Yours sounds like a very difficult place to be!
I have had a lot of problems with medication that has marginal or no effect and my Pdoc has said it will only have a certain amount of effect.
This is hard to take as I did once have lithium which helped significantly for over 20 years but no longer does anything.
I don't really have answers, keeping on forcing myself to do things is hard hard hard! So far I have been able to so am most likely better than I would have been staying in the four walls, which isn't saying much, but you are not me and it seems may have been fighting this intensity for longer so I cannot say what you should do.

I have great admiration for my friends who have had more severe problems for longer than me and are still alive. I suspect you come into that category too.

I salute you for still being here and somehow summoning the motivation to post here.
I don't know what else to say, so send what warmth and care I can.