It’s also a form of perfectionism. I deal with exactly what you are describing with a family member of mine. A part of his problem is that, I shit you not, I sincerely believe he thinks he is too good for a labor/service job, or community college, or coursera, or the gym, dating someone not perfect, etc. It didn’t go his way for so long, but the ego is still there. And what is the ego exactly if not an intense defense mechanism. They have lost all ability to slowly chip away at a problem.
No, you probably won’t get an office job in the next 5 years. Maybe in the next 10. No, you won’t have enough money to move out the next 5 years, but maybe in 10. Nope, you aren’t get laid anytime soon. Few people can accept the timeline and the sheer effort it will take, and the sheer time. That’s the crux of the problem, that they are truly behind and cannot deal with the time investment required.
Enough with the lies, and start from zero. The effort it takes to be just mediocre in this world is understated.