I recently started therapy for the first time. I was resistant to it my whole life. But finally enough was enough. It's been good to me I think. I recommend at least giving it a try.

Changes? Well I didn't have a degree, so when I hit a hard spot in 2009 my response was to get my butt back in school. It has been a positive experience. Perhaps you could consider working towards a degree(second one if you already have one) or taking any kind of community classes on a topic that interests you. Cooking, martial arts, whatever comes to mind. Same as therapy, you can always quit going if it turns out not to be your thing.