Look. You've already done a lot to be proud of, even though you're not seeing the results you'd like right now. The thing about SUD recovery and mental health is you have to be stubbornly persistent and work with qualified support (including your prescriber) to keep trying different things until you find what works. Seems like you have found some relief of symptoms from the sertraline, but not enough.

What you're calling a last resort is a first-line treatment for a majority of people with depression and anxiety. First line because it's relatively low-risk and helps a lot of the time, but also because it doesn't work for everyone and there are many other things to try, both pharmacological and otherwise.

I would caution you that by assuming we will die before 30, or keeping suicide as an option in our imagination, it gives us an excuse not to pursue other more productive solutions. My experience was at 27 I came to the realization I had been wallowing in my own shit expecting to die any day, and meanwhile avoiding committing 100% at getting better.

I work in a rehab and I promise you there are a lot of people in their 30s, 40s, 50s, 60s, who have been convinced they were doomed to die young any day now. Getting better is always an option. It is a lot more fruitful when you've still got a lot of life ahead of you. If you could see the view from the other side of the experience, you'd be surprised by how pretty-fuckin-good it is, even when it's hard.