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

### input:
I have been diagnosed with chronic depression/anxiety, on many medications over a twenty year period. But I still feel like my mind stays in a state of sadness. I have been in this state so long that I do not remember if I was ever happy! There are very few psychologist who take medicare, my primary health care provider! Sincerely, Eloise

### output:

Hello, Thanks for choosing Chat Doctor for posting your query. I have gone through your question in detail and I can understand what you are going through. From what you have stated it is quite clear that you are still having a depressive episode. You need proper treatment for the same. You have not mentioned which medication you have tried until now. There are various effective therapies for depression like fluoxetine, venlafaxine, bupropion, mirtazapine or Escitalopram, and they are all very effective and mostly safe. If you have not tried them it would be wise to combine your treatment or switch to these antidepressants. At the end it's a trial and error way of treating the things. You may also require some benzodiazepines like clonazepam or lorazepam for a short period like 2-3 weeks to reduce the anxiety and help with your sleep.  If you are averse to the Chat Doctor.  This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help you with your illness. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/