Brief Answer: clarifications Detailed Answer: Hello, Thanks for using health care magic for posting your query. I have gone through your question in detail and I can understand what you are going through. However I would require a couple of more details to help you in answering your query in a better justified way. 1. Have you done your thyroid levels any time? 2. What all other drugs have you tried? 3. Any ongoing stressor in life? 4. Any medical issues? Hope to hear from you at your earliest convenience. Regards and wish you good health, Dr. Srikanth Reddy MD Neuro-Psychiatrist and Sexologist

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Brief Answer: Resistant depression it is Detailed Answer: Hello Thanks for all the add on information. It seems that although you are on regular medication for three years, your depression still has not remitted. Its very commonly observed in our routine clinical practice. There are couple of steps that can be taken to get you on track: 1) Being borderline hypothyroid, it would be advisable to start thyroxine supplement at 25 Mic Gm per day. It will help in dealing with your depression. 2) Depakote dose needs to be increased. You have to increase it upto 1gm or 1.25gm to get its full benefit. Its a safe drug and should help you better in higher doses. 3) A first mood stablizer like bupropion should be good instead of buspin. Taken in 150mg dose, it should take care of your depression in a better way. 4) Try augmenting your treatment with cognitive behavioural therapy. This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help you with your illness. You may discuss there 4 options with your treating psychiatrist. He may change your therapy accordingly. None of the above points can be denied and they are all steps towards better improvement of your mood disorder. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link: bit.ly/dr-srikanth-reddy Wish you good health, Kind regards Dr. Srikanth Reddy M.D.

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Brief Answer: Can try Detailed Answer: Hello Cognitive behavioural therapy is mostly a face to face procedure. It may be done online using specialized software of computerized cognitive behavioural therapy and wont be possible on emails or health care magic forum. We can try a telephonic CBT as I have done a 4-6 of them this year which have gone good. You may request health care magic customer care to arrange a phone consultation for this CBT session. Kind regards Dr. Srikanth Reddy MD

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