I’m a guy who’s been intensely depressed and anxious my entire life. Here’s a summary. I hope it doesn’t come across as too self-pitying. It will surely be too long; I don’t have the energy to properly edit, and I’m sorry for that.

My parents were both emotionally abusive, and my father was sexually and physically abusive as well. My only sibling became a copy of her mother. I was constantly terrified of the world, and full of guilt for living. I was nice, and smart, and I managed to get a PhD, but that was about all in life that I’ve accomplished. I was isolated, and achingly lonely, but about all I could manage was to hide out and hope that somehow I’d become good enough of a person to somehow fix myself. Due to my childhood I was really messed up sexually, and had no ability to feel loved—for those and other reasons I wasn’t able to form long term romantic relationships. I would catch occasional glimpses of happiness, but just enough to realize what I was missing out on. And I missed out on just about everything.

Mostly I was just hanging on. The analogy I use is that of being driven underwater by a huge wave. It takes a while to figure out which way is up, and I would reach the surface and get a tiny sip of air… only to be driven down by the next wave. On and on.

Eventually I ended up on Medicare disability for depression, and kept sinking. Eventually I found a woman who was the first and only one to make me feel loved. The first person I ever trusted. But she was a psychopath or similar, and just pretended, for five years, to love me. (Don’t laugh, but she was only in it for the weird sexuality.) I gave her too much trust and power, and she stole everything I had, through identity theft. I have been completely crushed and nonfunctional in the decade since. I mean to the point of often not being able to get up from my bed (my mat, actually) to go to the bathroom, or turn on a light switch.

I can’t see any way that I could possibly turn things around in the time I have left to live, having wasted so much of it, and being where I am. No money, horrible teeth (especially painful to me, because, pathetically, the second thing in life that I accomplished was to take excellent care of them until the girlfriend destruction. (I’ve demolished them, due to intense nighttime grinding. There is no dental government aid for the poor, at least in my state. I am down to a pair of opposing teeth on either side, and they are shaky.) No friends. No interests. No clear thinking. No appetite, can’t sleep for days at a time, can’t breathe, have a tight fist gripping my gut every waking minute. No voice left, really. (I have been on withdrawal from klonopin since May, I am a physical mess due to that, and it’s not getting better.) I cannot make myself believe in God, and I have tried hard. Not a single person on Earth will miss me when I die.

I’ve seen psychiatrists and therapists all my adult life. Have tried every antidepressant there is, or nearly every one, multiple times. One experimental TMS depression treatment. No drugs have worked. I’ve resisted ECT until recently, because of the severe negative effects it had on a family member, but came to think that if it wiped my memory and/or identity it could be a better outcome than going on. But they tell me that they can’t do ECT on me for physical reasons. I could get TMS, but I’d have to pay half of it, and I don’t have that.

I’ve seen many talk therapists, to no effect. I don’t know why therapy hasn’t worked. Part of that may be due to the fact that I haven’t been able to afford top-flight therapists, but I suspect that most of the problem is that I’m just not able to get how to “do” therapy. Plus once your life falls apart past a certain point, the truly big issues have to do with the practical holes you’ve dug yourself into, which therapy doesn’t seem to address.

Finally, to the point. My psychiatrist, a resident being trained by a clinic, just graduated (off the usual schedule). That clinic doesn’t want me there, and I wasn’t getting any better. So I made an appointment with a psychiatrist who accepts Medicare and Medicaid. On my first visit, yesterday, three patients were scheduled for the same time. The psychiatrist showed up pretty late, no explanation. An hour later she saw me, took just a cursory history, then wrote out, on one prescription, the same meds I had been taking, in the same doses, then said I should make an appointment in a month. She didn’t ask if I had anyone to see for talk therapy or anything. Didn’t listen about my physical condition, or notice it. Seeing her won’t help anything.

I don’t know what to do. Literally. In any way. Like even the next step. Mental hospital won’t help (I tried that once), because there’s no procedure they can do there to help me, and I’m not suicidal. Plus I really don’t want taxpayers (people who, unlike me, contribute) to pay for something that won’t even help.

Anyone have any practical ideas that could help? I keep hoping there’s something to try that I haven’t thought of, but that’s just unwillingness to face the truth, I think. I used to try to offer advice in an online mental health forum, and I was, able, on occasion, to give good advice, I think/hope. But so often their problems seemed so large that I couldn’t think of anything meaningful at all. I have no idea what I could possibly tell someone like me, aside from “hang in there.”

Thank you.