I have been hospitalized twice for this.

I was experiencing weight gain of 5-7lbs a month,
I was sleeping 12-14hrs a day
no energy
constant sense of carrying a weight on my neck and back
extreme self esteem and paranoia of rejection

this last time it was being unable to go kayaking which was the trigger.

I have dealt with this all my life. The usual trigger has always been work. I am terrified I am going to do something wrong and quit before I might do so. I am 48 and have had 29 different employers (38 different jobs)