It's good that you're talking about this. That's the first step towards making things better. Just one more stranger's opinion: These things tend to feed on

It's good that you're talking about this. That's the first step towards making things better. Just one more stranger's opinion: These things tend to feed on themselves. (Stress makes it hard to focus, which is in and of itself stressful...) Also, I've heard that stress-related chemicals like cortisol stay in your body and make it more likely that future situations will trigger stress. If that's true, you could really benefit if you find some way to break the cycle. I've heard vigorous exercise is supposed to help (though possibly just because it improves your sleep). I'm sorry to hear about your RSI. I don't want to sound glib, but is there any way you can take another look at it? You've probably investigated all the possible work setups and all the medical options, but I can see that contributing to the mental overwhelm. Not sure what exactly you mean by "demanding family life," but I had a friend who told me his life got better when he started trying to say"no" to his family a little more often -- both immediate family and other family members. His thought was it's better for them and him if he's not there feeling overloaded, and then going through the rest of the week also overloaded. (My suggestion to him was to hire a cleaning woman or a baby-sitter or someone to lighten the load wherever he could.) Finally, could you think about changing jobs? (And then make sure you take some time off between the last job and the new one.) It sounds like you feel comfortable talking to your manager about reducing responsibilities, so maybe your employer isn't the problem. Just tossing this out there because you have ways to change the situations and choices you can make. Sometimes knowing that's there eases some of the angst. If all else fails, maybe grab a little downtime anyways. Taking a break is sometimes more productive than putting extra pressure on yourself when your brain isn't where it usually is -- since the pressure doesn't really resolve the situation. (I've gambled on the idea that I'll come back more productive after time off -- and it's actually worked more than a couple times.)