I too cannot rely on any thought of anyone "caring" as a deterrent to suicide. i've been 100% off of social media and no personal conctact with the closest friends I have and no one notices. Work would "miss" me if I didn't show up but if I told them I needed a week or two weeks away to treat my depression then they wouldn't notice until I was supposed to be back and even then they would probably give that date a little flexibility. I live alone in a house and keep to myself so I don't think anyone would have any reason to even look for me until I hadn't shown up for work for a few days.

I started therapy and an antidepressant but I am still in emotional pain and physical pain every day. Like you I have physical ailments including arthritis and a cardiac condition that keeps me from attempting any social activities that might help with my depression.

I am now in an IOP program I go to every day to get help and therapy with my depression. When I enrolled I had already tried everything and while I saw possible relief from some of my daily problems I know there is no relief from my longer term problems that I've been working on for years plus the health issues which just keep compounding.

So why did I seek out and enroll in an IOP?

Because I had NOT tried everything. I had no hope but I allowed myself to take a leap of faith (not in a religious sense... I am an athiest) but I took that leap that if I tried something different it might possibly help.

The program is a type of therapy that I had not tried before (DBT) and you know after I think 4 weeks in the program I think it is starting to work. I am invested and I practice the things they are teaching me when I am home and in stressful situations that lead me to having more acute feelings of suicide. I'm not thinking of suicide much anymore, I haven't been able to work for several weeks but now I am starting to have confidence that I might be able to actively apply this therapy to work and rejoin the workforce.

You said "I'm not interested in therapy because it won't help me sleep better" but you absolutely don't know that. If you've tried therapy before a different type of therapy might help. Depression absolutely affects sleep, you said the sleep apnea medication helps some but not enough. Maybe the depression is what is blocking the medication from going that extra distance. If that lets you sleep the sleep might put you on the road (with continued therapy) toward breaking the depression cycle. Like Marvin said above.

If you are desperate you owe it to yourself to try that before you try to end it, if only because you can't try them in the opposite order.