Sorry you're in such pain. I'm in a bit of the same state. I'm not having self-harming thoughts (although I always wish I wasn't born.)

I don't like the person I'm becoming in this, my most recent episode. The last time I was this bad was about 4 years ago but I was a lot more open about it and kinder with people during that one. This one has turned me into a bit of a monster and I've grown indifferent to engaging with others. The depression makes me have overblown reactions to people, and I ended a 20 year friendship because my friend was extremely rude to me after I gave her a birthday gift and she had no idea she came across that way. (There's more to it than that...there is some history, but this was the last straw, so to speak.) I've also had outbursts with a few others. I'm really ashamed of myself but I can't stop being so hypersensitive. I know not everyone is going to be nice all of the time.

I've also started avoiding everything big time out of fear of having an anxiety attack or crying spell. Just this evening I was a no-show at physical therapy (for sudden back pain due to having depressed lie-ins on a bad mattress for the last 6 months, ha) because I just had a complete wave of sadness wash over me and I didn't want to make a scene. Working is quite difficult and I discovered this afternoon that I made a big mistake last week (related to my department's protocol on file saving, too complicated to go into) that nobody happened to catch...everything is fine, but if it was I would have been in big trouble. Maybe that's why I skipped PT later.

It sucks when this stuff happens even when you and I are both under treatment. We are in the minority, because the majority of the population who have a mental health issue never seek professional help. We do, and we still struggle. It just doesn't seem fair, does it. I remember reminding an ex-psychiatrist [after he raised his voice in audible frustration which made me feel like my failure to get better was my fault] that I was the one who initiated a request for help, I was the one who made the phone call and had to miss time off work to come to these appointments, and that I could just sit home and drink to self-medicate instead...but that I was still trying.

Please seriously consider telling your psychiatrist about the self-harming thoughts, though. But I know none of us likes to open up that can of worms out of fear we'll be sent to the hospital or put on more rigid supervision, etc.