Im on pills given by a doctor

It's important to understand how those pills work. They're not magic happy pills, they're emotional numbing pills.

The purpose of that is numb all the bad emotions dragging you down, so that you don't feel so awful and can manage to do the things necessary to feel better. If you want to be happy, you use the pills to numb the bad feelings until you can feel some faint happiness, and then you taper off the pills slowly trying to stay above the water and happy, until the pills are gone and experience full strength happiness. It takes time for the brain to adjust, the same way it takes time to relax after a stressful event.

Some people also stay on the pills as it helps control emotional volatility too. For some people it does seem to help generally feel better too.

The reality is nobody really understands exactly how those works making it hard to predict what it'll do. We know what the molecule binds to and what those receptors are for, and what happens when there's increased serotonin, but in the end it's kind of just messing with knobs and figuring out if it's better or worse. Ideally those are prescribed in concert with a therapist to externally measure the changes you might not see yourself, and adjust as needed. Unfortunately those also tend to be prescribed somewhat randomly at walk-in clinics with no proper followup.

ive tried therapy

King of same thing, it's not magic, you don't just talk and feel better. The purpose of therapy is helping untangle how you feel so you can find the root cause and actions to take to change course. Also identify patterns and cycles, like self-sabotage.

Therapy with autism is complicated because we don't quite process emotions and reality the same way, so it needs to be a different approach and few therapists have solid experience with autistic patients. Personally, I can only really feel "I feel okay" and some degree of "I feel like shit", so one thing a therapist could do to help me is figure out whether I'm feeling anxiety, grief, pain.

In turn that also requires you to open up during therapy, and to take it seriously. It's not like a surgery or whatever where you go to power through it and come back home, if therapy is a chore it ain't gonna work.

For what it's worth, when I was 19 I felt really crappy and doomed too. I didn't think I'd ever dig myself out of it, but gradually I found my place in life and I'm doing alright now.

Life is very messy.