Gerry McCann said his family were lucky to have “survived” the “sustained” media attention and “misleading headlines”.
He told BBC Radio 4’s Today programme he had felt “suffocated and buried” and said the press had “repeatedly interfered” with the investigation into his daughter’s disappearance.
Madeleine was nearly four when she vanished from the family’s rented holiday flat in Praia da Luz, Portugal, in May 2007.
Mr McCann said he would “love to find her alive” but “the hope is slim”.
He also called for the resumption of the cancelled second phase of the Lord Leveson Inquiry, which would have looked into unlawful action taken by the media as well as relationships between journalists and politicians and the police.
Mr McCann and his wife, Kate, are among more than 30 people who have signed a letter to Sir Keir Starmer calling on the prime minister to reverse a decision by the previous Conservative government to close the inquiry.
He said: “We’re over a year into the government, and there haven’t been any changes.
“It’s not acceptable to me now, more than a year on, that Leveson and press regulation is no longer a priority.”
The media interest had taken a “huge toll” on his family, said Mr McCann.
He said that for months his family had journalists coming to his house and photographers “literally ramming their cameras against our car window”, which would terrify the couple’s two-year-old twins.
Mr McCann said: “We had sustained interest and misleading headlines for 15 months or more that forced us, forced us to take legal action to stop it. But no one, no one wants to go to court.
“We had tremendous support. But I can promise you, there were times where I felt like I was drowning, and it was the media, primarily.
“It was what was happening and the way things were being portrayed, where you were being suffocated and buried, and it felt like there wasn’t a way out.”
Mr McCann was asked about Polish national Julia Wandelt, who faced a trial earlier this year after she claimed to be Madeleine.
At Leicester Crown Court, Wandelt was found guilty of harassing Madeleine’s parents. She was found not guilty of stalking.
Mr McCann said he didn’t want to speak too much about Wandelt, as he does not know her personally.
He continued: “But, you know, I think there was an element of exploitation.
“A lot of media channels exploited her early on, putting her on front pages.”
When asked whether he thought they had “egged her on”, he said: “I think there was a large element of that, and other people were benefitting by one means or another, some financially, some possibly with other motives.”
Read more: How events unfolded over Madeleine’s disappearance
‘We fully understand she may be dead’
On the disappearance of his daughter, Mr McCann said: “Madeleine’s been missing for 18 years, and the bottom line is, we still don’t know what’s happened to her.”
He said that there was “no evidence”, adding: “I don’t even mean ‘convincing’ evidence – there is no evidence to say she’s dead.
“Now we fully understand she may be dead, it may even be probable, but we don’t know that.”
Mr McCann was asked whether he still holds out hope that he will find his missing daughter.
In response, he said: “Well, obviously, the hope is slim, but it’s not extinguished.
“But we need to find out what’s happened to her.
“I’d love to find her alive, but we need to find out what happened and bring whoever’s responsible to justice, and other children and people are at risk while that perpetrator is free.”
