I think that having chiron in the 10th house brings about feeling inadequate when presenting yourself to others, when in the realm of work, and ambition.
If you look to the very bottom of the chart the IC, is the place where you feel your roots, your home, your heart....
You have neptune conjunct that area....
You may have experienced a missing father, in the way of emotions or missing some sort of an aspect of what home should be to you in your eyes. You feel dis-illusioned in that area of your life, like what you thought things were are not...
Uranus is also conjunct the IC. A placement where you never really felt like you could put down roots. You may feel like you did not belong at home. You may have had to grow up very early and become independent as well.
I was reading from Liz Green and she was saying in her book Relating, that the mother's attitudes towards the child is seen in the 10th house with any planets there.
My mother was an escapist alcoholic and demanded that I was at her beck and call to hide her problems. I have neptune on my MC in the 10th house and this is very much like her. I have also chosen a career to help those with medical issues, so my co-dependant issues with my mother are now gone, I still find myself helping others that probably dont deserve it.
I see your chiron so close there. Was your mother wounded, did she hurt you, was she deeply hurt so she may show herself like this in your life?
It seems like you feel like your basic needs may not have been met as a child, as seen in your chart. So you find other ways of nurturing yourself, but drugs, self-inflicted pain and so forth...
I see a beautiful opportunity to care for others. Chiron in the 10th makes it very hard to heal yourself, but through healing others you can get a better self-esteem and strength from within....
You have a moon rising and it rules the 10th house, so this can make you very nurturing towards others, you have to be careful though not to take on too much of others pain, you must protect yourself.
Your 6th house rules neptune and shows where you are good at in terms of service. I think that this is beautiful because you can bring the issues you had in your home to help serve others.
I have so many hard placments in my chart is isnt even funny. I am self-destructive too. I know where you are coming from and I think that finding an outlet to that behavior is so important, and this is such an important first step in finding something positive for you to heal.
I think that seeing your sun and mercury in the 9th house is a blessing. My lovely sister has this natally and I have it happening as a transit right now. I think that academia will serve you well. School, studying life, studying things around you can be healing. As a gemini, in the 9th house you have the gift to go out and learn so much, it is getting past the esteem issues first. If you just say "I will do it" and go out there and make a point to leave the house and say hi to people it may stimulate your sun to really grow.
A flower does not flourish without being nurtured. You may not have had that with your family, but you can always nurture yourself. When you give yourself water, sunlight and a little bit of fertilizer (lol) you can become the flower you want to be, a rose, a daisy, a fern...whatever you want out of life is yours for the taking!
Honestly, I hate to be around people, but I have made it a point this year to do it! I have met some bad people and some nice people, but going out there and being me has been the best experience of it all.
I wish you luck.