Goal, I also get what you are writing; I recognise many of the same experiences and feelings.
My instinct, though, is that you probably are depressed and could benefit from medication, along with the psychotherapy. Would you be able to speak to your GP about it, and get his/her view?
My house was also a tip for a very long time, while I was busy hating myself, self-sabotaging, and worrying about a lonely future. I still have a hard time staying on top of things, but I use the Flylady's tip that "you can do anything for 20 minutes", and just spend 20 minutes whenever I can either tidying, or mopping, or putting on laundry... basically just doing ONE chore and getting it over with. The feeling of satisfaction afterwards is always worth it. but yes, getting started is the hardest part.
What are you doing to boost your self-esteem? For myself, I found that using Pete Walker's flashback management checklist every time I felt overwhelmed worked, along with forcing myself to schedule plenty of social activities. Others have found affirmations, inner-child therapy, and other things useful to them. What's your approach?