When talking no longer helps... When the only meds you can tolerate don't lift the mood enough anymore...

I feel like I am shutting down. Some days I'm so low and desperate for someone to help me through it - yet I can't bring myself to call a crisis line. It all feels too overwhelming, too much effort to explain, so I don't.
Been in and out of counselling with different counsellors for the past 5 years. Now it's just for maintenance. I'm all talked out.
I finally realised that the only person who can change things in my life, is me. No one else can do it for me. But it doesn't seem worth it anymore.
I accepted a long time ago that one day I would end my life. It is no longer a question of if, but when.