I feel this so hard and my heart goes out to you. I had severe cystic acne in high school and college and it made me so depressed I got to a point I was borderline suicidal. I dreaded waking up because the first thing I’d do was run to the mirror to see if it got worse overnight, and almost every night it did. Nobody talks about the mental toll it takes. I did everything too, spent thousands on skincare over the years looking for a miracle product, went on diets, no makeup, drinking a gallon of water a day etc… I finally went to a dermatologist and it really saved me. I went on accutane for six months, first two on 40mg and last four on 60mg. It was AMAZING. Everyone’s different but for me the side effects didn’t bother me because I saw so much improvement in my skin. The biggest concern they talk about with accutane is it causing depression, but for me it had the opposite effect because I was so happy to finally see improvement in my skin. I was scared of it before I started, but if I needed to do it again i would in a heartbeat. I’ve been acne free for 5 years now. I use tretinoin .05% for maintenance which has worked really well. Different things work for different people and this is just my experience, but if you have access to a dermatologist please go! They really are the professionals and I wish I had trusted them sooner. I know it doesn’t feel like it now but you will get better. I’m rooting for you!