In vocational matters, I should begin with a disclaimer based on current events. The global pandemic has rather uniquely imperiled the vocations and finances of practically everyone worldwide. While I am not going to ignore the individuality I see in every chart, I must emphasize that I am not able to help much with what is now nearly a universal problem. Being nearly universal means that astrologers have little to compare with and little experience to draw upon. In your case I will concentrate on the individual things in your chart, but I cannot offer much advice concerning the global pandemic and the vocational challenges that are directly tied to that.
I cannot see an obvious challenge to your vocational success except for Neptune on Mc; of course Mc is very instrumental to understanding your vocational status and focus, and Neptune is very challenging planet to have conjunct any part of one's chart, let alone Mc, but Neptune is not out of place for any worker in the mental health field because Neptune is closely associated with the general welfare of human beings, particularly those who are troubled or disadvantaged. Neptune is closely aligned with pathologies of various kinds.
I fully understand your feelings about fate in this regard, because outer planets represent concepts that are a bit cosmic and in the realm of things beyond our personal control. To research this further, either as a psychiatrist or an astrologer, I recommend The Astrology of Fate by Liz Greene. It is the chief treatment of this matter, and Greene is a very eloquent writer.
Since you are investigating a particular complaint of yours, I will look further for challenges and afflictions. Mars-conjunct-Saturn is a famously difficult combination, but it can be quite brilliantly helpful when sextile to Mc. It represents bitter hardships that show that your chart has more than the average level of difficulty, but its situation sextile the Mc can be quite helpful in many ways. It is better understood as part of the stellium Pluto/Saturn/Mars. With this stellium sextile Neptune on Mc, I would suppose that you are particularly interested in dangerous pathologies such as suicides and those who are criminally insane.
To have Neptune angular suggests that you are impressionable and susceptible to confusion. You are colored by your surroundings and environment, but you still retain your concept of your individuality. This sensitivity is helpful in your profession, but it comes with vulnerabilities and challenges. With Pluto sextile said Neptune, I would expect psychic sensitivities and paranormal gifts. It also suggests that you will struggle with the mystery that you don't have the answer to the question, "Why am I here?" You may not fully solve that mystery to your satisfaction.
I don't see as much vocational challenge as I expected to see, so I would suggest advice that I might give when a chart is dominated by Neptune energy. Try to organize more. Try to make your spiritual and psychic insights practical.
Transiting Neptune is crossing your natal Ascendant now, and that is a critical and challenging time, but it is obviously temporary.
Transiting Juptier/Pluto/Saturn is squaring, generally, your natal Jupiter/Pluto/Saturn. This suggests brutally hard labor as your practicality seems to struggle with your attempt to do the impossible. You feel that impossible levels of patience are required of you. You are driven, but you are burdened too, and the result is great restlessness.
Solar Arc Ascendant is opposed to your natal Pluto. This brings to the fore the very concept of being a psychological counselor. You are keenly aware of how power is used in relationships. You may be dealing with someone who has authority over you in a crucial way. There may be an introduction, if not a relationship, to a fascinating person.
Solar Arc Moon is trine natal Sun. There may be a very significant romance. Many people get married at such times. It is a sensual and deeply moving time for you.
Solar Arc Uranus is oppose your Sun. Actually that has been true for a year at least, but we allow a wide orb for Sun in solar arc directions, so it is well within orb. It is an accident-prone time. Take precautions accordingly. Don't drive or operate machinery when you are rushed or upset. You may be introduced or in a relationship with someone you consider a genius.