Welcome lrywin,
You've done remarkably well. I can understand what you mean by saying therapy isn't enough sometimes. Some of the things we have within take time and growth to process.
I've spent many years free from emotional pain. I still struggle with shame attacks and still need to find out what causes it. Every time I understand one part of it there seems to be something else that I can't quite grasp.
I don't know if you've tried Effexor, but it works on Migraines also. My daughter and my grandson have chronic daily migraines and the Effexor has helped them a lot. I've also been told it is the hardest of all the anti-depressant to come off of. The benefit needs to outweigh the risk.
I'm glad you're here. Congratulations on all the success you've shared. You've worked hard.
Hugs,
MG