SG, how about not leaving your pdoc, but just getting a therapist in addition to your pdoc? I've seen that many people here on PC have both a pdoc and a therapist. That way you could keep the longstanding relationship but maybe benefit from a new approach too. It sounds like you need something to give this stuck depression a boot and joggle it towards movement, and maybe a new T could do this.

I'm not sure where you are at with your meds (I think I remember you mentioning Lexapro before), but I wanted to share with you an interesting article I read this summer on a different meds approach to depression for people who had tried the standard ADs and not had luck with them. It involved using very low doses of narcotics, non-addicting ones. It is not widely used in the U.S. because of the phobia about naracotics here. But these drugs were able to cure some intractable cases of depression that other meds did not. If you are interested, please let me know, and I will look up the reference (it's in a popular magazine somewhere at home). It was very thought-provoking.