I moderate an online OCD support group, and while that’s not exactly the same as what you’re experiencing, a lot of the people I’ve talked to would relate to statements like “you can’t talk to anyone about what’s really going on in your head anyway, because telling someone can only lead to them walking away in anger or disgust or just plain boredom” and “when you think about dying, and you know you don’t want to die, but you’re afraid that you’re nearing that point where what you want won’t even matter, you won’t even have a choice.”
(Somewhat extreme) case in point, in case you need some reassurance that whatever thoughts are swimming in your head are no more bizarre than anyone else’s and you should absolutely talk to someone about them. Yes, psychologists are expensive, but merely talking about these problems with someone who can help you process them is cathartic, even before Cognitive Behavioural Therapy exercises and whatever other clinical homework that psychs assign.
If you really can’t afford a therapist (in terms of time, money, or emotional investment), at least vent to someone anonymously on the internet. I am no psychiatric expert, but I know from experience that it feels great to dump your thoughts and feelings onto a page in a way that’s raw and unobstructed by any potential detriment to your career or personal life. There is no shortage of places that facilitate this.
All of these problems which attack our self-image really do a number on our ability to respect ourselves. The problem with that is that it’s hard to find a way of practicing self-compassion that isn’t completely token. For me, it’s useful to ask myself “what would you do if a friend came to you with these issues? What would you say to them?” And of course the answer is “I would do my best to understand how they’re feeling, to understand what they need to do to get themselves into a better space, and help them to achieve that.”* That way you can avoid hating yourself for what you’re thinking and feeling (mindfulness meditation is also useful for this if you’re very patient) and motivate yourself to bring it up with a friend.
And for what it’s worth, a lot of people do well without pharmacological assistance. In fact, I’d say it’s usually fairly useless to take SSRIs without addressing the underlying thought patterns — drugs are a symptomatic patch which don’t really address the reasons for chronically feeling shitty. They just sort of help you function when your body and mind is screaming at you to become the sessile heap of lumpy mashed potatoes that you think you are.
So yeah, pills are okay, especially if they appear to be helping you, but you shouldn’t rely solely on them to get you through the long-term struggle. You need people to whom you can communicate without censoring yourself, as hard as that can be.
*: My response would actually be closer to “I don’t have any friends, what are you on about?”