As for anti-depressants, have you tried an
MAOI yet? Yes, it is an old drug but it is also effective. I am on Emsam which is a transdermal patch. There are diet restrictions if you are on an MAOI but I have "slipped" without bad result and I think it may be because I am on the patch instead of a pill. The diet is a low tyramine diet so you can't have aged cheeses, aged, smoked, cured, dried meats, pickled things like saurkraut, soy or soy sauce.