When you say that you need to change, it makes me feel like you're actually saying that feeling like this is your own fault, that you’re somehow chosen it above feeling okay. That puts an awful lot of pressure and guilt on yourself which is undeserved. I don't think you would choose to feel like this.
I know kindness towards yourself and selfcare are very far from you right now so i'll just leave you with an excercise my psychologist asked me to do as often as i remember. The thing is to just ask yourself every now and then “what do i want right now and what do i need??” When we hate ourselves compulsively we learn to ignore our wants and needs. A small act of selfcare can be to ask yourself what you need right now. Checking in on your needs and acknowlegding their existence. You don't have to act on them but to get back to basics it can be a good excercise to do.
Sorry if my reply was useless. You matter to a lot of people, Matt. It’d be so tragic to lose you to an illness that really only wants to destroy you <3