You need to prioritise. You said that you're about to go mad and i believe you. You also mentioned being destroyed by yourself or by the piano, and I believe that is not far around the corner, too.
You say that music is your only way for your life, your career and your fulfilment, but please consider that you will have no fulfilment, no career, no life and certainly no music if you die.
Please get your priorities right. Your mind AND your body, including your aching arms, are telling you something, which is that you're about to fall apart.
Do you realize that a black and white view of the world is always going to leave you feeling upset and disagreeable, because in fact, most of the world actually exists in different shades of colour and grey? Do you realize that this negativity and pessimism pervades your posts so far?
Can you please make looking after your health, and in particular, your mental health, one of your most urgent priorities for 2012?