There’s lots of well-intended answers. I will also join the choir that says, aside seeking therapy on your own, find a therapy solution that works for you. Seeing your Dr is a good idea, getting a referral from him even better (he is not specialized, but he can do a quick assessment).
Now onwards to independent self-therapy. I can share my method and experience. So far tried and true.
I had to first understand where my self-loathing came from. In my case it was mostly environmental, specifically my father – who believes/believed in tough love. His theory that you should never give in, never show weakness, shape your children with tough love – be critical of them at all times etc. Without too many descriptors this continued itself as a ‘voice’ that always negatively judged anything I did as insufficient. Too imperfect, and not worthy. It left behind a trace of a system that “did his work for him”. And although I now understand through his personality – that he intended well, I have softened my attitude toward him – and the effects of our interaction.
The other bit is a potential and not negligible genetic pre-disposition to at least dysthymia from my mother’s side of the family. My dad’s on the high neuroticism scale – a disposition I also have to deal with and soften down on purpose.
In all cases you have to do the above analysis. It’s always genetics + epigenetics (env. influences on gene expression) + environment. There’s respective reasons for your specific situation.
Now, there’s two ways of dealing with this and I recommend the simultaneous route. Dealing with the symptoms (behavioral), behavior and brain networks directly in terms of procedural thought patterns – and then dealing with the deeper network connections and associations with arising thoughts (cognitive) .
No matter what health professional you will choose to help you – you are the one that will be doing the neural changes / work. We don’t yet have any reliable ways of doing that for you. So, prepare yourself for a step-based change system. It helps a lot to have someone else keep track of your progress especially while going through the middle of the ‘pain’ source-areas.
A lot of the above has to do with the past, and who you are now. As you may beginning to understand, you’re not fully responsible for who you are. And as such you really should not feel guilty about it. You do share responsibility, but in comparison to the other forces it’s fairly small – though not negligible. Put your mental energy focusing on who you want to become – over which you may have some power. You can affect your future behaviors to get closer and closer to that goal. Environmental factors will still affect you, and even genetic (health issues etc). But this is what it is, it’s better to be alive. Life’s not perfect, why should you be? You can try to become perfect, you’ll never reach it – but trying is what matters. Focus on that. Who you are, is not who you want to be – this is likely your biggest clash. It’s fine, nobody is. Except for few that reach a very high level of acceptance, and have given up on the chase. They just will what they want to become, and accept the outcomes but with some improvement.
I hope you find the above helpful. I’d be willing to provide support over skype or similar usable electronic medium. Not free, it’s something I’m working on. I’m not however a replacement for your choice of a health professional. Only another modifier. Should you consider it, you can find my details on http://phoebusg.com – all the best.