Triage, OP. It sounds like the low hanging fruit is your trip abroad to see your parents. And it also sounds like the idea of that is causing you a lot of stress about money and your limited time. In the short term it seems the most logical way to deal with that is to cancel your trip. If it’s so important to your parents they can travel to you. This doesn’t solve your money, in-law or upcoming college issues but it can take some stress off your plate. Plan a visit with your parents when things stabilize some.

Welcome to mid-life. We are dealing with our teens' medical issues and our own professional issues, both of which are very serious. Forget about family visits, ha, that's not happening. Siblings are carrying the load right now for eldercare, because we have too much going on.

When the problems get intense, you'll find yourself just closing your mind to secondary issues. Your brain starts compartmentalizing out of extreme need.

Hang in there, OP. Do whatever you can to get some quality sleep. It doesn't help that perimenopause hits at the exact same time and messes up sleep!

Dh and I have too many expectations on us: teens about to go to college, his family having issues with eldercare, money, my family wanting us to visit abroad...How do we balance all this and also exist as people? Right now we have the eldercare issue in-laws are not able to sort out, and my parents are so hopeful about the visit which basically means $$$$$ and the one break we have. I have anxiety about it, trying to please everyone, worrying about college for my kids, how irresponsible my in-laws are...It feels like too much.