How long should one leave feelings of being on an unsatisfactory or unsustainable career path before seeking help?

This is a challenging and deep question.
On the one hand - day to day ups and downs are inevitable in any job and developing a certain degree of resilience to those is vital in any career.

On the other - leaving things until levels of stress, burnout or frank depression regarding a career that is not feeling "right" often results in a spiral downwards  and at times this even precludes seeking career guidance. Why? Because the process of undergoing career guidance really effectively is one where a person needs to be in the right frame of mind - namely - relaxed, open minded and creative with time and energy to put to it. Rather too often we see professional people who are worn out and quite down about their career situation. In these cases we need to do some work with the individual to ensure they are not just wanting and needing career support but that they are ready and able to engage with it.

It is my view that our workbook is almost a diagnostic tool for depression in that when a person is suffering low mood - they find it almost impossible to complete it. This is because there are searching questions within it that require some deep mulling and if a person is struggling merely to function day to day then adding what seems like just one more stress is not sensible.

This is why timing for career guidance is far more important than people may at first realise. Yes of course an unsatisfactory career situation needs addressing but if you are not in the frame of mind most likely to help you address this - then joining our programmes are in short - a waste of money.

To try to help combat this need for "pre - career guidance" warm up  - I wrote the ebook "easy career change good career choice". It covers a range of things to think about way way before getting to the career guidance stage. It seems logical if one is going to spend time and money investing in ones career to be well prepared for this rather than lurching into it without much thought other than "I am a doctor get me out of here".

So the answer to the question I think has to be this. If you have career doubts or feelings of mismatch or a sense that you are not on a pathway that is sustainable or attractive - the sooner you start to address this the better. You may discover ( as a fair proportion do) that you ARE in fact in a good career path but you are not handling your career or planning it ahead as well as you could be. Conversely you may discover that there are some fundamental areas of dissonance between who you are or would aspire to be and what the career path you are on can bring. Either way - the discovery process will aid things along. In short - I would say don't leave any feelings of career disappointment, drift, dissatisfaction, plateau or mismatch as they generally don't get better. They need to be acknowledged, flushed out in full and addressed in a sensitive, realistic, structured yet creative way.

?People often ask me what career planning I do for myself.
It could of course be the shoemaker with no shoes!

However I do use most of the techniques I espouse to others. A couple are particularly useful.
I think these might well be called "advanced" level career planning - not to blow my own trumpet you understand - but because these are techniques that do not always sit comfortably with those just joining a career guidance programme and undergoing perhaps what might be the first in depth career guidance they have ever had.

1 The first technique is to simply think what I want.  Ahhaaa - but that is NOT so simple if one is overwhelmed by frustration and exhaustion or if other people are muddying the waters. When I ask that question point blank 'what do you want" - I am often met with a blank look or a despairing one or the phrase "I just don't know".  This presents a minor barrier to career guidance but it can be overcome . However without addressing this issue the person is likely to want you - the career guide - to define this for them. 
RULE number one in career guidance - do not make other people's dreams and decisions for them!!!!
It is important to facilitate THEM to do this for THEMSELVES.

2 Having decided what I want more of ( or less of - but the more of is generally better in terms of motivation - ie carrot not stick ) I think creatively about all the possible ways in which that might be achieved and then I visualise how each way might end up or look like.

Sounds simple enough but if a person is anxious or even depressed or burnt out - thinking creatively might ( even for a highly creative person and not everyone is) be extremely difficulty.

This is why I don't recommend these approaches unless a person seems truly ready for them.
I would like to teach these techniques more as they are very effective. The challenge remains that in a room full of people - at any one time only a handful will be truly ready to engage with these techniques.

So - part of the career guidance process must involve a plan to get into a better place where one CAN adopt these techniques - even if only in part and occasionally to begin with.