With all due respect, my understanding of Isolated Guy's main issues can be split in two: love and sex.
The physical part, that's what I want to talk about.

May I suggest that you consider using sex workers to help your physical self... Or should I say, dare I suggest.
There are wonderful professionals out there who are caring and loving and I wonder if you've ever given yourself that kind of pleasure.

Sex can be a source of altered states of the mind, for better or worse, and since you highlighted the physicalness of your situation, I thought I might as well introduce loveless sex into this conversation.

Sex has become such a taboo issue since the Aids epidemic, yet I can't separate it from my depression/anxiety.

Hope it helps a bit and that I'm not offending anyone - not my intention.

Peace

p.s. one of my most beloved friends in the world is convinced that he's the master monster of ugliness. he met someone online, though, and they've been living together for years. he's like real tall and real fat and all. i find him beautiful, though, and so does his gf. maybe there's a light that never goes out.