Ugh, SK, I really suggest you look for someone else. It's fine to supplement, but it's ridiculous that you're on all this medication and feel so terrible. Plus, when you pay out of pocket, when they want to see you more frequently after making a med adjustment or because you're doing really bad, it gets really hard financially. I wouldn't just look at budgeting for his cash fee based on whatever frequency you're seeing him at now.

And just be honest with yourself, is he helping? Do you want to keep seeing him because he is an effective psychiatrist, or because it's hard to find someone else and change is difficult and maybe you are attached to him? I really hope you consider someone else. It's hard hearing about you seeing this psychiatrist and therapist who don't really seem helpful. I know severe depression can be very paralyzing and it's hard when you feel so bad to take action to make a change. Maybe this is a blessing in disguise because you'll be forced to do something different no matter what - and you have an opportunity to take a step in a different direction. This whole thing, while extremely stressful, could end up being the catalyst that turns things around for you. You've been feeling bad for so long... and I do think there's someone out there who can help you more than he has.