Like I said, your narcissism isn't your own fault, nor is it a morbid form of self-love like you call it. The concept of narcissism has a certain connotation in surface cultural level which is wholly different from its original intent. It's a pretty common misconception, made by idiots. The original myth of Narcissus was a tragedy, and his death was revered by all the gods of Olympus. It's sad, more than anything, that you act the way you do. I'll try to explain your retardation in simpler terms than I've tried so far. Your narcissist identification, along with self-accusations which you parade like some gay pride flag, is specific to melancholia in the psychoanalytic sense of the word. In depression with psychotic elements as you display, what is happening is the delirious awaiting of punishment (my brain is doing this, not me!! I'm not in control!!). The mourning is the disinvestment of the object of desire, bearing the idea that testing reality shows that, what you loved, does not exist anymore. This manifests, in your case, as a sort of negative narcissism.
In an individual such as yourself, you are not afraid of getting sick and dying as a hypochondriac is, but of being guilty. You spend your life constantly worried about your guilt in things your have done wrong, sins you have committed, etc. Although to the outsider and to yourself, you may seem particularly conscientious, moral, and even interested in others, the fact is that you are only interested in your morals, in your conscience, in what others may say about you, etc. The narcissism underlying the physical or moral hypochondria is the same narcissism of the vain person, except that it is less apparent, as such, to the unprepared eye. One finds this kind of narcissism particularly in a state of melancholy, characterized by feelings of feelings of inadequacy, of falseness, of self-accusation, things you blatantly display (maybe not so blatant to yourself, since you are consumed by a specter of narcissism unfortunately). This will be my last time replying to you, though, since I am aware that narcissists, generally do not listen to what others say, nor are they really interested in what others say. All I recommend is that you make some serious changes from within, though given your age if you are being truthful, it's probably too late for you.
I've also recognized you as such an individual by your susceptibility to criticism. So far in this thread alone, it has manifested by by denying the validity of said criticism, or by reacting with anger and despondency. Also, upon my last post, notice how you are now hiding behind an attitude of modesty and humility; it is not uncommon, indeed, for an individual's narcissistic orientation to take his humility as the object of his self-admiration, so it doesn't surprise me hearing about your "years" of volunteer work, which to me seems more like your moral fetish than anything at this point.
As a side note, I definitely believe in mental illness and it's a real plague upon society. I empathize deeply with anyone struggling with afflictions of the mind which can be at times worse than physical ailments. The difference between my empathy for them and the lack there of for you is that you seem like one of those people who know exactly what they need to do to stop being depressed, but choose not to do it either due to reasons mentioned above or a deeper more deep-seated device that you use to continue masturbating your own ego. You seem like one of those weak-willed, cowardly individuals who unwittingly fall in love with their own psychic malaise and romanticize their lives as a worthless parasite. "Woe is me, I've tried it all but alas, nothing works! This stupid brain of mine, it couldn't be any fault of mine, no!"
>I wouldn't call something that's bothered me for nearly 2 decades
Your mental age is seemingly inferior to your chronological age. This is irrelevant.
I'm not trying to shit on you at your expense, I'm trying to help you honestly. Wake the fuck up and smell the sunshine.