Bipolar II, borderline personality disorder, OCD (trichotillomania), generalized and social anxiety disorder, anorexia nervosa (currently in remission), C-PTSD.
When I was younger and hadn't already tried everything, life was difficult but I still had hope. I was certain that some combination of therapy, medication, and committed self-regulation would result in something that looked like a normal life. A spouse, a dog or two, a house, a career. But after two and a half decades, all that hope is gone. I've done it all. SSRIs, atypicals, antipsychotics, mood stabilizers (both lithium and anti-epileptics), MAOIs, tricyclics. Nothing worked for longer than 18 months. I've done DBT, CBT, talk therapy, inpatient and outpatient. I've even tried spirituality via Buddhism. The only thing I haven't done is ECT/TMS (just no) or ketamine infusion (expensive and not covered by insurance.)
For awhile I cared that I didn't care. Like, it would bother me that I had no social life or support system. Or a pet. Or my own home. Healthy meals. Things to look forward to. It made me sad that I wanted to be dead all the time and that I would try to make it so once in awhile. I thought I might deserve better.
Now, though, I don't give a fuck. This is it. This is my life. It must be what I deserve, because I certainly tried hard enough for it to not be this way. I have finally reached the point where I no longer care that I don't care. It just is. I can't even be bothered to kill myself. Too much effort. If I manage to brush my teeth and eat once a day I've done the most I can do to take care of myself, and there's no one else around to give a shit that I don't give a shit. I was pretty happy to get cancer, but unfortunately it's not really a deadly kind. So I just linger.
I've learned quite a bit through this process. I've learned that if you're poor but not inclined to be a criminal it's almost impossible to get steady, ongoing treatment. I've been dropped by tons of providers because people hate my insurance and stop taking it. I've learned that most people think that mentally ill people are bad, not sick. But the most important thing I've learned is that if you can't fix your low self-esteem, nothing else can be fixed. You have to care about yourself and believe that you deserve to be happier in order to keep being persistent about your self-care. Without that fundamental belief, you can't maintain the inner strength required to survive severe symptoms and advocate for yourself while in the midst of a crisis. Because sometimes there's no one else to do it for you.