I saw you post about ketamine injections and learned that you are a veteran who is out of options for chronic dysthymia. So it seems that all that self-chastising and self-loathing you expressed was your dysthymia speaking. You also mentioned never ending psychotic depression and I wonder if these illusory relationships in which you invest real energy are just manifestations of low grade psychosis, meaning that your grasp and hold on reality is tenuous at best. I just wonder and offer to you this option of looking at your life through this lens. Not sure this will help soften the feelings of pain for you but maybe if you see that the painful feelings are your dysthymia and psychosis speaking, you can gain some distance from them?