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thomblake comments on Where to Intervene in a Human? - Less Wrong
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In my experience, one doesn't notice things that are wrong until there is something to contrast them to. For example, you might not even notice that you need new glasses until seeing the world through better ones.
So a first step might just be radical change. Be mindful of the adjustments you're making when changing food, location, or employment. Flail about a bit and do informal self-experimentation along as many dimensions as possible. This should help highlight location / emotional / physical conditions and suchlike that are getting in the way.
I realized I needed glasses when I was hiking with a friend. She took off her glasses to clean them, and I happened to look through them. It was a rather instant reaction of "oh wow, I need glasses!"
I got lucky in that she has an almost identical prescription to me, obviously :)