Thanks for writing to Just Answer!
Please DO NOT increase your dosage. You are at the high end of the dosage scale now. In my experience as a psych nurse, I have known of people who did
well at 60mg, but when they went higher on the Cymbalta, they actually got more depressed. I can't explain scientifically how that could happen, but I've seen it happen to two people. If you are getting your medications from a family doctor, it may be time to consult with a psychiatrist who has a more in-depth knowledge of the various antidepressants.
It sounds like you have tried a lot of medications with only limited success, from the list of "already tried." Here are some other things to consider...
Therapy is an important part of treating depression. You may already be doing this, but it's worth emphasizing.
If you aren't spending much time out of doors, it may well be worth asking your family doctor to test your Vit D levels. A lack of that vitamin can really affect your sense of well-being. There's a simple blood test to check it. If you find that you do have a deficiency, the treatment is simple and the effects can be profound.
Do anything you can to raise your serotonin levels naturally. Taking a 45 minute walk once a day can work wonders (although I know it's hard to think about doing when you are depressed.....think of it as a prescription, not as exercise.) Studies are showing that exercise can help lift depression.
Finding a way to help others can also do wonders for a depressed mood. 1. It gets one out of the house and active. 2. You get good feelings from helping someone in need 3. Seeing the plight of others worse off than ourselves can make our own situation seem more tolerable.
This suggestion may sound odd, but it's very effective in increasing enjoyment of life, and something that I ask my therapy clients to do on a regular basis. Every morning, sit down with a piece of paper or journal and write down 5 things that are good in your life that you are grateful for.
One more idea: if you enjoy writing, you might try reading The Artist's Way by Julia Cameron. In it she has a writing practice which includes writing 3 handwritten pages of what ever is on your mind, every morning, before you start your day...even if you have to start by writing over and over "I have nothing to write about" Sooner or later, something will
come to mind...and I have found that often something comes to mind that's really bothering you that you were unaware of.
I know I have wandered away from discussing medication, but in my experience, medication alone is not enough to lift a heavy depression. Therapy and activities like those I mentioned above are an important part of getting to feeling better.