Hi Laura -- I agree that you are ahead of the pack by addressing your depression using so many approaches at a relatively young age.

My medication (Effexor) has given me relief from suffering -- after many years of seeing Ts on and off -- that I never dreamed of. Doesn't mean I don't ever have bad hours, but the overall level of being able to appreciate life is higher than I ever hoped it might be.

I am wondering, however, if even this depression has a situational trigger, albeit one that may not be immediately apparent. Dr. Burns talks in one of his Feeling Good books about a patient who was a busy entrepreneur all week long but sunk into depression during her weekends, when there was too much unstructured time. That's not an obvious situational factor -- yet it was a real trigger for her.

Perhaps you can explore this possibility, as well as meds.

You've done so much work on yourself -- good for you. It can only keep getting better.