Hello, Welcome to healthcaremagic.com, From your account it is clear that your friend is harbouring a depressive illness. Post-operative anxiety & depressive symptoms are common to be found. This is because of the increased physical and psychological stress to which an individual is subjected to during and after the surgery. More over your friend is already on antidepressant but not adequate response to medications is being noticed. I would advice you to take her to a psychiatrist in person for detailed evaluation. Moreover she might be in need of inpatient treatment. Also only after detailed evaluation and observation next treatment plan can be decided. Treatment includes antidepressants, anxiolytics, benzodiazepines, ECT can also be used depending on the severity of illness. Thank you