G'day!
It's been a while since I dropped in here - sorry for the delayed reply.
I think the thing that keeps me going is going into some sort of "machine mode". I identify that xyz needs to be done, I ignore the part of me that is internally screaming that it's just all too much, and I get on with it, accepting that I will continue to feel just as tired, fried, and whatever else, as I do at the time. My motivation for career change I guess was driven by being really unhappy in what I was doing before (software engineering). After my last retrenchment in 2011 an insightful friend challenged me to think about what I would most like to do next, regardless of how impossible it might seem, and not to limit my ideas to IT. After some thought, medicine was what I came up with - and the rest, as they say, is now history.
I don't know that this "machine mode" thing is necessarily a healthy adaptation, but it's one that enables me to get stuff done. The risk in this sort of compartmentalisation is that it allows me to set aside stuff I haven't dealt with effectively in favour of managing the present... and so it may never be dealt with as I move on. Anyway, here I am now working in my new career and I can say that the hard slog has paid off. I am happy to roll up to work each day and feel like I'm making a meaningful contribution to the wellbeing of others - and that's pretty satisfying.
I'm now seeing a psychiatrist, but it's early days yet and so far she has not tried anything too exotic, just a change to a different AD I haven't yet tried. So far no significant response, although I do find that my memory, concentration and ability to apply myself to/start new activities is improved, and without any noticeable adverse effects. Not entirely what I'm looking for by way of a response but it's better than nothing. We have talked about the theory of impaired dopamine response being a possible key component in the negative symptoms of dysthymia; she is open to the idea but doesn't have strong feelings one way or the other. She is rightly cautious about going down that road though, so we will be exploring other more conventional treatment options first.
If my experience qualifies me to make any observations about your situations, then perhaps it's this: don't let fear be the determinant of what is possible. There will be possibilities that may well be out of reach at this stage of your life (but may come back within reach later, as they did for me) but there will be others that are achievable, albeit with the possibility of siginificant commitment, hard work, and the need to have more modest expectations of your lifestyle in the interim.
Why are you dissatisfied with your current career? Is it because dysthymia has robbed you of the ability to enjoy anything, or do you actively dislike what you are doing? I think this is a key distinction, and one I didn't appreciate before my diagnosis. If you don't actually dislike your current occupation then I'd suggest making radical career changes might not make you any happier - chances are you wouldn't feel much different doing anything else. If on the other hand you can't bear the thought of another year doing the same old same-old then perhaps it's time to broaden your thinking and accept the challenge - if you could do anything at all - no obstacles - what would it be? What stands in your way? Are they really insurmountable, or can you find a way to make it work?
Emergency, police & ambulance (24 Hrs)
Connect with a lifeline crisis supporter (24 Hrs)
Suicide callback service (24 Hrs)
Kids helpline (24 Hrs)
13 YARN