I'm in a very similar situation. I'm at the half-century mark too and have not experienced any of my extremely tiny dreams -- things that many people take for granted. Most people would call them basic human psychological needs. In that sense, it has not gotten "better". Although it has recovered recently from even worse.

At this point, I am glad to accept any degree of better in the hope that will give me strength to do better still in turn. And to be any less bloody miserable in the short term. I toil away at it and I try to be as kind to myself as I can.

In that sense, it got better. Something a little better came along. Hardest thing I've ever done in the face of what felt like a lifetime of failure (including the failure of professional help). And I'm still nowhere near done. But I feel stronger and my suffering is less.

So, for me, one thing that's helped is not constantly dwelling on where I would like to be and what I've never had. The big picture stuff is too overwhelming. I went back to just trying to get through the day. Then be a little less miserable. Then trying to find some small pleasures in life by doing things. Break it down into manageable pieces and focus on the task at hand.

Sorry, I can't give better advice without knowing more about what you are struggling with. I guess I would generally recommend that if you have been in therapy and/or struggling with this for years, you may be trying to bite off more than you can chew at once. The big fixes didn't work for me. All that's helped is an accumulation of little things. Frustrating at times. But at least it has helped when none of the grand theories did.

I guess ... you don't have to believe -- do it anyways. Control whatever it is within your power to control no matter how seemingly small. You deserve better.