Hello MJB124: I'm sorry you are experiencing this difficulty. But kudos to you on your professional accomplishments! I don't know as there is much of anything I can offer with regard to the specifics of your post. But I noticed no one had replied to your post. So I thought I would.

I've never been offered a diagnosis by any of the mental health professionals I've seen over the years. So I don't know what mine would be. But you mentioned feeling worn out & tired. This is certainly something I have always struggled with. It seemed like, no matter how much I slept, I would still be dragging the next day. And if I was in a particularly stressful period of my life, I would have difficulty sleeping at all. Plus now, as I'm aging, being able to sleep at all is becoming more-&-more of a challenge. In my case, I think a lot of this is related to the high levels of anxiety I have always carried around. I would presume that, as an RN in an ICU, there's quite a bit of stress in your life as well.

You mentioned you sometimes miss doses of medication. That is certainly something to be avoided to the extent possible, of course. I'm no longer on med's of any sort. But when I was, if I missed a single dose, it didn't seem to have too much effect (although I would notice it as the day wore on.) But missing doses more than just once in a while would certainly be something to be concerned about, I would presume.

I do have to say that I had to chuckle a bit at your comment about downplaying the effects of your symptoms on your life when you see your psychiatrist. This has always been a problem for me. Any time I would see my pdoc, or a therapist, no matter how I was feeling inside, I'd just reflexively slap a smile on my face & say everything's okay. Somehow I just simply couldn't manage to do otherwise... & I still can't.

Anyway, those are my thoughts with regard to your post. I hope your upcoming appointment with your pdoc goes well.