Is it even possible to beat mental illness?

Hey man, thanks for sharing. Never easy to talk about these things.

Your health, both physical and mental, is first and foremost. You can restart your career at some point, but health you'll never get back. Taking care of yourself should be your #1 priority. If your current course of treatment isn't working out, try a different therapist. Worked for me, albeit I wasn't dealing with an issue to the extent you are.

It sounds like you've built up enough political capital and leeway at work to take a step back. I'd encourage you to do so.

I went through a phase of depression and shutting myself off in my apartment for a while, and was lucky enough to find some coping mechanisms that are not "eat healthy, go get sunshine and work out". Wasn't a cure but helped me through the day. If you want to chat, man feel free to DM, happy to share. 

Stay strong. You're not alone.

I’ve been dealing with a mental illness for 20 years. There are ups and downs.

Hit up the gym, get enough sleep, use coping mechanisms to deal with stress and if you really want to take your life up a notch, join an MMA gym or boxing or Muay Thai. Life changing.

Also, be a hydrohomie and hydrate all the time and take 5,000 - 10,000 IU of D3 daily. 

Also, just go to a bar by yourself and grab some drinks. You’ll meet people. Put yourself out there - the drinks will relax you. 

1) go to the gym. Or go outside and run. Physical well-being = mental well-being.

2) find some hobbies. I don't care if it's biking, hiking, cooking fuck it could be gardening for what i care. Find something meaningful, purposeful, and what you look forward to

3) go up on the meet up app, find some people to meet up with. Go to the local bar. Talk to strangers. Ask them to hang out. You'll start building out a network of friends this way 

over time, you'll find meaning in your personal, social, life 

If you are lonely, consider joining this discord—people from all walks of life chatting about econ/fin/pop culture/relationships etc. 
 

https://discord.gg/wAkmCY2M

As someone who struggles with mental health issues and emotional disabilities, I'm proud to see those who suffer talking about their problems with people that can help. I know very well that it can be difficult to face problems like this, and I've dealt with similar issues in the past, especially in regards to relationships and dating. Perhaps my advice is a bit repetitive, but it might be worth considering taking a temporary step from work to attend the partial hospital program, then see how your mental state has been to think about going back to your job. I know from two great experiences that programs like this can be very helpful. I also agree with other monkeys' suggestions of getting a hobby, because you could meet new people through similar interests and become friends or find a date.

I hope our advice is helpful for you, OP. Good luck and Godspeed.

I don't think that I can add too much to the excellent advices given before, especially the ones related to working out and practicing martial arts, I can't stress those two points enough. It's about building positive habits that continue building further positive habits.Much force, you're not alone sooner than you realize you'll be more than fine physically and mentally and wonderful things will start to happen one after another. Take everyday step by step trying to focus on the positive as much as possible, you got this.

Reach out to some of your old friends. Not FB or text message....like an actual call on their phone. People just get out of touch at this age, but you may be surprised how happy they might be to hear from you. 

Also, while it may be unhealthy to just have drinking buddies, I value a lot of my old friendships that were more based on beer and jokes rather than being somebody in the finance world. When I meet people now, the conservation turns into "so what do you do?" within 2 minutes so that the counterparty can investigate whether you are a human being worth knowing.

Never easy to talk about these things, so good on you. Not a panacea, but you might appreciate learning a new activity as well as free writing. Tried to improve my mental health a bit this week by writing about a few topics: what I was grateful for, things I was looking forward to, and what I admired about people I knew. Also donated to a friend's fundraiser which felt good. For the new hobby or activity, try to take a few hours on a weekend night to join something in your community. It could be anything from volunteering to a group class on cooking or dance. It might be difficult at first but you'll meet new people. The change of environment could be helpful for you.

Get outside and run. Until you cant. Then you walk for a few minutes and start running again. Repeat until you cant. Your brain will repair itself soon after the endorphins kick in.

Not much to add except I was depressed for years and thought it would be impossible to beat until I finally found the right meds for me. Last two years have been infinitely better and finally feel what I imagine is closer to "normal". It was difficult and I felt extremely hopeless for years but I promise you it is possible and when things get better that you will be so much stronger for having dealt with this. Biggest realization for me was that some therapist/psychiatrists are useless and that if it's not working it could be worth switching them up to somebody you feel is better equipped to help with your specific circumstances.

Highly recommend PHP, it is a scary step to make but way better than doing nothing. I wish I would have know about PHP before I ended up attempting and then inpatient for a week. PHP will majorly help you.

I won't go reply by reply but thanks everything.

1.  I quit drinking a couple years ago.  Drinking alone or going home drunk alone was becoming dangerous so it was a personal decision to quit for the time being.  Maybe one day I'll start drinking again.

2.  I don't know what I'm really into anymore.  I don't really have any interests nowadays.  I've been thinking about taking non-credit classes at a local college but I'll need to wait until the winter term, I missed the fall ones.  Maybe photography, real estate, and another general hobby one.

3.  The hospital program is a no go.  There's no good way to tell my boss "hey I'm nuts and need to go the hospital 3 times a week for 3 months so I'll need to run early and log back on late".  Honestly, if I had the money to quit for 3 months I'd do it though.

4.  I reached out to one of my friends maybe 8 months ago.  I just texted him something along the lines "hey what's going on why'd you stop hitting me up?".  He gave me some BS excuse about how we just lost touch, meanwhile I was texting him every 3-4 weeks to see what was going on that he would read and ignore.  I never bothered replying it wasn't worth an argument.  

5.  I wrote down some other suggestions from here that I'm going to try applying.  Mainly different class ideas, I saw some supplements, etc.

In my experience? No, you never beat it or get over it or any of that. You just learn to live with it and that's all. 

I was diagnosed with depression as a teen. Major depressive disorder runs hard in my family and I have relatives on disability because they can't even leave their house from it, I had a sibling kill themselves over it which only made my own depression even worse. I have been medicated for it, been off medication, all of it. Nothing "cures" you. The medication mostly just makes you numb enough to just do things in life without thinking about the depression. 

The point is, you gotta find your own things to live for. Hobbies help. One day I decided I was going to learn to sew so I got a sewing machine and just learned from scratch, now I make my own shirts. I started playing the drums as a new creative outlet and it really helps. Learn an instrument, write a book even if you think it will suck, write poetry, find something you can enjoy. 

I don't know what to say really because everyone's struggle is different. I thought I was low, then my brother killed himself out of nowhere. Then I was REALLY low. Whatever you do, stay alive. Even if you think no one will care, people will care! Life is beautiful out there somewhere, sometimes you gotta find it and sometimes you don't find it until later in life. Keep going!

What is your diagnosis?

Please read "Feeling Good" or find a therapist certified by the Feeling Good Institute. It is really one of the only true CBT books/therapies out there. Beck Institute is good too. Helped me and many others.

First rule:  Take care of YOU first.

Second rule:  You are your own advocate.  Speak up if something is not working.

Third rule:  It IS in your head.  Understand that.  You WILL find your way out of the wilderness.

Fourth.  Love yourself and Live

Final rule.  Ask for help.  If not enough...ask for MORE.

Those of us who suffer from mental issues each have to find our own path.  I was so fucked up for YEARS, because I didnt ask for help. I found my path (leaving NYC, talking to people openly about my issues and training myself) and you will find yours.

We are here if you need us.

I am younger than you but I feel similarly. I never had friends, but I feel very disconnected from my family. I am also on medication, in therapy, and have bi-monthly appointments with a psychiatrist, that nobody knows about. I was excited about what my life might look like now, but even with a good (I think) job coming up* after I graduate, I am depressed as fuck. Never even held a hand, would probably be eaten by guilt if I did. 

*My family is conservative as fuck, they will probably stop me from moving for the new job and I will probably be even more depressed being surrounded by them and only them. 

It’s been a while since I posted here. And, fuck, do I feel underequipped. But, I will try to add some differential value.

I was diagnosed with anxiety a few years ago. And the same period coincided with I not taking anything in my career or personal life seriously. I was at home, working as a freelancer, and life went past me. That was the first half of my 20s. On the plus side, I had supportive friends, family, and love.

A few months ago, I changed my therapist. I was seeing the other one only twice in a year because of a very weird situation. But the change helped me organize my thoughts and start the right meds. Alongside this, I changed countries.

So, my two cents of advice would be pretty straightforward:

1. Move the fuck out of wherever you are. Sometimes, we start defining life in terms of where we live and who we perceive ourselves to be. It is almost ugly to see that you can change any of the two variables and your general idea of your life shifts dramatically. So, at the core of it all, I believe you might be witnessing some self-esteem issues. Change that by changing the definition of your life. Move towards a different and perhaps new human experience. And that begins with changing homes, cities, or even countries.

2. Stop being ashamed of your story. I know, this sounds like a cliché, but hang on for a second. Sometimes it is challenging to move beyond our problems because we are too embarrassed to acknowledge them. You have definitely acknowledged them since you have seen professionals. But, at some level deep inside you, do you feel ashamed of the way life has turned out? I certainly felt that way, even though I knew I was partially responsible for the shitshow.

Dissociate yourself from the way life has been going on for the last 4-5 years. The period has included one global pandemic and who knows how many random events that affected your personal and professional life. Sure, some of them would have turned out differently, but most of them did not. So, stop thinking that you are the one who has screwed it all up.

Most fuck ups are a mix of “life happened to me” and “here is what I did to life”. Don’t go extreme on any of the two sentiments.

3. I would not ask you to journal, try hallucinogens, or work out till the Endorphins kick in. However, I wouldn’t rule out those methods entirely. They do seem to work for a lot of people. Instead, I would nudge you to take an inventory of – what gets you excited? Not happy or fulfilled, just plain excited for a while. Track that. Chase that. And go to its core.

It can be art, television, porn, sex, or anything else that gives you momentary joy. The entire world has gone under the blanket of ‘purpose’ and ‘values’ and the hullaballoo. I think most of it can be simplified by just finding a healthy balance of enjoyable human experiences. So, dissect your sources of pleasure and explore them further. I find writing to be an objective measure of doing this. But, you are free to choose your own methods – journal, self-talk, or something else. Find things that are not self-damaging but give some pleasure, and explore them further.

4. And if none of this seems to work – volunteer. Pick any local non-profit that works for children or the disabled, and associate with them. First, give them a healthy donation and do not claim deductions (I know what I am talking about; this is not a tax planning class, this is a Redefining Your Self Esteem class). Second, start volunteering meaningfully every week and track your progress. Be selfless at SAINT LEVEL and do not preach, promote, or publicize your work. This is for you.

Being in non-profit groups helps you talk to people and share your story. It also helps you see your net impact on the world around you. And, that can be a meaningful experience.

As you meet people, try to understand what pain have they experienced. I am not saying that this would help you get over your stuff. Far from it. It will redefine individual pain as a human being for you. You might have felt low self-esteem, anxiety, and depression. While someone else, a seemingly healthy person, got drawn into depression because of a great personal loss. Your stories couldn’t have been more different. But, empathetically, you share the baseline of pain.

The general assumption is that empathy is great for understanding the people around you. I would say that it is a great tool to understand yourself. So, practice more of it.

5. And – also, are you in the best shape of your life? It can have a significant impact on your self-image. If you are, put a goal to finish a triathlon (Ironman or something similar), and see if it excites you. If it does not, measure your body dimensions and use them to determine what would be the best shape you can be in. Choose any of the two methods. Get started. And don’t bother stopping. (The two alternatives focus on the same idea – having a physically exhilarating goal that results in you reaching the best shape you have ever attained.)

As always – feel free to discard every single thing I said here. I have refrained from recommending books and movies because I think your problem runs much deeper to get affected in any material way by a few hours of disengagement from everyday existence. You must reorganize your life and in due process, discover who you are. This is not you. This is the result of what happened between when life was doing you and you were doing life. Now, focus on the latter. And we will see where that takes us.

I am throwing this out for the first time – but if you really feel like you don’t have anyone to talk to, feel free to drop me a message. I will not respond immediately but I will try to be useful and listen to whatever noise is running in your head. And, also, I am not selling anything. So, cheers to that.

More power to you, mate.

When people talk about finding ways to deal with mental illness it almost always revolves around somewhat superficial remedies, medication, exercise, change in behavioral habits, etc. While that will help alleviate certain symptoms and help you discover coping skills, this approach still leaves most people struggling in the long run. 

(Controversial opinion ahead)

Depression and anxiety are what I like to refer to as the mental equivalent of a low-grade fever. Fevers are problematic in themselves but they are always indicators of underlying systemic problems; depression and anxiety are the same. They are manifestations of trauma that most usually has occurred during childhood development. A lot of therapist over-prescribe medication and never ask or discuss probing questions about their patient's childhood experience and they do not link past events and emotions to present actions and behavior and experiences. I would advise you to look for a therapist that can link what you experienced/witnessed as a child and your current beliefs about yourself and your life, and your general mental outlook.

Sorry to sound harsh but if it took you until after you graduated to figure out your friends weren't your friends you might not be the most self-aware or emotionally aware individual. You might have trouble forming meaningful relationships because you might avoid or are scared of true intimacy (just speculating). I hope things get better for you but this might be a great opportunity to dig deeper into who you really are. 

Keeping a journal and writing down your deepest fears and desires, and going over them with a therapist to help you identify any pathological thought patterns should help.

Sorry can defs relate to what your going through man. 

Personally, meditation helped so much for me I recommend trying out apps like Waking Up and see if you like it. The ability to be aware of negative thoughts and feelings does wonders. I think its really easy for people to say "just stop worrying", "be more optimistic", "put yourself out there" when you have anxiety and immense stress. In reality, its very hard to execute on those things because humans can't control what they think and feel. Meditating made me accept those emotions and thoughts while giving me the space to see things differently. 

In conjunction with this, I recommend journalling stressful stuff. Any negative thoughts you have write it down, classify it into distortions (jumpting to conlcusions, magnifying etc) and then right a rational response to it. After doing it pretty frequently, you'll start to think differently and by writing your thoughts down you realise how ridiculous they sound.

Also exercise alot, I think this is just simple brain chemistry. I've started running regularly and its one of the best things I've done during COVID. 

Finally, these are just my opinion and what worked for me. Personally, taking mental health and happiness into my own hands by researching and reading books made me much more committed to doing all of this. In comparison, when I used to do therapy/meds it's always been like okay I just do whatever therapist tells me but also pretty ceebs and seems bs. Good luck man I really hope you get through this. It always gets better you've done so well so far be kind to yourself.   

…

There are some posts that looks like yours on WSO, I usually try to chime in on those. I really think that your post goes beyond of what a anonymous forum can do, you should seek real life help. I would even think about quiting my job if I was felling like you and had some money.

Being physically sick and not being able to focus is a pretty big concern .

I have learnt that the best relationships start with giving without expecting anything back - leads to new synergetic relationships. Best to give to people who cannot give back - whether it is our time, talent, money, friendship. These relationships really last - they may not start off with getting a high at a bar, but they pay off over a longer time.

Unfortunately, we are taught in america to "network" with people who are most powerful (leads to race, gender, age discrimination), coolest (leads to isolation of the other), wealthiest (leads to poor financial decisions). 

During COVID, seeing how some people came through for me and how I now feel about such persons, taught me what is most important in relationships and what makes me truly happy. 

I would agree with a lot of the things mentioned above, especially about getting out of the apartment and exercising. I have had a history of similar issues and after moving to a new city alone during COVID I was feeling very depressed as well. Things that helped me was minimizing the "wasted time" of just sitting in my apartment looking at my phone, on Netflix etc. Try and leave the apartment every day. Whether it be going on a long walk with good music, a hard workout, going to try some interesting food in another part of the city, just keeping the mind active/occupied really helped. Like people mentioned, joining some form of gym where there is a group/interactive component is beneficially both socially and for accountability.

Another thing I would recommend is meditation/MBSR. I thought this was ridiculous at first when my therapist recommended it but it has been extremely helpful both personally as well as even professionally by helping with my focus. Just 10 minutes a day can really make a difference. It may seem like a joke to people (my former self included), but it seriously did and still does wonders for me. I would recommed the Palouse Mindfulness free intro program, just google it and everything you need is on the website. There's a reason why this is such a hot topic in the space of wellness/health, and is being actively introduced in the military. Joe Rogan had an interesting podcast a week or so ago with an expert on mindfulness if you want to learn more about it.

As for the social scene, it sucks (especially for an introvert like me), but you have to put yourself out there. I think it all plays into the broader discussion going on around the issues of being a young man these days. I bet there are a lot of guys out there who are in a similar situation but don't know how to meet anyone. You really just have to try everything and I promise you some friends will come around. Go to a bar and watch a game and strike up some conversations, go play golf and match up with some guys around your age, talk people up at a coffee shop/food truck, or try some random rec sport and go to happy hour after. It takes time but you can eventually find people, as someone who was going through the same thing, I know the feeling, it will all get better, the more energy you put into self-improvement the better you will feel.

Its time to take big action.

If i were you I’d jump to a remote job. Then move to one of those work remote resorts/communities on an island. Get outside in nature and around a bunch of new people who just moved to a new place themselves and don’t know anyone either. It will revitalize you.

Whats the point in staying at your current job/city/lifestyle if you aren’t happy.

Yeah bro I've been where you've been. Sometimes a change and a fresh start is what you need when you get stuck in a bad place. A new job or city is a chance to meet new people and make new connections. 

I once read many years ago that the objective is to not "beat" psychological issues but rather to learn to manage them. Perhaps the negative voices in our heads never go away completely, they will pop up at some point once triggered no matter how well we have buried them through therapy, drugs, etc. Therefore, our task becomes not one of beating mental illness but instead to learn to manage it on a day-to-day or week-to-week or month-to-month basis. 

This doesn't mean you're a ticking time bomb waiting to go off at a moments notice. But it does mean that you acknowledge that you've got some issues that need to be worked on, that it's a daily practice, and you're working to get to a point where your mental fortifications are strong enough to withstand the barrage of the negative thoughts/feeling.

It helps me to think of it this way as cheesy as it might sound: your mind is a castle in the middle of the sea. Sometimes the water (your thoughts/emotions) is calm, other times it's smashing against your rocky shores. It's not about "beating" the water, that's impossible and it's always there in some shape or form. It's about how well you've built your fortifications to withstand the crashing waves when they do hit.

I've dealt with a lot of psychological shit from messed up family members for the past 20 years of my life. I can sympathize with the dark days and the feelings of worthlessness. My life started to change when I did the following:

-eliminated most people from my life as most of them weren't going anywhere in life

-was fortunate to have a very small few friends who were brutally honest and called me out on lousy thinking and behavior on my part

-went to therapy for 1.5 years

-got obsessed with learning about emotions and how crucial it is to manage them

An important thing to note about therapy is to be careful. I know many who get addicted to therapy and they bounce around from therapist to therapist for many years, never really getting anywhere. I went into therapy with a deadline - not an exact date but I knew this was to end at some point, sooner rather than later. It was an experience to help me build and use psychological tools but once I had them and learned to use them, it was on me to continue the journey on my own.

Get off social media if you have it. Get off Netflix as well. Get your body moving as much as you can. Hit the gym hard every day, spend as much time outdoors as possible and not stuck in your apartment. Make sure your health is in check with respect to diet and go get a rigorous work up of all your blood metrics including lipids, hormones, vitamin/mineral levels, etc. and correct anything that is out of balance. 

I can go on and on but I'll leave you with this: find a purpose. Find something that will keep you going no matter how shitty you feel. Maybe it's a place you want to travel to, a skill you want to learn, a goal you want to accomplish, a type of person you want to become, anything. But it needs to be strong enough to pull you through your worst days. The world is full of purposeless people which is part of the reason why so many are miserable. Find yours and at the very least, you'll have a rudder to help you steer, even when the seas get rough. 

I am sure everyone on WSO could comment on your topic because mental illness is something that affects every family.  Even if you do not have mental illness yourself, you are probably going to have a family member who has these issues.   Isaiah_53_5 💎🙌💎🙌💎 has provided some very good advice.  There is science behind exercise in how it affects the brain.  You do not have to have mental illness to get a benefit from exercise.  I would just add that if your current plan of meds and doctors is not working, try a new plan.  To some extent, a plan is guess work.  A doctor or therapist does not necessarily know what is going to work for you.  It is also possible that a doctor may not have diagnosed you correctly.  Also, whatever you are doing now is not working, so you might want to seek help from someone else.  

It’s possible. The biggest problem is that people on this forum don’t remember God. If they did, they wouldn’t run into their problems and not be able to deal with them the way they do

oh by the way, try ketamine. it disassociates your mind and body and puts your problems in perspective. 

Hey bud,

Mental health has often been an overlooked and/or misunderstood topic that probably affects more people than you can imagine. I think the fact you acknowledge you're struggling shows that you're strong and you should be happy because you're trying very hard. Here is a rather long rant and my perspective, since I feel like I can relate a lot to this. 

I think some people in this thread framed it very well - it's not so much about "beating" it, but rather coming up with tried and tested methods that work best for you and learning to managing it better over time. It was one of those hard & bitter "adulting" life lessons I feel like was inevitable to confront at one point. Once you get a better handle on it over time (and I'm sure you will!), you'll be capable of doing amazing things. Remember to take it one day at a time. 

One cliché theme I've personally really realized during my career and life in general is that everyone's different - what might make me depressed or sad might not affect you adversely and vice versa. Some people may be struggling due to a genuine physical distortion such as a Vitamin B deficiency, or an unsuspecting thyroid imbalance. Others might just be overwhelmed with life in general, be it a breakup with a longtime significant other, death of a family member, struggling to meet amends, could be anything.

I spent my first job working 14+ hour days on the night shift, barely getting any sunlight. I was by myself in one city while 90% of my other friends were still together after college having a blast in another, making me feel extremely lonely and forgotten about. I had rather severe insomnia so I resorted to just drinking by myself hard liquor until I forced myself to be knocked out. Suicidal thoughts were constant. While some conditions over time got better, this pattern of behavior grew from daily habits to a lifestyle for years and before I knew it, my health really deteriorated to the extent the # of ER trips I made in one year was more than the rest of my entire life combined. Bottom line - I neglected my health both physically and mentally resulting in a rather catastrophic series of events. Lot of my college "buddies" who I thought I could depend on for even the smallest of supports abandoned me, thinking I was some crackpot. Even someone who I believed to be the love of my life at the time ditched me for some other guy she had just met. I ended up just hating myself even more, telling myself how I was a failure and what I did to make it end up all wrong. 

I tell you all of this not to sell some sob story but to show it can happen to anyone, but the other kicker - I got over it. I refused to acknowledge something was inherently wrong with me for years but once I finally took that initial step, everything was uphill from there (which is why I'm praising you constantly for your awareness and already taking action now!). It's also a young thing but you'll hopefully and eventually realize that things like money, career and merely stepping stones and don't define the person you are. There's more to life than that, and this might sound really obvious but if you step back and think about it, especially in our industry, we place ourselves in a bit of a rat race and pre define what's success and happiness. We're so hung up on wealth, status, we sometimes forget the basics like taking care of ourselves. It's pretty healthy to pick up a hobby or lifestyle that's unrelated to your work, be it yoga, oil painting, or anything else remotely random - world is full of endless possibilities.  

I took a brief hiatus from work. At the time, it was a very tough pill to swallow only cause at my age (around yours), money and career success seemed like the most important priorities. It wasn't. Health will always be your #1. I spent that time to really revamp everything from the ground up, including diet, sleeping habits, and shopping for therapists. It was tough at first - a lot of time was spent brooding and me just blaming myself for how far from grace I've fallen. I can't say it all happened over night but as more time passed by, I felt like I went through a deep "cleanse" of both my mind & body. All the negative thoughts in my head, while didn't completely dissipate, the voices for those grew softer over time. All my ailments accrued from a reckless lifestyle (erratic heartbeat, problems in the throat, even some neural damage) eventually were all taken care of and gone for good. Despite the pause in career, I was able to make my way back in stronger than ever. Most importantly though, I really learned to love myself. Fuck what your job, status, or anyone else says. You need to value and put yourself above anything else. Do I still have problems and get depressed from time to time? Yes. But it was also a problem life threw at me, I figured out something that worked for me and now I know how to handle it should it come at me again, and I'm sure it will. I know you can too. Embrace your struggle as part of who you are, work to battle it, and seek out the people that are worthwhile - the ones who will support you and can help you help yourself. Don't let it get to you my dude. 

Anyhow, thanks for coming to my TED talk. Hang in there OP, chin up :)

Join clubs or an organization you find interest in. That is meaning in life. You’ll find like minded people & have a good time.

Delete social media & porn. I promise you it’s doing way more damage than you realize

Extreme but consider a change of jobs if you want. Or just start doing a hard stop at 50 hours a week.

On the social network / support part, you need to put yourself out there and really hope for the best. If you're afraid of rejection socially then you'll just be stuck where you are. If you weren't a dick in school or in work, you can assume that any rejection / unanswered calls are because not personal.

Sometimes it only really takes one person. Moving for work is also extremely common and if you're in NYC / London / HK, there will be a ton of expats in a similar situation and if you pass the smell test with one, it's easy enough for them to introduce a whole friends group to you.

Re: therapy & meds. May be the American way is to treat this an illness and completely separate. In some ways it is and it shouldn't be seen as part of you, but mental issues aren't like a cold where you pop some meds and go to bed. You have to be really transparent with yourself and decide to take action where you can.

The meds and therapy are to help you get there. Programme aside I think you need a break. Assuming you have leave, you can frame it as taking a month off work (it's xmas season now anyway), citing CV and being cooped up at home working for 2 years as a reason you need a short break.