### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello,Ive suffered with severe depression for many years.  I take a heady cocktail of Venlafaxine, Mirtazipine,Diazepam and a beta blocker to treat the depression.  I also suffer with anxiety and post traumatic stress disorder.  I have requested a medication review from a psychiatrist as I have been taking these medications for several years and I still feel extremely depressed.  Prior to seeing the Psychiatrist; I was wondering if there is anything else I should be mentioning to him/her? Also; are there alternative medications you could suggest I discuss with the Psychiatrist?Many thanks,Tracy Arnold.

### output:

Dear, We understand your concerns went through your details. Clinical depressive disorder is a neurochemical disorder. The Main Causes of Depression ranges from genetics, loss of loved one, grief, obsession to serious illness and substance abuse. There are many researchers who believe that an imbalance in serotonin levels may influence mood in a way that leads to depression. Anxiety and PTSD could be clubbed with your depressive disorder. Clinical depression is usually treated with a combination of psychiatric medicines, psychotherapy, lifestyle changes, meditation and exercise. These therapy methods are highly personalized methods and therefore only an expert will be able to help. Once you make the necessary amendments in your life with the help of the above said therapies and lifestyle changes, learn how to manage the depressive episodes without medicines and learn to relax, the medicines can be weaned off over a period of one year. Please consult a psychologist. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome. Good luck. Take care.