Have you explored WHY you feel emotionally annihilated? If not, this should supply some answers.

I'm sure dealing with the acne would help both the self esteem and the overly young appearance. What do you think?

About the careerless and lack of direction, to me this is the most difficult to solve. I have the same problem - lack of focus on something particular in this world, but I am exploring actively. Are you? Of course this can be associated with many disorders, but it's not my job to pathologize things for anyone, including for myself.

Solving the emotional and physical issues could help in solving the deeper issues, which can also be tackled directly. However, if you are escaping into movies (not saying you are, but I've had a tendency to do so, or with books) then you are not dealing with these issues directly. Since you haven't described struggling with them, I interpret that maybe you have been letting life's flow carry you in whatever direction.

Also, what are these expectations other people have of you? Do these play into the other 3 concerns of yours that I referred to?