Most of the people I work with spent months — sometimes longer — asking some version of this before scheduling a fit call. Is this just what the job is? Is everyone this tired? Is this a me problem or a career problem?
These reasonable questions tend to keep people in ambivalence longer than necessary.
The job is hard. That’s true and also not the full picture.
BigLaw is genuinely demanding. Hospital medicine is genuinely grueling. Running a company at scale is disorienting in ways that are hard to describe from the outside. The conditions are real, and the toll it takes on you is palpable. Most importantly, you’re not weak for finding it hard.
Sustained high performance under pressure produces specific changes in how your nervous system functions — changes that persist past the demanding stretch, that affect sleep even when the schedule normalizes, that show up at home in ways that have nothing to do with what’s happening at work. The system adapts to the demand, and those adaptations don’t always reverse on their own.
The question isn’t whether you’re resilient enough.
It’s whether rest and time off can sufficiently address it — or whether it’s moved beyond that point.
Some markers that suggest it’s beyond that point:
- Sleep that doesn’t restore. You’re getting enough hours and waking up exhausted.
- Emotional flatness that follows you outside the job — not tired-after-a-hard-week flat, but flat in ways that affect how you experience things you used to care about.
- The absence of something that used to be there: enjoyment, presence, a sense of forward momentum — not diminished but genuinely hard to access.
- Irritability in contexts where it doesn’t fit, with people you care about, over things that shouldn’t register.
The clinical picture:
These symptoms are not necessarily evidence of something permanent. They’re symptoms with a mechanism, and they respond to treatment.
Therapy doesn’t address the job itself — though the job is relevant and we’ll talk about it. It addresses the physiological and psychological patterns that have developed in response to the conditions you’ve been working in, and what it would take to move in a different direction.
If you’re not sure whether what you’re experiencing is serious enough to bring to therapy — that uncertainty is worth a 15-minute conversation.