At what point do I say enough?

Fabulous!
sounds like 2026 will get off to a great start! xx

Good luck OP!!!

@sickleaveornot you do whatever you need to to keep getting better xxx

You’ve done the right thing. I was signed off with burnout for two weeks before the summer holidays (I work in a school). I was trying to push through to the end of term but couldn’t make it. It was absolutely the right decision. You need to look after yourself first before you can help anyone else. You can’t pour from an empty jug as the saying goes. Good luck with the job hunt.

Please take your own advice.

It’s worth starting look for other jobs but don’t rush if you’re life has been upheaved so much recently. Start looking, brush up your CV.
I’m late diagnosed AuDHD (Autism at 33, ADHD at 41). I’m medicated for that after years of trying anti-depressants which numbed, but never uplifted me. I ran out of meds recently and had 5 days off them. I felt so flat, so down, lethargic. Told DD I ran out and she said ‘Oh! It’s that why you’ve been more chaotic recently?!’ 😆 apparently so! It’s not a magic cure but it makes a big difference to me well being.

I would give yourself and your body time to get used to the change in medication, which for anybody could make them feel a bit off.
I would take 2 weeks off but instead of thinking I’ve been signed off work, I’m going backwards this is a setback, I’m mentally spiralling.
I’d say I’ve got 2 weeks holiday time, unexpected to do something nice. Each day I’d so something just for me. I’d see it as a reset time and relax.
Just simply changing signed off for holiday mentally feels better.
big hugs x

That's really interesting. I hope you find something that works for you

Well done, proud of you

Not answering your post but:

Have you ever been assessed for ADHD? There's increasing evidence that many women diagnosed with bipolar (and who dont respond "normally" to medication do respond very well to ADHD medication and on further investigation may actually have ADHD rather than bipolar).

Okay I get that. I’m glad you’re going back to your GP, I hope the time off does you good and you manage to get back on an even keel.

For what it’s worth, I have been in your shoes in the sense that I didn't think I was ‘ill enough’ to take time off until it was too late. Unfortunately with that mindset, you keep going until you are forced to take the time off because you have reached failure point. Don’t wait for that day, it might be that you will not manage to hold it together with a client for example. And if that happens, it won’t be ‘the sign’ you need time off, it will be the sign that you have needed time off for ages and didn’t act on it and in doing so failed in your duty of care to a client. That’s so much worse. You’re doing the right thing by stepping away and looking after yourself first. Well done and get well soon 🌷

You’re not supposed to wait until something is as bad as it could possibly be before you allow yourself time to heal. You need the time to heal to prevent it from getting as bad as it could be.

I waited far too long. I didn’t go off until I was told categorically by someone in occ health ‘Why on earth are you at work? You’re not fit. You’re off sick from this moment’. I’m quite amazed in retrospect I came to no harm.
If you’re looking for a sign to go off sick - this is it. Take time for yourself to recuperate.

MH professional here - you need to get signed off.
Look at the worst case scenario hypothetically (trigger warning)

Youre stressed, you miss something, a pt completes suicide and you were the last professional they engaged with. You're in coroners court. Your GP provides testimony that you wouldn't take time off. Bang goes your career.

Just take the time off, there's no shame in it, regulate yourself, and get it in writing to your employer that you don't feel supported. It doesn't sound like you're very senior (I'm not being nasty at all), so your line manager has to take responsibility for you (as long as you are taking responsibility for your own MH and following your your GP advice.
Take the two weeks off - a week isn't enough for your nervous system to regulate.
I hope you're feeling better soon, much love x

IMO you either trust your doctors judgement for your care or you don't..

They've got your meds right in the past, they are making adjustments now and they are advising time off.

From where I'm sat you need to just do the hard thing and make the decision to take that health advice and switch off to the work viewpoint.

Just decide now, I'm getting signed off. Don't think about how you'll do it or tell work, that's tomorrow's problem.

Today you take care of you. Make the decision and the rest will fall into place.

what I'm struggling with is is at what point does struggling turn into being signed off.

I left it too long and couldn’t go back. Escorted away from the premises in bits. I was ill for months and I doubt I’ll ever to be able to work at the same level again. Get signed off, if you quickly feel better you can go back to work.

And please do consider joining a union.

Good luck-wishing you better very soon.

Do you have a union rep who could advise you?