I see you have some good advice from others HW.
For the record I've never taken meds but I wouldn't say not take them. It's a personal choice and only you will know whether to go down that road.
Family? My advice would be to severe the ties completely. You are never going to feel the self care thing if you have all on sundry battering you emotionally.
I don't speak to any of my mum's family since her passing. My partner doesn't communicate with his brother and family. And any so-called friends that are only that by name would probably fizzle out if you were to stop making the effort. This all sounds very sad and it is, but you need to concentrate on you and put yourself first.
Self care / loving yourself isn't just about looking in the mirror and admiring what you see or being proud. It's also about making life decisions and cutting away any negativity and that very much includes the people that give you that feeling. Maybe make some gradual changes and see how you feel. Learn to say "No" and not feel guilty. You have a therapist so you are already on the right path.