Well, now we have an interesting development in our story...
On Tuesday, that brutal day of pain and hopelessness, I contacted my doctor to follow up on the thought that there was something more to these big feelings than just work-related dissatisfaction. I saw her yesterday morning, and though I wasn't as emotional as I had been at other times in the last little while, I still cried as I described my struggle to perform and care about work. Surprisingly, she was pretty adamant that I take a medical leave, starting immediately.
She thought that a big contributor to my difficulties may be garden-variety depression -- a little Zoloft and talk therapy, and 3 months off, would help get me back in balance and enable me to approach the career transition question with more equanimity. I talked her into letting me stay for 4 more weeks, to complete the big event I'm in charge of pulling off, but now I'm even questioning that (the waiting, that is).
After the initial shock of the idea of "giving up" and "running away" and "letting down my co-workers" by taking a medical leave, I must say it's SO wonderful to imagine having peace and quiet in which to unwind and restore myself. I'm not thinking about a medical leave the same way I was thinking about a personal leave -- for a personal leave, the goal was to find my next purpose. For a medical leave, the purpose is to simply be. Make no decisions, don't try to learn or plan or make progress on a path. Just read, and walk, and meditate, and do yoga, and have lunch with friends. With a medical leave, I'm not making any statement about the job, and it will be there when I come back. If I'm feeling better and my doctor agrees, I can return before the 3 months is up. If I'm still in turmoil, she extends the leave.
So I'm going to take the weekend to come to terms with the idea of a medical leave, and think about whether immediately or in 4 weeks is best for me.