I don’t know where to start
I'm gonna try to be concise here, but like the title says, I don't know where to start.
I'm 32, cisgendered male. I live alone in a city, and I work a full-time job.
I have had issues with binge eating since I was very young. Food helps me regulate myself. Without it, I find it very difficult to cope.
I find it incredibly difficult to stay in my body or physical sensations. I dissociate often. After many years of therapy and talking with close friends I've been able to get a little bit of comfort in my skin, but it is still extremely difficult.
I am overweight, medically I think I qualify as obese. I am around 335 pounds. I am very tall and have a big frame, and used to lift weights, so my body carries the weight better than it might otherwise. A friend describes my body type as "retired linebacker", which feels accurate. But I am not happy with my body image in general. It's worth mentioning that I was heavily shamed for being overweight by my father since early childhood. I have high blood sugar and am at risk for diabetes; I have compensated for this by trying to exercise and cut out sugars, but this is very difficult to maintain because of binge eating.
I have suspected for a long time that I may have Aspergers, or be somewhere on the Autism spectrum. I have read a lot about the spectrum and feel a commonality between my experiences, the things I've read, and the reported experiences of others, including here on Reddit. I am very good at mimicking others' speech and mannerisms so I have been able to "pass". This is a survival strategy I developed in my early years because my awkwardness tended to result in ostracism or physical violence from classmates. Related to Aspergers, I should say that overeating has a hugely physical, textural, sensory component for me; it helps me feel like there is "weight" in my body, which feels comforting and reassuring.
For a couple of years I was seeing a therapist with a sensorimotor specialty, mainly because my binge eating was getting out of control. She was very helpful in helping me deal with physical sensations and processing some traumatic childhood memories. She was dismissive of the possibility of Aspergers, and suggested I may be bipolar. I do have manic periods and extremely depressed periods, so this may be accurate.
I definitely suffer from severe depression. I can isolate myself for long periods of time and lose myself in my preferred coping mechanisms (TV, film, videogames, music). I have difficulty in relationships with people, often because city living means that I have to do a lot of movement and traveling to maintain social relationships, and those things are difficult for me as they produce overwhelming amounts of anxiety. However, when I am able to get out and be social, it generally feels very good. I really enjoy getting out of my comfort zone and joining the rest of the human race, but it is also overwhelming.
In general, I am overwhelmed by life. I have just enough energy to get through each day, with the help of a lot of extra food, which is where most of my money goes (paying rent in a major city is also very costly). But my health and weight have been in a less-than-ideal place for a while now, and I don't think that's sustainable as I get older. I would like to live healthy and exercise more, but it is extremely difficult for me to get out of my depression vortex and do something good for myself, even though I feel great after. Inevitably, I slide back down into wanting to do nothing at all. I'm not suicidal, but I think about death a lot, and how it could happen to anyone at any time. It makes me want to not waste my energy on things.
In addition to all of this, I do not like seeing doctors. I have medical trauma from childhood and in general, I have found doctors to be extremely dismissive of my issues because they want to boil everything down to my weight. Obviously my weight is a big problem, but my mental health issues are what cause my weight, and they are unwilling to address it. I also go to Kaiser, where I feel like my doctor is shuffling me through an assembly line. Besides the mental health issues I've mentioned, I also have a few physical issues that need tending to, but I've been reticent to start doing it. I generally want to feel like I'm trusted hands, and I simply don't at Kaiser, because I never even know who these people are. I'm thinking of switching to the non-Kaiser option at my work so I can go to a smaller practice and get more personal attention.
There's a lot going on here and if you read all this, I really appreciate it. I just don't know where to begin. Therapists have helped me cope to a degree, but I don't know if I should be looking for official Aspergers diagnosis, or getting diagnosed for bipolar, or looking for a new GP, seeking direct treatment for binge eating, or what. And I get so extremely overwhelmed and frightened by the complexity of my health and mental health issues that it makes me hide in my apartment and try to pretend it isn't happening. And I'm trying to stop doing that.
Any advice is appreciated.