I am totally for all the things that Creative1onder has espoused over and over in all his posts. Who wouldn't be. All those things would be beneficial to anyone mental illness or not and have been to me. That is not the point I have been trying to make. The point is for me that inspite of implementing all those things over twenty years I still get regular recurrent cyclical severe depression. That is the point.

I will copy and paste something from another discussion below -

I have gone to much therapy and group therapy over the years. Always been 100% honest in therapy and in group.
I learned CBT in therapy and practice it everyday.
Started therapy again with someone who incorporates all the forms, CBT, DBT, and so on.
I practice mindfulness everyday.
Have very consistently meditated over the last twenty years.
Self help books and work books.
Spiritual books and practices.
Long time member of AA and practice its twelve steps and principles. Very similar to therapy with the added spiritual dimension. It is very focused on personal growth, changing thinking and behaviour, and spiritual growth. Have done my fair share of searching and fearless moral inventories and shared it all with someone.
Alanon, ACOA
A good support network.
A good fulfilling career.
Tons of exercise at work.

I am in no way perfect in these things but I have worked very hard at it. They have helped me immensely in daily living and in personal relationships and so on. I am not depressed all the time and it is when I am not depressed that they help. I am totally all for all those practices and they have helped me in general a ton.........

BUT I still get regular recurrent cyclical depression like I always have. it has gotten worse in recent years despite all these things that you would think would help alleviate it. When I am in the middle of a severe depression none of those things work even if I am able to practice them. I can be in the middle of working, getting lots of exercise, and everything is great and the depression will hit me like a ton of bricks out of the blue. It usually has to run its course and it always does. The length of time varies and it always returns. When it hits it is very severe. Suicidal, can't get out of bed, don't shower for weeks, severe.

What am I to do?
Whether that is treatment resistant I do not know. To me it is. It leads me to believe that in my case it is very genetically and biologically ingrained in me. it follows seasonal cycles. Not SAD but three or four times a year that I can set the calender by. There is also a family history that would back this up.