I'm restless mid-career, do I need change or perspective?

You are restless in the middle of it all, and you cannot tell whether you need to change something or just see it differently. That is a real fork, and mistaking one for the other is costly. Slowing down to ask the question is wiser than lunging at either answer. Sometimes restlessness means the situation is genuinely wrong and must change. Sometimes it means the situation is fine but you have lost sight of why it mattered. The feeling is the same from the inside, which is why you have to test it rather than trust the first story you tell yourself. Try a perspective shift first, because it is cheaper. For two weeks, deliberately notice what is good in the work you have. If the restlessness fades, it was perspective. If it stays, it is change. Let the experiment answer what worry cannot.