I am a forty three year old single female, highly sensitive, suffering from depression since childhood and social phobia/anxiety for at least twenty years now. I can no longer keep a job now it is so crippling.

I have tried Effexor, Paxil, Prozac, Lithium, Buspar, Luvox, Zoloft, Valium and Ativan, the latest two I cannot have due to the severe habit formation. My question to you is "Is there any hope for me?", I suspect I am treatment resistant !

Thank you for this question. You are describing an issue for all psychiatric patients that are very important. It may be your anxiety that is interfering with your recovery. When the medications aren't helping, I think you have to consider a form of therapy that will help you with the anxiety. The therapies like cognitive behavior therapy or behavior therapy are often effective, but require hard work and practice.

My good friend Dr. Ernest McCrank has illuminated for me the importance of these talking therapies for patient's recovery from anxiety. It has also been my observation that many bipolar patients have significant anxiety relating to the trauma of living through a manic or depressive episode.

An excellent book on 'here and now' thinking that can reduce anxiety also, is titled 'Peace Is Every Step' by Thich Nat Hahn. Another option is Gabapentin as an augmentation to the behavioral therapies. Clonazepam or Rivotril is a benzodiazepine that has less abuse potential and can also help one use the talking therapies.

Thanks, and I hope this helps.