years ago when nothing worked for me my pdoc put me on an mao inhibitor. they are the old school ADs and they have dietary restrictions but sometimes they work when nothing else has. i didn't think it worked for me although my doc thought it helped as i got a job shortly after going on it. you might also want to get your thyroid checked if you haven't already done that. it helps to go to someone who really understands thyroid disorders though. there are many tests and a lot of people go undiagnosed. i just started taking vitamin D and am seeing good results with that. i always knew i had that seasonal affective disorder but i didn't know vitamin D could make such a difference. it's best to get that checked by a doc though as taking too much can be dangerous.