Take help anywhere you can: here, pdoc, family.

Two things I'd like to say:

Due to early CSA, I have felt suicidal most of my life. I'm a Christian, so I try to make it through each day, because I see death as a blessing. But to cause it myself would devastate a few people. I worry a lot because I fear losing my 70-year-old mom will trigger the worst. I think what I wish for is to be "numb", "calm", "quiet" and less afraid rather than dead. There's the conundrum. Because not feeling is not living.

As to the responsibility of working, I think it really helps. Perhaps my downward spiral began when I married a man who supported me, and my physical and mental health prevented me from working. Then my adult daughters left for college in rapid succession, and that daily responsibility was over, too. I'm not much of a housekeeper, so my responsibility to my husband is really just washing his clothes, cooking (which I really love, and keeping the kitchen and bathrooms clean. Life is a little better since I rescued Tally, a sweet, wonderful Chihuahua who takes up patience and time. My point is obligations help. When I must do something, it's a little less time sitting, worrying.

Having said all that, your mental/physical well-being comes first. Please talk to your pdoc. It's too soon to know how the Effexor will help until there's a therapeutic level in your bloodstream, but I assure you you are no "bother" to a qualified doctor, and you are simply not the first patient to let an expert know that you need relief more quickly. If you need to take time off work for hospitalization or more aggressive therapy, TAKE IT. You're job will be there, or if not, there are other jobs and you are so smart and creative and talented. There are other jobs; there is no other you.