<3 I'm sorry to hear you are struggling so much lately.
I can really relate to not being able to follow through on an alternate coping list/distractions list after a certain point.
Maybe re-thinking the whole therapy thing might be a good idea? or trying to talk to your PDoc about the meds at least? I know it's difficult to see little improvement after working so hard, but maybe a different approach needs to happen in T? I was in T for 13 years before I started hitting upon something that truely helped. It wasn't so much that I had bad T's, but I was refusing to address some of the huge underlying issues. Not that I am facing that stuff that I didn't want to face, I'm seeing more over-all improvement. I'm not trying to imply that you have stuff you are not facing, just that a change in style or procedure mght benefit you more?
I like CANDC's suggestions around lifestyle support for your mood. They can make a big impact on things...
I hope you are able to find some relief soon. Would you be able to reach out if the sui thoughts start to turn more to intent?