<s>[INST] hello doctor! i am from india suffering from depression for the past 10 yrs i do know how to classify according to medical terms but in my view i m suffering from moderate to severe depression. have frustrating cognitive impairment and i have taken medicines for the past 10 yrs ranging from fludac, veniz xr 75,sertaline, clomipromine but in vain pls help [/INST] Healthier can be many reasons for not responding to medication. I don't know your complete history so can only mention probable cause, and you need to figure out which one you are having. One is you may be misdiagnosed, and you may be having more than just depression. A combination of depression and personality disorder or bipolar disorder. Secondly you did not comply to treatment as advices, and thus you develop resistance to treatmentThirdly you may have not persisted with one doctor and every new doctor advices you knew treatment, and you never took treatment in adequate doses and durationFourt you may have needed augmentation treatment which your psychiatrist did not fifth you may have additional medical illness like thyroid problem or any other endocrine disorder or any other medication which interfere with antidepressantsSixth you may have some personal stressor which is persistent over these years and you don't have any escape from it, which remain the main reason of your problem, and you are not able to get received </s>