@TheDesireIsReal I'm close with someone who has very similar, if not the same, diagnoses and had some of the same concerns about meds. (I've gotten her permission to share about her story.) She was also worried about not having the time to take meds, remembering to take her medication, being able to find a med provider who listens, and managing side effects. I've seen, and she attests, to how much easier and more joyful her life is with a med provider who cares and who has helped her find the right meds at the right dosage for her so she can enjoy her life and be productive without the crashes, burned bridges, or real risks to herself or others, and she's found ways to make taking meds easier to take and remember.
In addition to my friend's experience, I can speak about my own life. As someone walking her own journey with her own challenges (anxiety, history of depression, likely ADHD, probably C-PTSD at one point), who has been with loved ones through their mental health journeys, and who tried to handle things on her own for a very long time (some reasons out of my control and some within), please consider your options and don't wait until it's too late. Therapy and meds have made a world of difference for me and have helped me create and maintain a life worth living. It is possible to enjoy life and kink and be there for others while also taking care of ourselves. I'd argue that taking care of ourselves by utilizing supports like meds helps us to better be there for our loved ones.
The fact that you're asking the question is a sign that things are probably not heading in a helpful direction. It sounds incredibly stressful to manage the experiences and urges on top of all you do to care for your family. Does it have to be all or nothing? Could the right meds help you have more time and energy for your loved ones and for kink play if you're not having to fight your brain?
Chances are, there's a happy medium where you can engage with your Dom while also getting some additional support and both enjoy having feelings without the emptiness or level of safety risk. As someone with different diagnoses and different experiences but who has had to learn the power of asking for help when I've been in a rough spot, no one person, Dominant or not, can or should manage our mental health for us. Your Dom is not a replacement for professional support.
It sounds like you have a good relationship with your therapist. Could you ask them to help you find a med provider who is a good fit for you, specifically? They'd likely have professional connections and be able to refer you to someone who listens. Also, hearing from my friend about antipsychotic side effects, yes, they can be brutal, and, there are so many more options these days and more antipsychotic options all the time that don't have the same side effects and/or not as severely. My friend and her provider found the right combination and the right dosages, and she was able to taper off the heavier meds and is happy and in a good place in life. The meds have helped her to achieve and maintain her goals.
Another plus is that you're an adult. You get to decide whether or not you want to take certain meds or ask for a dosage change. Your providers work for you. If you don't like something, you can speak up and/or find someone who will listen. For time spent on meds, there are med options available as long-acting injections and/or other options; it doesn't necessarily have to be pills. Your therapist could also work with you to create strategies to help you remember to take meds and/or make taking meds easier. A different friend of mine would put an M&M in her pill organizer for every day so she had that to look forward to in addition to the medication. (That friend is also doing well and found the right balance of meds for her.)
Isn't your safety and wellbeing worth at least considering your options? If that's harder to consider right now, isn't your family's health and wellbeing worth seeing what's available? At the very least, meds could improve your quality of life and help you have more time and energy for your loved ones. At most, it could prevent a tragedy for your family and/or someone else's family if you do happen to go from zero-to-sixty and do something you can't take back. Is it work the risk to tough it out when there are meds options that could make life easier and/or more enjoyable?
It's obvious to me there are people here who care about you, and we'd love to see you happy and living your life without struggling so hard. Meds could be one part of that equation. I really hope you'll bring them up to your therapist and find out more about the options available to you. Wishing you all the best.