Tell Me About It: I should be grateful for having a good job but I feel sick inside

PROBLEM: Coming back to work after a break has nearly killed me. I know I should be grateful for having a good job in a prestigious company but I feel sick inside all the time. For the first week off I was completely exhausted, and then I began worrying about coming back and all the usual stuff started happening: I was getting no sleep, was feeling anxious in the pit of my stomach and was getting snappier all the time.

This week was almost breaking point. I ended up having a huge row with my boss and I know now that I am never going to progress. This feeling started about a month into the job, but I kept thinking it would change if I worked harder or was more positive.

Instead, I’m now working late every night and not getting enough done, and my performance-management meetings are horrendous; essentially they keep telling me I am falling below targets. If I could leave I would, but I need the salary to keep up my rent and I don’t want to move to a similar job.

I have stopped having an interest in other things and my social life is almost nil. I know my friends are sick of me going on about my job but I can’t stop thinking about it. I would love to meet someone, but I’m beginning to think that will never happen. My friends are telling me to take up online dating but I just don’t have the energy. I feel like I am old before my time and there is nothing I can do about it.

ADVICE: It sounds as though you need to do something about your life, as you could be sliding into a place that is difficult to get out of. You are clear about one thing: work is the major cause of your troubles. This needs to be addressed.

However, your capacity to solve problems or be creative about your future is deteriorating with every passing week, so your resilience might be the place to start. It is very hard to make a life decision from a place of anxiety or negative emotion, as you might regret it later.

However, it sounds as if fear has been keeping you in your job. The effect of this is to increase your anxiety and to undermine your sense of capacity. It is true that if you leave you might need to take a cut in income and prestige, and your lifestyle could change, but you need to weigh this up against possible depression and unhappiness at work. Perhaps you need to put an exit plan into action.

The first part of this plan is to say, “This time next year I will be doing something else.” Then you have a year to implement life changes and this is long enough to allow you not to panic and to recruit some support. Could you go and see a career advisory service to begin the discussion about what might be a better fit for you in terms of work?

Perhaps there is a conversion course you could do to widen your skills base? Or there might be a possibility of an internship that would offer you an option for a career change?

These options all involves change, and this might be difficult for you when you feel so low, but if the change is gradual, you might gain energy and confidence from it.

The anxiety you have been living with is severe, and this must be tackled either before or alongside any change you set in motion. Perhaps see your GP, a counsellor or very good friend to get support while you are instigating this change.

Doing nothing will only deepen your despair and confirm your organisation’s opinion of you as someone not worth investing in, so the earlier you act, the better the possibility of a good outcome.

There is a very real possibility that you will lose some income and some status by leaving this job, but there is also the possibility of you finding something to spend eight to 10 hours each day that might be energising and fulfilling for you.

Many people who change jobs wonder why they did not do this earlier in their lives, and perhaps it is worth seeking someone like this out, as it will help you to believe in a different future. Ask friends if they know any people who have changed career and organise to meet them for coffee to ask how they did it. This will give you hope, and some of your fears might be allayed.

Can you ask your family for some financial support while the change is happening? Help them to understand that your health and wellbeing are dependent on it and you hope to return the favour when their time of need comes. Now is the time to lean on those close to you and to decide that you are worth this change.

• Trish Murphy is a psychotherapist. Email tellmeaboutit@irishtimes.com for advice. We regret that personal correspondence cannot be entered into