I am sorry you are suffering. I do understand long term depression. It sounds like your doctor has you on a good plan with your meds. I would stick to this for a couple months to see if it will truly help. No medicine can help us without a good trial. I have head of Sam E but it does interact with my duloxetine so I do not take it. I use a Happy Light everyday while I eat breakfast or lunch. You can google that. It is an intense light that is nothing like the light bulbs used around the house. Google Bright Light Therapy. I spent $45.00 on one, and it has been the best investment in my health. Public Libraries also have ones you can check out, to give it a try.