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at the end of one's tether at the utmost limit of one's strength, resources, or abilities.
be-all and end-all a thing or person of utmost importance or significance.
extreme of the highest degree, or of a very high degree; utmost. [1/7 definitions]
extremity the greatest degree or utmost extreme. [1/4 definitions]
main utmost. [1/5 definitions]
nth highest or most extreme; utmost. [1/3 definitions]
ultimate the furthest extreme; the utmost. [1/9 definitions]
ultima Thule the farthest point or limit; utmost degree. [1/2 definitions]
uttermost utmost.