Time for change but how?

Things in my living situation are about to boil over, or i am about to boil over. I know I need to change some things but I have no clue as to how to go about it. How do you get THERE from HERE? I was sitting in the tub just now and I realized I had my face buried in the washrag for an extended time, not moving and loud thoughts banging against my temples. After 20 years of therapy , treatment and a butt load of self help books the first thoughts that came to my mind were, "your trapped, the only way out is to kill yourself". I actively told my head that was a lie and that everyday i sit in meetings with people who change their situations all the time. That was the voice of illness telling me that living a life I would enjoy filled with the freedom that should come with being a grown man would never be mine, that I was incapable of living a clean grown up life. I know there is a life out there, I know I am doing real , good work moving toward it but as far as the real steps I need to take to get there are a mystery. I can stay clean, I know how to do that but how do I get my car fixed, find work and get a place to live in order to get away from my fucked up sister and the mother who depends on me not to grow up?