I think the thing you are missing is probably the community sense you had though. In your youth you went online to talk about x-files instead of going to the mall; people on IRC probably recognized your username, probably knew your opinions on scully and moulder. You can derive some self-worth from feeling like people know you, or feeling like people are interested in what you have to say. Now you have to scream at the top of your lungs while masturbating on camera to have a chance of being heard. Discord exists for now, you can find some small fandom to engage with there. You can accept the fact that your ego is not adapted to measuring yourself against all of humanity at once and find a smaller pond to swim around in; or start screaming and masturbating.

So funny to be in therapy telling your friend-for-hire that you are anxious and uncertain about what to do, because the idea of living modestly and giving to the needy is not even worthy of consideration to them.