I know that when I experienced a major depressive episode a number of years ago, I tried an SSRI. It wasn't the right one and the GP doctor who prescribed it went on vacation (forgot to let me know). So when I called her office to say I needed something else, there was no one there to help until she returned in three weeks. I ended up in the hospital. It took some different trial combinations of SSRI's, anti-anxiety, mood stablizers and a sleeping aid to get me to a place where I could again function. I think now that I might not have needed so many medication interventions or even the hospitalization if I'd been able to receive more medical interventions earlier on in the process. . . but who knows.

In any case, during the time I sought out medication, I was also going to therapy with an MSW therapist. But it wasn't helping. I liked my therapist, but I couldn't hear anything she said because I was so deep into the depths of despair. The failure of therapy had nothing to do with the skill of the therapist; it was all brain based at that point. I finally got on the right medications and therapy began to work--I could hold still long enough to process my thoughts and feelings without acting on them impulsively. I've been off the meds for over five years and haven't felt the need to go back on them . . . although I do miss the sleep aid (ambien) because I suffer from chronic insomnia, but I work hard to keep my sleep schedule as regular as possible.

I would suggest trying a combination of meds and therapy. Don't give up until you've exhausted every avenue!