Dear David,
It sounds like you are not missing anything by not being at the family thing.
How about taking some time off for yourself? Can you request a free Friday soon, for example?

Go back to that pyschaitrist. I don't see what the big deal is that he had a different patient or chart in front of him than he really did. I always used to walk in with my list of meds and name on a sheet of paper and hand it to the guy. No big deal.
My absolutely fabulous talk therapist used to fall asleep. I didn't care. It was late in the afternoon and he otherwise was my life saver.

The UK system has lots of support in place. I know this because of a poster on another board. He talked about a "drop in" -- we have those here, maybe I have the term slightly off. He had a swim group and so on.

The insurance companies here AND the system in the UK encourage talk therapies becuase they are cheaper than the pyschiatrist visists. You might benefit from talking. You seem like a verbal guy. How about group therapy?
CBT, as you know, can help people manage their lives, get better at making decisions, help them learn to recognize their moods, help them deal with the side effects of the meds, help them change their thinking patterns . . . And DBT can help get you grounded again.

Go back and get back on a med or two. Maybe you need a mood stabilzer, or something that will cut the anxiety. I'm reading anxiety in your post. Or is it agitation? Worry? How would you define it? Overwhelmed?

You sound really hard on yourself. I know that in your work you are encouraging and supportive. Can you learn to be encouraging and supportive to yourself?

And really, let the family stuff wash off like water off a duck's back. Let it go. Sometimes those of us with those kinds of families do much better with the family out of sight and out of mind.

Feel better.

Mari