After reading all the replies the first thing I did was to go and check the difficulty level and it was set to one level below the hardest option!
I am not sure if this was the games default or at some point I thought I was a badass and turned it up myself and forgot about it.... but now I am on novice and I can actually kill enemies

I am also going to stick to using one type of weapon and armor as before I was just switching them in and out all the time, I really did not realise there were so many different ways to play or that I needed to level up the skill of certain things.
I use a 10x rule early in the game, if the items value isn't 10x its weight I don't bother to pick it up. Later on you will have a ton of money and can bump that up to like 20x or so...
