Innerzone; That is more clear. Yes if you are not happy in your job that can suck the life out of you. The making of huge-life altering decisions without putting thought into it may be a function of mania or hypomania. I know I have come up with some doozies, but luckily my hypomania never last very long, so I come to my senses before making the jump. Perhaps a good next step as far as finding a career is seeing a career counselor. You could get some testing on what types of jobs are better suited to you. My brother (who isn't diagnosed, but is quite symptomatic), struggles with the same thing. He is extremely intelligent, but tends to set his expectations very low on what jobs to pursue. Part of it is definitely a self esteem issue; we both had horrific childhoods, but I also think it's a safety mechanism. If he doesn't stretch himself he won't fail, but he too is very burnt out.

As far as thinking others are talking about you etc. to me this may be paranoia. It comes down to who cares? If you don't value their opinion and that's the conclusion I would come to from your line of, "And from the dearth of people to have a half-intelligent conversation with. " then why even think about it. It's human nature to think that people are thinking, talking about oneself etc. etc., but most people are so wrapped up about themselves others don't even come on their radar. I think where the line is drawn between paranoia and just normal insight is when it affects are lives negatively. i.e. if we are using too much energy thinking about such things, if it's affecting our self esteem etc.

I'm not sure what PHMNP is, but for me my therapist has helped me gain perspective when I "know" another person's actions, words etc. were about me. Her line is "you will never know, so don't waste your energy thinking about it".