Treatment Resistant Depression Suggestions for Treatment I was diagnosed with dysthymia 15 years ago (likely onset in childhood), and this was confirmed through a neuropsychological assessment 5 years ago. I've also been diagnosed with ADHD-PI, and I have stronger than average intellectual abilities.

My primary disabling symptoms are anhedonia, exhaustion, and irritability. I have to wind myself up to get through the the work day (I have a demanding job), and then I am exhausted after (it's hard even to cook for myself and feel zombified). I've had many physicals over the year and there doesn't appear to be a physical cause. When I try to push myself I can get intensely irritable and feel like I want to crawl out of my own skin.

40/f/white. Citralopram/Wellbutrin/Dexidrine. Tried to add Abilify but had serious side effects and had to stop within a week.

Have had years of counselling off and on.

Next steps?