I think you should be honest with your pdoc and tell him exactly what you are feeling just as you wrote it here (and very eloquently too!) Yes treatment options will then come up and possible hospitalization might be discussed, but how can you feel better if you keep how you feel to yourself or just share it with anonymous strangers?

I know living with depression can feel like a long road going nowhere, but many, many people with this illness have to keep changing up their meds and trying new approaches. Some of us have a treatment resistant form of the disease and need more help and more ongoing support than others. What is the alternative? Accepting unending misery--and you deserve better!

Good luck to you and god bless. I can certainly relate to how you feel now. I hope you will reach out to a professional and try to address it, even though you are so right--it can be a colossal pain in the you know what.