I have treatment resistant bipolar depression, so I can relate and say I'm so sorry it's hell, for me most days I'm depressed, and I'm literally tried almost every med and med cocktail and not much works... but there are a few suggestions that have helped me. Get regular labs drawn for thyroid, vitamin d, and b, testosterone, because if those are low, they can cause depression. Also, GeneSight Psychotropic test, helps determine which meds they can use for you. Typically, ECT is 98% effective, and there's VNS and TMS which I don't know much about. But for me ECT, didn't help, so I suffer quite a bit and just keep switching the meds around. For me since I'm bipolar, Lithium has helped somewhat, and Cymbalta and Nefazodone seem to not poop out on me for awhile, and sunlight and mood lights help a bit. For me since it's all a chemical condition, all types of counseling have been useless. When I'm real down, only a med change helps. And when I'm okay, I still don't find therapy helpful. Best of luck, and remember, they're always coming up with new stuff!