Suicidal OCD

I am typing as I sit on the couch after a mental breakdown due to the frustration and fear I have with my Suicidal OCD intrusive thoughts. I know so much about why this is happening from therapy, research, and self help books that I feel like knowing this much about my condition is almost making it harder to recover. It’s like I feel like since I logically understand my problem, why can’t I change my response to it? I know logically that these thoughts are stuck in a loop because I have assigned meaning to them and am so scared of the concept of harming myself, yet ERP/CBT hasn’t yet helped much with my ability to tolerate the anxiety. I have moments where I feel good but the sense of impending doom and feeling like I “am bound to hurt myself” always comes back. At least for the last 2-3 months since this theme and OCD flare started. I don’t have any physical compulsions that me or my therapist have been able to identify except *maybe* researching too much. But other than that, my compulsions are all mental. However, I can’t pinpoint what exactly they are. It’s also important to note that I don’t avoid anything. I still use knives when I need to, I don’t hide them like others with this theme do. Yes they can trigger anxiety but I don’t actively avoid them or other items that trigger/have potential to harm me. When I do audio exposures (listening to my voice saying I am going to hurt myself), I hold a knife to my wrist to intensify the ERP, per my therapists request… and still the same or similar level of fear behind suicidal and harm OCD thoughts is there. Has anyone dealt with this and can help provide some insight as to what helped you? Anything is helpful here except negativity.

Every time I feel like I'm doing something major that OCD has held me back from, or even just in a good headspace, something else will happen that sets me back of triggers my anger and hopelessness. This morning I felt so hopeless and didn't want to get out of bed. But I made myself get up, and order some groceries because I hadn't been eating much lately. Having a hard time with food prep and making sure everything is clean enough to use and eat. Anyway I ordered some stuff to have delivered bc I knew the stores would be packed on Sunday morning. I made coffee and started feeling like I could get some things done today I'd been avoiding, and that I could handle things. When I went down to grab the grocery bag that had been delivered, it was on the ground outside my building and it had some red spot on the outside, which is my biggest trigger with contamination right now. It was really discouraging and I got so, so angry. I know that there's not OCD god, and that things happen, and that I don't know what the red mark was, but I also don't know how to not worry that the person delivering it was bleeding or that I could use anything I got without worrying I'm in danger. Ive been desperately trying to find help and a therapist, even switched my insurance to see if it helped but I've had no luck and my life is unraveling right now. If anyone has any advice or encouragement, It would be greatly helpful.

How can I tell the difference between suicidal ocd and suicidal thoughts?