Struggling with Depression, ADHD, and PTSD - Do I Have Another Disorder?

I have everything you have and a lot of this feels similar to me minus the seeing things / hallucinations. Id 100% ask a doctor about this

Self destructive BPD. I could almost guarantee it. Definitely talk to your behavioral health team and maybe try some DBT and check out Dr. Daniel Fox’s resources on the matter.

specifically because you mention the paranoia in relationships, that sounds like it could be bpd? bipolar would also be a possibility. the best thing you can do to get better is to keep seeing your therapist and psychiatrist and try and follow their treatments - and tell them if one isn't working for you! does your psychiatrist know about the mood swings, psychosis, low self esteem and suicidal/homicidal ideation? if not, those (the first two especially) are important details to share. they could put you on a mood stabiliser instead of an antidepressant, which might help both the ups and downs of mood swings. your therapist can teach you tools like dbt, which you can use to control other emotional symptoms. you might also be put on an antipsychotic for the psychosis - a common one that's also used for depression (and bipolar disorder for that matter) is abilify. i hated it myself but if you're bugged by the psychosis, and your psych thinks it's a good idea for you, that might be worth a try too - it definitely stopped all of my psychotic symptoms when i used it. good luck and stay safe