Have you been tried on any other kind of medication? There are different families of drugs that work in different ways and have different side effects. Different people respond differently too. Depending one what you're on there may also be slow release versions which can soften any side effects.
Have you had any other support? Counselling or CBT through IAPT?
If you google "centre for clinical interventions" (CCI) there are lots of free CBT modules on different topics you can look through. You could pick an area that your struggling with and have a little look through to see if there are things you could start to implement. I always find the way they're split into little modules for each topic helpful as it means you don't get overwhelmed by lots and lots of information or tasks to try. You can just read an intro and go away and ponder it for a while, or try one exercise.
It's great that you have work and feel positive about it, so I absolutely understand why you don't want that to be compromised.
Do you think it would help at all to feel you had options and/or a bit of control over things?
This was just me, so if it's not helpful disregard it, but I found it helpful to use work as my place where I tested out CBT and started tweaking some of the things in my life that were making me so unhappy. Would that be possible for you?
Having places where you can open up about how unhappy you are without having to put a positive spin on it is important. Mind run Elefriends if you want somewhere you can get support from other people going through similar things. I found it a great comfort for a long time. Elefriends.org
You can email samaritans - [email protected]. I usually find it easier and more hopeful than calling, although you can call too 116 123. You don't have to be suicidal to talk to them.
One other thing I started was making a list of all the things that interested me or I'd ever wondered about trying, and then spent time just looking up local events. I ended up trying lots of random stuff that sounded interesting, and over time I started to feel more confident and learnt how to keep my anxiety in check. Some of them I loved, some were mildly enjoyable, some were interesting, some were a bit dull.
It took my mind off worrying about the future and having a grand plan for it. It was easier to just have some nice experiences in my life.
Do you have anything like that you could try? I looked at community events, charities, adult learning courses and open evenings, leisure centre... Anything I could think of. Then picked the ones that appealed and I could do.
If it sounds intimidating, the "trick" I used was to tell myself I just had to sign up and then if that was all I managed I would recognise that was an achievement instead of beating myself up. Then once I'd signed up I'd tell myself, that if all I could do was get to the venue then that was enough bravery and I would be proud of myself. Then once I got there I'd tell myself if I wanted to leave as soon as I got inside I could.
Which meant I usually ended up going and staying and enjoying myself, because I had given myself permission to leave if it was too much and I knew I was not going to give myself a hard time for it. Small stuff like that can really help.
If that sounds like too much could you just set up s little diary planner for yourself scheduling out your day and the things you have to do (like getting ready for work, travelling, working, home, dinner, etc) and then find some time spots to plan a few extra nice things this week? Going for a short walk or watching your favourite film or something like that?
Then gradually build up the extras you're planning for yourself each week as it gets a bit easier?
And/or keep a little notebook where you jot down at the end of the day all the things you've achieved today. By which I mean all the things you struggled with but tried anyway. If it's been a really rough day it might just be managing to get out of bed and get through the day, on other days it might be small things you did that were hard but you were glad you finished.
It can help to see you're getting things done.
If holding everything in your head is too much it can help to see your week planned out. When I'm really struggling I have a week planner notepad where I write down everything that's coming up and that I'm worrying about remembering or fitting in, and then I tick it off as I get through it. Stops me worrying so much, eases the eight of things I feel like I'm carrying, and makes it feel less insurmountable, especially once you see you are getting through it.
These are just things that have helped me. If they don't sound right for you, ignore them. But there will be things out there that will help you, so please don't despair completely or feel like you're alone. You're really not. Take care 