Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
I'm sorry that you're going through a rough patch right now. It seems that you've tried a number of things to help your situation. I certainly wouldn't diagnose over the internet (neither appropriate nor ethical), but I do have some advice regarding the proper treatments for OCD (anxiety) and depression.
First of all, St. John's Wort (no "h," by the way) is an herbal remedy used to treat very mild depression only. St. John's Wort has not been recommended as a treatment for Major Depression or OCD. Citalopram, as an SSRI, is likely to be a more appropriate medical treatment for OCD/depression - but should be used under the supervision of a physician/MD.
Research has consistently demonstrated that treatment plus medication is more effective than medication alone or treatment alone for depression and/or anxiety. Further research has shown that Cognitive Behavioral Therapy (CBT) is the most effective form of psychological treatment/intervention - particularly in dealing with mood and/or anxiety disorders (like OCD).
A licensed psychologist/psychotherapist with specific training in CBT modalities would be able to address your concerns. I would encourage you to find a licensed mental health professional with whom to work, employing CBT. If you are addressing OCD, a specific form of CBT is called Exposure with Response Prevention (ERP) [Lots of letters, I know... sorry.] ERP has been found to be as effective or more effective than traditional medications for OCD. Be sure when you speak to a possible licensed mental health professional that s/he employs CBT techniques - not just "influences from CBT" or "an eclectic approach."
With regard to medical treatment, many/most physicians appear to begin with a Selective Serotonin Reuptake Inhibitor (SSRI) to treat anxiety. Because I am not an MD, it is beyond my purview to address medication concerns, however.
Again, the mantra of years of research says: medication or treatment alone is not as effective as both working in tandem. Some research has also indicated that insight-oriented talk therapy is counter-productive with some forms of mood and/or anxiety disturbance... it actually exacerbates the condition(s) [This is especially true with OCD]. So, seek out a CBT therapist who will provide targeted, efficient, and effective therapy - not someone who signs you as a "lifer." If you're going to a therapist for years, something about the therapy isn't working.
Your psychiatrist *may* know of a CBT licensed mental health professional. Please make certain, however, that they employ CBT practices.
If $$ is a super-big issue, you might want to consider contacting your local Community Mental Health Center. These tend to offer free or greatly reduced cost mental health services, including therapy and/or med management, depending upon your ability to pay.
Thanks. I hope you're well and that this was helpful.
* FEEDBACK ENCOURAGED. Please contact me prior to leaving negative feedback so that we can resolve the matter. I am eager to work with all JA clients to provide them with useful/helpful answers. Thanks again.