Here are some ideas: Have you ever tried higher doses of wellbutrin (the max is 450mg/day) or seroquel (max 800mg/day)? Don't forget you need to be monitored for metabolic syndrome since seroquel can lead to that. Wellbutrin is the least likely antidepressant to cause sexual side effects...the 2nd least likely is mirtazapine which can also help you sleep (monitor for any increased appetite & weight gain with mirtazapine, although on average seroquel is a bigger culprit for that). And FYI, some research has shown the appetite & weight gain side effects is not necessarily dose dependent and can occur even at small doses like the one you are one.
Another strategy that is backed up by science & research but prescribers are neglecting is low to medium dose lithium to augment antidepressants. I'm not sure if you're tried any benzos (ativan/klonopin) for the anxiety; keep in mind these can be addictive. Buspar would be a non-addictive substitute.
You said you tried therapy, but for how long? Real psychotherapy is often a longer term treatment. I tell patients a minimum trial is weekly for 6 months. Some people benefit from therapy for several years.
The next question is are you combining all the modalities together. In other words, fine tune your meds with a prescriber, get consistent psychotherapy, keep doing yoga and or meditation, focus on nutrition & exercise, spiritual life, hobbies, stress management, good relationships, and reading self-help books (1) The Seven Spiritual Laws of Success by Deepak Chopra, 2) The Depression Workbook: A Guide for Living with Depression and Manic Depression, Second Edition by Mary Ellen Copeland and Matthew McKay 3) The Feeling Good Handbook by David D. Burns; 4) The Relaxation & Stress Reduction Workbook (New Harbinger Self-Help Workbook) by XXXXX XXXXX).
Treat yourself holistically and try to balance your life.
I hope this helps. Good luck & take care.
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