I've had a diagnosis of "recurrent, severe, treatment resistant depression" for going on 20 years. It has been a problem for longer than that.

I have tried many kinds of meds, and have been disappointed with the results (as far as I am concerned, they are not a particularly useful option for me).
I have tried talk therapy, self-help, lifestyle changes, you name it.

What seems to REALLY work for me - but only if it is persisted in over time - is a combination of these three things (and it HAS to be in combination):
* Clarifying my personal values and committing to living by them;
* Insight-oriented psychodynamic therapy (to figure out where my issues originated and how they operate);
* Action-oriented Cognitive Behavioral Therapy (with an emphasis on behavioral change).

I sometimes wondered what's wrong with me, since many things can cause depressive symptoms or be comorbid with them. I have had my thyroid, blood sugar levels and testosterone tested - all normal. I have taken every respected self test I can get my hands on. The results of these tell me what I already suspected: Social Anxiety, Low Self-Esteem, Learned Helplessness, Avoidant Personality characteristics (but not a Personality Disorder, apparently), and pessimistic rumination (optimism and I parted ways some time ago it seems).

People who have known me well over the years are always giving me these kinds of well intentioned comments: "You need to be bolder, you're too timid"; "Why do you let people walk all over you?"; "You need to show the courage of your convictions"; "You're a good person who can't see the good in himself"; "You need to work on your self worth"; "Why do you always hesitate over everything?"; "Get out of that 'shell' of yours"; "Don't let the competition or the naysayers get you down". They're all totally correct.

Meds I can afford. They consistently don't work as well as I would like, or don't work at all, and I collect side effects the way some children collect Pokemon. Books I can afford. Sometimes they help a bit, sometimes they make me feel even worse (some authors suggestions seem to feed my depression a three course meal). The one thing I can't afford right now is the talk therapy mix that actually DOES work! *rolls eyes*

So where do I go from here? I've had enough. Right now, beginning today, the BS has to end. I can't live like this. I've been told time and again "You're very high functioning". I really beg to differ.