I'm sorry you are feeling like this. I know what it's like to feel worthless and to have your mind essentially bully you. These negative thoughts you are experiencing can be seen as an abusive voice in your head telling you hurtful things. Have you made mistakes? Do you need to make changes? Sure, most of us have and do need to make changes, but that doesn't mean these thoughts are an accurate representation of the situation or that you deserve to feel this way. When you live with these voices long enough you start to believe it to be true. Or at least that's how it's worked for me. Maybe someone in your life has told you these mean things in the past and you have internalized them? Would you ever say the things you say to yourself to someone else even if they were struggling? I doubt it based on your compassionate posts here. Try to offer yourself some self compassion, even if you don't yet believe you deserve it.

Dealing with mental health issues is not a sprint, it's a marathon. We may need to take breaks, then get back up and keep going. Maybe things we have tried in the past have not worked and we need to try something new. I think there's always the possibility you have not received the right kind of treatment or been stable enough to fully commit to it. There are many types of therapy, and the wrong one might not really help. What types of therapy have you tried? For example, I have not been treating my OCD with the evidence-based therapy shown to work for it and this might well be the reason I am not making progress. I hope you'll give it another shot and talk to your pdoc honestly about how your feeling and options for treatment.