Sunday evenings it was this creeping "ohhh fuck," this horrible sense of looming dread. And every night I'd come home with a bruised soul and ravaged nerves. Not so great after all. Plus I didn't know what depression was at that point and so didn't know how to deal with it. And then at a later job I thought I was at what should be a dream job for me, at least in terms of the general field, and yet didn't care about it at all and languished for years. So I recommend not taking your ideas of what jobs you should like too seriously. Or rather don't hold onto it so tightly. Forget about what it was supposed to be and take stock of what it is and how you are in it. Adjust. Allow yourself to be fluid and flexible and recognize that your life will be long and have many chapters. Each will be like a mini life and not like the last one. And most won't be things you would have pictured, even when you dreamed about the perfect thing. The best is yet to come. You're in the worst right now.

So - what to do. Stay or go. I think short term you need to address the acute misery and that will have to be through medication. Therapy will not fix you quickly but medicine can make a difference very quickly, even if not a fix (and it probably won't be) - just a soothing or a dulling or some clarity or a stabilization. With some stability, you can better cope with this, have a different mind, and be in a better place to make decisions, to let therapy work, etc. So go the backup/emergency psych route now and get some help. Some here are adddressing the inpatient thing. I can't speak to that but it's an option. And then if you still have to get out of there, get out, but make sure you have a landing spot. And that spot may not be a new job. That won't fix you. This is about more than your job and your shit comes with you wherever you go, I promise. Can you afford to live without income for a while? (savings goes sooo fast). Can you move back home? Can you pay for meds and psychological services without income? If not could your parents pay for it? Make a drastic change if you have to but be safe and smart about it.

Also, as a tip from someone who has been there, don't beat yourself up too much projecting forward and catastrophizing. I'm a pro at this, addicted to it, and have wrestled with it for a long time, so I know what you're going through. You don't have enough resources to worry about the future right now or about anybody but yourself. So lay down those burdens. Don't worry about your future or your company's future or your coworkers' workload. Here's the reality of the work world - your company will dump you as soon as it needs to if it ever makes the most sense for them. Loyalty is great but business is doing what makes sense. You need to harden your heart a bit and embrace the truth of that from the other end. You do what you need to do and don't worry about your company or coworkers. People come and go all the time. Everybody is replaceable. The operation won't fold up because you leave. They'll adjust, just like you would if they canned you. Do what's right for you. It's understood that staff will shift and cycle. Don't let that imagined burden block your path. And don't worry that such a move will tarnish your resume for all time. You're just getting started.

Also, get used to being miserable for a while and toughen up. You have a long road ahead of you and will need to build new survival skills and tolerance muscles. One day at a time. You feel like you can't stand it but you can. And if you have to stand it, then stand it. It won't be easy. It will hurt. And you'll do it for as long as you need to. At some point things will change, most likely gradually. But stay focused on the now. This wasn't supposed to happen but it did. It shouldn't be in your way but it is. Life would have been better without it but it's yours for now. Your path will be different because of it. Accept that and work on improving it.

Lastly, don't feel guilty or ridiculous that you feel bad. You feel how you feel whether you're in a tony suburb or a mud hut in Burma. Don't tell yourself how you're supposed to feel or say that you don't have justification for how you feel. It's here and won't go away because you think it doesn't deserve to be. That guilt/shame/frustration just makes it worse.

I wish you the very best and am sending good thoughts your way. As the PSA says, "it gets better."
posted by kookoobirdz at 8:27 AM on September 2, 2011 [7 favorites]

Good lord are you depressed.

Absolutely do *not* make any life decisions in this state.

What I really want is a psychiatrist appointment NOW but that's unrealistic.

Not really, and the fact that you still want to take care of yourself is very good news. Give a call to your local ER -- most will have a psychiatrist on call.

As others have mentioned, you have a serious medical condition. Treat it as one.
posted by Tell Me No Lies at 11:43 AM on September 2, 2011

thank you so much for the responses everyone. i mean it. every one of them has helped me in some way.

most of the doctors covered on my insurance are through another hospital, and i found out that in order to get appointments there i would need to set up a primary care dr at THAT hospital, make an appointment for THEM, then get a referral appointment to a new psych. at my current place the idea of just "getting an appointment with someone else" was somehow not an option.

it seems like the only way to cut through the infinite red tape to getting a damn appointment with someone soon is to just go to the emergency room and ask for a psychiatrist who is on call. where i am most likely taking valuable time away from someone who;s actually about to hang themselves or overdose. this is miserable. i'm going to get on my bike and see how it goes.
posted by sarahj at 1:30 PM on September 2, 2011

So now I'm in an emergency waiting room. The most recent nurse who talked to me really gave me the vibe that I shouldn't be here. Going to have to wait a while, but at least I'll get to talk to someone. Eventually.
posted by sarahj at 3:33 PM on September 2, 2011

taking valuable time away from someone who;s actually about to hang themselves or overdose.

Don't worry, the people with broken legs are taking valuable time away from the heart attack patients. ERs understand how to prioritize.

Good for you for going.

Hang in there.
posted by Tell Me No Lies at 3:59 PM on September 2, 2011

Fuck that vibe and keep re-reading this thread until you are getting the help you need and deserve.
posted by girlpublisher at 8:03 PM on September 2, 2011 [2 favorites]

Stay. Don't read too much into the 'vibe' you get from other people - you're depressed, remember? ;)
posted by obiwanwasabi at 6:13 AM on September 3, 2011

a bad job is worse for your mental health than unemployment.

That's a fascinating study, but in the last paragraph the authors point out that it was conducted entirely in Australia, which has relatively generous welfare benefits and nationalised health care. I'm assuming the OP is in the U.S., and losing her health insurance probably wouldn't do her any good at all. Not that that's how it should be, of course.

OP, I think you did the right thing. I hope the fact that you haven't posted again means you're receiving help right now.
posted by Perodicticus potto at 2:38 PM on September 3, 2011

Thank you all so so much for all the replies. After 6 hours hanging around emergency psych services on Friday night I got to talk with a psychiatrist, and got some info about an intensive outpatient program to possibly go to. On Tuesday I have to call my insurance company and find out whether the program will be covered. If it's covered and there's space in the program I can start Tuesday night. But I'd still be expected to go to work that day.

I'm just having a lot of trouble dealing with having to go back to work, especially after having been 'called out' on being a shitty employee. And also the fact that I'd not only be going to work but doing this intensive and difficult sounding thing afterwards a bunch of days in a row. And also that my insurance probably won't cover this program, and/or it'll be full, and even then I'll still have to get through a work day first. and I still won't really have a therapist. and I have to wait until tuesday!

There was another program that they mentioned but it was a full day program, it was further away/more difficult to get to, I still wouldn't know if it's covered, and I'd definitely have to take another day off work which I don't think I should. They could have signed me up for that one right away... maybe I should have done it.

Anyway, thanks for the nudge towards emergency services, mefi... I probably wouldn't have done it otherwise. I'm considering taking medical leave from work but I feel like this isn't serious enough to merit that, I wouldn't be able to get a doctor's approval soon enough, and that's pretty much just a gateway to me not coming back to work ever. Plus I think I would have to go back to work to get the papers. (Yes this is seriously the way i'm thinking right now. I'm aware that this is ridiculous.) I'm going to do some research on partial hospitalization programs but again I'm not sure if I'm "that bad". I'm really hoping this is just the meds that fucked me up and once I'm off them for long enough I'll get better.

thanks again so much :)
posted by sarahj at 10:41 PM on September 3, 2011

I'm so glad you've been given some options. Just another thought - is mental illness legally classified as a disability where you are? If so, then your employer has certain responsibilities toward you and cannot simply write you off as a "shitty employee."

My boss at a previous job once tried to dismiss my anxiety and panic attacks as a "bad attitude." I told my doctor this (just before he gave me a certificate signing me off work), and he said something I've often found worth sharing: "Bosses always think that, until it happens to them."
posted by Perodicticus potto at 11:48 PM on September 3, 2011 [1 favorite]

I really really need to stress right now that you can call in tomorrow, say it is for an FMLA condition, and you have FIFTEEN DAYS to get the paperwork in.

If you are eligible for FMLA I seriously suggest you do this.

And be aware that hospitals have programs for when you can't afford services. And it's better to get the help you need and have to be on a payment plan later than lose your job now because you didn't get help.
posted by SMPA at 7:14 PM on September 5, 2011

And I gave you a link to the papers you need in my first post in this thread. You don't need to go in to work to get them. Your HR department can fax anything you need, as well.
posted by SMPA at 7:17 PM on September 5, 2011

I just don't know whether to take the jump and do the medical leave. it just seems really drastic. and everything i've read about partial hospitalizations sounds really intimidating and like it would be just as unhelpful as what i've already done. i called the doctor i saw on friday back tonight and she wasn't very helpful on what I should do, just a brusque "come in and we can get you set up." i don't know what I was expecting there, though. I have to go to emergency to talk to anyone, always. are walk-in appointments just not a thing anywhere?
posted by sarahj at 7:34 PM on September 5, 2011

Sorry, can't help you there - I only know about free, accessible health care in Australia, not whatever monstrous system you're dealing with. Are there any community support groups you could link up with? If you're not suicidal, and have it 'together' enough to arrange appointments and attend them, then yes, hospitalisation might be overkill. Do you need to be hospitalised to get medical leave? Friends diagnosed with depression in Australia have just been able to use their regular sick leave even though they were mostly at home trying to get used to their meds and getting plenty of morning sun and exercise.
posted by obiwanwasabi at 8:28 PM on September 5, 2011

Walk-in appointments aren't really a thing anymore, not for psychiatric stuff. And really not for normal doctors, either - that's what urgent care is for. The place in Somerville that I linked to is the mental health equivalent.

I was full of "am I really that sick, how can this help, this is so, so insanely scary" thoughts when I went in to my intake session and before the first day of the PHP program. Heck, even the second day. But it's really helping. I sent you a MeMail with more stuff, but I wanted to say this out loud: I do not regret doing the partial hospitalization program even though it can be really nerve-wracking. It might turn out to be one of the best things I've done for my mental health ever.
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 4:48 AM on September 6, 2011

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