hi bpcyclist, thank for the reply! We have not tried couples therapy but have agreed to try soon. I have a therapist who has agreed to do it so hopefully that will be a helpful process. The work with the pdoc and therapist seems to be making progress but it is INTENSE working so hard on my life right now. I am trying to address my childhood, my job, my relationship, my confidence, my sense of self, my long term depression and anxiety/social anxiety. So even though I feel progress happening, I sometimes feel worse than ever. I'm unsure exactly what the medicine is doing or if what I am on what is best for me. I do feel more free to take action in my life since starting medication which is very liberating but I'm also just sad and stuck in negative thought cycles all the time, I really almost never have positive thoughts or memories (this is not new but it has not improved on the meds).