This is very powerful and I believe that's how depression can make us feel. Trapped, drowning and imprisoned because of all the emotions we feel at once yet cannot explain.

I engage in love making
with the self-loathing that blossoms
within my punctured veins
and poisoned heart,
as the guilt and grief
encumbers my soul
as if it were a jacket of lead,
that is the vexing warden
keeping me trapped
at the bottom, underwater,
losing my ability to breathe.
^^
This is the most powerful part of writing I have read in ages. You have been hurt throughout life and it shows because you feel trapped and self-loathing.

Take care Em