I’m in a high-stress work situation where the organization is way too reliant on me to maintain day-to-day operations. We’re working on hiring a second person for my role, but it’s likely to take six months to find someone and get them on board.

And I’m afraid that I’m burning out now. I’m tired all the time and grumpy. Worse, in the last couple weeks I seem to be losing the ability to think. I’ll read an email and be unable to make sense of the words, or unable to figure out what to do with it – it’s just a blank white fog in my brain where I should have words and ideas and next steps. My productivity is less than half what it should be, and I’m horribly embarrassed and ashamed of myself.

I’m taking sick days and leaving work early when I can, which helps a bit, but not enough. I’m also doing all the recommended self-care stuff – diet, sleep, exercise. I’m scheduling a doctor’s appointment for next week.

I have a very good boss, which is the only reason I haven’t said screw it all and bought a one-way plane ticket to Tahiti. (I hear it’s a magical place.) Any thoughts on how to approach this with him? Under normal circumstances I’d try to arrange for some vacation time, but I’m afraid a week or two of rest isn’t going to fix the problem, just delay it a while. Any substantial amount of time off is going to really hurt my department. They may need to bring in someone to cover for me, which would be very expensive. I’m afraid it’d destroy my reputation as someone who can be relied on. What options do I have? What should I be doing next?