I am prescribed zyprexa 20mg tegretol 200mg 3x and lexapro 10mg.

I stopped tegratol like 3 weeks ago because I felt it was causing rash like acne all over my body. So I wanted to see if it would go away.
A rash from medication is the sign of an allergic reaction. A rash should never be dismissed or ignored. Have you told your pdoc about the rash?

I've been cutting the zyprexa since back home for about 3 months because I can't function on 20mg. And I get tremors. I take about 5mg or 10mg.
I was taking Latuda last year and found it helpful. Then I developed a severe tremor from it. My pdoc told me to immediately stop taking the Latuda because of the possibility of TD. Unfortunately, many psych meds cause tremor. Nevertheless, the tremor should not be ignored. Again, have you told your pdoc about the tremor?

Recently prescribed lexapro and it seems to have destroyed my libido. I haven't taken it in 2 days.
That is such a serious problem for many people, especially for men. Loss of libido is a very real reason that many people are not med-compliant. Another subject to discuss with your pdoc.

I am obsessed with side effects and its been like this since I started medications 14 years ago.
Its appaerant to everyone close to me that I can't function without medication.

I can't help but play doctor its like a serious problem I have. I am stable now just tired and depressed.

Should I suck it up and take them as prescribed? Come clean to the pdoc?

Does anyone else struggle with taking pills as prescribed?
I think you're being awfully hard on yourself. The side-effects you've described in this post are all extremely important to discuss with your pdoc. I'm not surprised that you feel tired and depressed. I would feel the same way...I'm guessing that you feel you're in a no-win situation?