Career Advice/Experiences With Starting Over/Reinventing in Mid-40s with Depression and Anxiety

In advance, I know this is long, but I think the background is necessary.

I am 43 years old, divorced, with two kids. One child leaves for college this year, one will leave in two years. For approximately the past 20 years, I have been working as an attorney at the same medium-large size law firm.

I have had problems with my work for probably at least 10 years. Approximately five years ago, I took a voluntary three month sabbatical, because my insomnia and anxiety grew so bad that I was not really functioning well. The sabbatical helped bring the insomnia back under control (somewhat, I’ve never slept well), but has not resolved the underlying issues. Now the insomnia is back like it was years ago.

I have major depression (including dysthymia) and generalized anxiety disorder. Both diagnosed by both a board licensed psychologist (Ph.D) and psychiatrist. (I have seen multiple therapists and psychiatrists over the years.) I have tried all of the standard SSRIs, SNRIs, and various other drugs that they have advised. I tried them all for as long as the psychiatrists dictated. I only quit the drugs when they told me I should. I write this so you know I did not make the mistake of just deciding to stop them myself, or quitting them before they reach efficacy. (Often the first question/statement I hear is, “You know the drugs take weeks/months to work, right?”) Nothing has helped. I have also tried the other standard suggestions for depression and anxiety, which I would roughly bundle together as eating better, exercising regularly, meditation, gratitude, journaling, and other standard suggestions.

I now find myself in a difficult situation. I am having a very difficult time at work. My concentration and focus are shot. My memory for the details necessary to do my job as an attorney seems to be gone. I am incredibly indecisive. I wake up frequently in the middle of the night, heart pounding.

A couple of my colleagues suggested that I try for disability. They have seen my issues first hand, believe I am genuinely miserable, and that I need to make a change. My firm has a long-term disability policy that technically covers inability to work due to mental disorders (including anxiety and depression). I do believe that I technically meet the definition for disability under the policy. I’m not faking this. I really do not think I can continue to do this job.

At the same time, I know how insurers work. I’m not literally a drooling wreck. I can still read and write (even though I cannot really concentrate on it for periods of time). I still get up each day. I take showers. I have great fear that they insurer will either reject a claim outright or perhaps accept it on a very short-term basis, looking for the first chance they get to terminate coverage.

I unfortunately am not the beneficiary of a trust fund. I have some money to get by in the short-term, but I need income for the long-term. I find myself in this situation where I am subject to depression and anxiety that makes me wonder whether I could perform at any other job. I worry that I would have a resume with a big gap in it that would make it impossible (particularly at my age) to get another job. I have no marketable skills outside of my legal training. If I am being honest, I have let my legal skills deteriorate badly – it is hard to really put yourself into learning and keeping up when you feel like you are barely dragging yourself into the office each day. I have tried over the years to simply force myself to do it, but that only goes so far when you have no passion whatsoever. Attempting to get insurance is a dilemma, because if it works long-term it solves the problem, but applying for it and getting rejected means I am surrendering my current job and will have a huge gap on my resume that is hard to explain, without any income.

Finally, even if I were to try to go find something else, I do not feel any passion toward any other career. It’s not like there is something that I want to do. I have tried different things – pro bono work in areas outside my expertise, for example. I’ve tried volunteering. I’ve tried exploring (hell, I even took a full day adult aptitude/skills test) other options, and there is nothing that hits me that I would like to do, or for which I feel any sort of passion that would lead to a 40 hour a week thing.

I know this is a lot of venting, and also whininess. But I’m really feeling like I’m at the end of my rope. How do you reinvent yourself in your mid-40s, when you can’t keep doing what you’ve been doing, but when you feel no passion for anything else? Even if I could find something else, what are the odds that I could actually get in starting in my mid-40s? Additional education and training is a big risk, as it feels like it could end up just eating away faster at my limited financial reserves, particularly when without any passion or drive, I could just end up hating the new thing as well. Then there is always the issue of whether I could even get into a new career, with the resume gap, age issue, etc.

I know this is open ended, but I’m looking for anyone else who has experienced this. Who perhaps has successfully transitioned to something new in their mid-40s (doing it while feeling fatigued and drained – if I could find a way to feel a ton of energy, or even some, it would obviously be easier, but I have been working on that without success for years). I’m looking for thoughts, advice, ways to move forward. Because I’m really anxious about all of this and my future, but cannot figure out a good way forward.

As someone that is a few years older and still trying to figure out what to be when they grow up, I feel you. The biggest problem seems to be the lack of passion to do anything. And I can’t help but think that lack of passion, as well as the focus and concentration issues are related to the depression and trouble sleeping.

Sounds like it has been awhile since you were on medication for it. Maybe it’s time to get with a doctor again and give it another go, since they are coming up with new things all the time.

Quick question, did you try CBT or biofeedback therapy?

I’ve been seeing a psychiatrist now. It is hard to find one I like (like literally, so many of them simply aren’t seeing new patients, and the ones who are its months and months to get in).

Problem is, he by his own admission does not really have a lot of options. Part of what is bothering me is that he almost visibly seems to be at the “throwing shit at a wall” stage.

For example, in a recent telephone call, he said about the only thing left drug-wise are MAO inhibitors. Said (no, I’m not dramatizing this) “Most psychiatrists won’t even prescribe them anymore, but I do.”

I asked why. He responded, “I don’t have time to explain it; you can just look it up on WebMD/Mayo through Google.”

In addition to how terrible that made me feel, when I did look them up, good god. Incredibly restricted diet, nasty side effects. Why is the diet so restricted? Well, it turns out if you accidentally eat something high in tyramine (which apparently includes a shit load of foods, and not just exotic stuff, we’re talking anything pickled, soy sauce, meat tenderizers, cured foods, and much more), well, you can apparently have blood pressure spikes that can even be fatal. Good god.

His other suggestion was possibly electric shock therapy. Which he said most people won’t do because it is “very cumbersome.” When I asked him what that meant, he said you have to have someone transport you to and from, and sit with you for 24 hours.

Yeah, I’m a single guy.

So I’m trying to figure out the “how to get better” angle of it, including possibly drugs as you said, but I can’t say it feels promising.

Definitely CBT. I’m not sure what biofeedback therapy is, but I have done things involving meditation, controlled breathing, using cold water on your face to slow heartrate, and things like that.

I know it has a bad rap but have you considered ECT? A close friend of mine had it done when nothing else helped with his severe depression and it worked for him.

Have you been to a chiropractor? I’m seeing a subtype that’s new to me. It’s called “NUCCA” which stands for National Upper Cervical Chiropractic Association. They only mess directly with the neck, no back-cracking stuff.

I think it might be worth checking out. It’s possible that the lack of success with those medications is due to an underlying issue. A misalignment could be contributing to your sympathetic nervous system being revved up. That could create an uphill battle for the meds to work.

you could also Check here to see if there’s an MPS practitioner in your area. MPS is like accupuncture but instead of needles, they apply a small electrical current to the points. I’ve found this incredibly useful for dealing with a variety of physical problems. But if you are willing to go to the chiropractor, I’d do that first, for the same reason (if you do have an underlying spinal misalignment, that could limit the effectiveness of MPS, as was the case with treating my tinnitus).

[/quote][quote=“Misguided, post:6, topic:129147, full:true”]
Have you been to a chiropractor? I’m seeing a subtype that’s new to me. It’s called “NUCCA” which stands for National Upper Cervical Chiropractic Association. They only mess directly with the neck, no back-cracking stuff.

I think it might be worth checking out. It’s possible that the lack of success with those medications is due to an underlying issue. A misalignment could be contributing to your sympathetic nervous system being revved up. That could create an uphill battle for the meds to work.

you could also Check here to see if there’s an MPS practitioner in your area. MPS is like accupuncture but instead of needles, they apply a small electrical current to the points. I’ve found this incredibly useful for dealing with a variety of physical problems. But if you are willing to go to the chiropractor, I’d do that first, for the same reason (if you do have an underlying spinal misalignment, that could limit the effectiveness of MPS, as was the case with treating my tinnitus).
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No chiropractor. I’ll confess I’m a bit leery of them. I have had full physicals and other medical checks done by my doctor (thyroid, vitamin, etc.).

Part of my problem is that I am finding it very difficult to figure out how much of this is depression and anxiety that is preventing me from performing my job, and how much of it is a job that is very badly suited for my depression and anxiety (e.g. does the job particularly exacerbate my depression and anxiety).

I say that because I would like to see whether stopping the job makes me feel better. I’d rather do that before zapping my brain with electricity (because hey, I’m not really keen on zapping my brain with electricity just to do a job - I’d perhaps try it if I still feel utterly miserable without the job, but how do I know now what that will be like). But I cannot stop the job without getting the long-term disability insurer on board. I’m assume the long-term disability insurer will insist I try “everything” treatment-wise to stop the job (or at least as a condition to it), including brain zapping, because again, they’re looking for any reason to deny claims. So I’m kind of in a Catch-22. (Also, if I just try a different job now, and I have these same feelings of fatigue, futility, and inability to concentrate and focus, then I will have lost the ability to claim under the long-term disability policy, while finding myself unable to work, which is a pretty shitty situation to be in.)

Again, these guys only use for gentle pressure on the neck. One of the biggest problems with most doctors these days is that they don’t think abut the whole patient or the whole patient’s body. This is especially true with certain specialties (I’m looking at you orthopedists). When I had to quit working because of problems with my thumb, the orthopedic surgeon and the physical therapy were useless. It took the massage therapist that practices MPS to tell me the problem with my hand was really a problem with my shoulder.

So, what I’m trying to say is that it’s possible you have an unknown spinal misalignment which is hampering other treatment modalities from working. Or maybe not. But if nothing else is working, it seems worth a shot.

I’m willing to look into it at least.

Might be worth it. All I can tell you is that I’m making progress treating an illness (tinnitus) that the conventional medical establishment has no treatment for.

Are you excercising regularly? I know this is a broad left field kind of suggestion but if you aren’t exercising regularly, I suggest you take it up… there is a lot of data showing that exercise helps improve your frame of mind.

I was. I went a full year at the gym, three times a week, weight lifting and walking for cardio.

I’ve fallen off the wagon a bit in the last six months (though I still do some bodyweight exercise at home; pushups, squats, things like that), but I cannot say I saw any difference during that year. (I mean, I probably felt a little better physically, but it did not help with the depression/anxiety.)

Sorry, I missed this:

If you took a sabbatical 5 years ago and it helped somewhat (per my closer reading of your text, apologies), perhaps it’s worth taking another? Then re-evaluate from there?

I would have to take short-term disability (which is effectively a sabbatical) before applying for long-term disability.

The problem is the nature of my job. Taking a second sabbatical will de facto mean the end of my job, I think. As an attorney who does business with the same clients, suggestions of mental instability or even poor health can only go so far. In essence, having this happen a second time in five years is going to make both my colleagues and clients likely move on. While I theoretically could come back to work, it is a technicality, as I will lose my clients and fairly rapidly be shown the door.

There is the additional issue that I tried the sabbatical before, and it did not “take” (i.e. I’m back in the same spot), so I know I need to try to figure out something that works better long-term.

What about a few weeks vacation? Would that be enough? Surely that’s allowed? edit: does going on an actual vacation help at all?

As a thought experiment. What specifically about the job makes it so unpalatable? When you think ahead about what you need to do each day as you go to work, what exact sequence of actions do you dread the most?

Could there be another job that avoids that stuff?

I have avoided going on vacation, because I’d rather not deal with how incredibly depressed and miserable I feel in those last days of vacation before I have to come back. I mean I get really black, somber, horrible moods before I have to go back.

In addition, I am paid based on hourly billings. Essentially, a week’s vacation (say 40 hours) means two months that I have to work from 6:00-7:00 at night instead of going home at 6:00. It’s never made much sense to me to add torture to each day for months in order to take a single week off.

I do not know of another job that avoids the stuff I hate - I hate this, but I also cannot think of another job that I would want to do (well, any job that is actually obtainable - I’m assuming porn star is probably out the window).

I hate most of the clients. Rich, alpha male asshole types who are hyper-demanding. Never know when work is going to come in. If it comes in, well, then you have to do it, right then. Make sure it is right. But don’t spend any time on it, because you cost so much per hour. But make sure it is right.

The work itself is both highly detailed (you have to get it right - malpractice suits are not fun), but also extremely boring (at least to me). Arguing over comma splices, indemnification provisions, warranty language for a living. Hoping that you caught the asshole tricks the other side tried to put into the document.

Arguing for a living all day. Arguing things that really are not subject for argument. Pretending there’s a “right” answer for what really comes down to which side wants the deal more. Pretending that there is an argument for why a limitation should be $500,000, instead of $1,000,000, when the reality is that the client just wants to push until the other side stops giving.

Having to pretend to be friends with people you have no interest in because they might have work. Having to go to social events not for the social event (because you’re uninterested in it), but because there might be people there who could have work.

I’m rattling this stuff off pretty quickly. There’s so much more. But I hate it. It seems really odd to say, but the job is both incredibly boring (because I do not care about much of any of it) while also being incredibly stressful (because people can be sued for millions of dollars over quirks of language in a contract).

Geez man, yeah, that sounds awful. I suggest doing anything else for a career.

Have you considered programming, tech, IT that sort of thing? Lots of jobs in that field. It is more building stuff and less arbitrary arguing…

There’s probably also startups looking for people with a legal background, if you dig.

What about legal work for an employer you like, or who stands for something you agree with? I know legal practices are pretty specialized, but could you work for an organization like the Red Cross or a group that feeds people, or some other nonprofit?

I know it’s sort of trite but to figure out what you’d like to do have you ever answered the question about what you would do if you could do anything in the world you wanted? Or what’s your dream job? I’m not sure those questions would help if you are suffering from depression or anxiety though. It seems like you should fix those issues so that you can get more in touch with Your feelings about work and the kind of job you would like.

Bear in mind that is my quite like jaundiced description. I’m sure others think much differently about it, and view it differently as well.

I’m just worried about my deeper problems. I have, for example, thought about IT. Even getting an A+ certification and working help-desk or something. But I’m worried I’ll take the same sour attitude and find it miserable. Then there’s the whole issue of trying to start at the mid-40s.

I don’t, for example, have any desire to do IT. Memorizing network terms and concepts, etc. would just be work, not something I have any passion for. I’ve thought about it simply as I obviously need to do something so as to not end up homeless.

I would like to fix those issues, but it starts to feel out of reach when I’ve been trying for so long. It just starts to feel like this is how I am, which is part of the problem. I feel like I can’t do this anymore, but I don’t know what else to do (including literally how to get the enthusiasm and passion to do something when I am simply unenthusiastic about almost everything).

This sounds really difficult, SlyFrog. I’ve seen something very similar with my wife, who has struggled with anxiety and severe depression for years. Finding meaningful work or a hobby is definitely a good route–it’s really the only thing that makes a substantial, sustained difference for her. It’s a vicious cycle, right? You need something to engage your passion, but you almost can’t feel passionate about anything. Remember that that lack of passion is primarily your disease in action–if there’s anything you think even might remotely get you engaged, I would go for it.

Also, lean on your friends. You won’t want to see them because your mental state makes you not want to socialize, but do the best you can. Again, try to kick yourself out of the self-reinforcing cycle and you might start to feel better.

My wife has first hand experience with ECT, so if you are curious about it I can try to explain what it’s like. She was just about at the lowest point a person could get–literally suicidal–and I think ECT saved her life, but it does have costs and burdens.

Hope all this advice isn’t too presumptuous. Believe me, I’m very aware of the kind of struggles you’re facing. Keep us updated!