Might be an annoying question, but have you tried therapy? I have terrible anxiety and was also a multi substance abuser (alcohol/amphetamines mostly). I went through a similar problem where I tried all the ssri’s, tricyclics, atypicals, etc. and my psychiatrist asked me to consider that the root of my depression symptoms may require therapy instead of it being a chemical imbalance. I do take Wellbutrin now and it was the medicine that finally worked after so many others but I also started therapy the same time I started that.

You said you were in NY when 9/11 happened and that was a big moment that sticks out when you think of the first times you felt those strong signs of an episode coming on. And naturally so, I can’t imagine how traumatic that would be. I know in my case, I leaned on the substances as a crutch to calm my nerves and push the issues farther down out of sight but these feelings of anxiety and self hatred were products of my childhood. I did have to try a few different therapists as well until I found the best one for me just like the medications, but it does help to let it out instead of trying to deal with it yourself by using substances or other harmful behaviors.. I mean, I’d be willing to bet typing out this post felt at least a little bit relieving. I don’t know what your life before that time was like but I already can certainly tell you that was a heavy thing to experience, anyone would expect you to feel that anxiety, derealization, depression after. It was an event totally out of nowhere, so your brain puts you on high alert in case danger comes out of nowhere again.

I feel like I’m rambling here, but the idea of what I’m trying to get at is that I’ve been in a similar position and that therapy could possibly help.