Maybe you already read one of my countless posts about my depression and social anxiety. I'm suffering from them since I waas 15. Now I'm 21. It first started with social anxiety, I'd say, then because of the issues the social anxiety gives the depression came and then complete anhedonia, lack of drive, appetite and huge cognitive deficiency making me feel dumb and retarded, mentally as well as physiologically, right now.

And I don't know how to change it, I tried a lot like 10 medications (SSRIs, SNRIs, MAOIs) and right now on a tricyclic antidepressant called Amitriptyline. I also tried socializing weeks daily but it seems that my brain never gets an aha-effect or wow, this it how it works, my brain just doesn't learn any new patterns or cognitions (according socializing, university, knowledge etc. etc.). I also tried 2x depth psychological therapy and right now I'm in a  behavioral therapy.

The Amitriptyline doesn't work neither. It was my first antidepressant after more than 9 months now, I started it on 20th of December 2020. But I also started abusing Kratom daily since October 2020 and Phenibut since 3 weeks daily now as without it I wouldn't be able to function in the traineeship for my university which I am in right now. I start thinking about maybe those are the reasons I don't get effects from the Amitriptyline. Also regarding the antidepressants I tried before I always was abusing alcohol at first, then some years later phenibut and now kratom daily. The first 4 antidepressants I had I didn't use any substance at all (not even alcohol/nicotine) but I also didn't get any effects. 

All is fucked up: my brain chemistry my thinking my body. I feel retarded and dumb, mentally as well as physiologically. I don't know what to say in social events, I can't open up myself and feel free or be myself. I can't keep or learn new knowledge, I can't focus at all in conversations as well as classes in university. I can't study. I can't stand up in the morning. I can't eat. I can't sleep. I can't make any new friends or make romantic relationships even if all the people I know tell me I'm so good looking but this doesn't touch my self esteem at all. My self esteem, -trust and -value are at zero. I can't find any clear or rational thoughts but countless incredibly painful negative thoughts. And I fuck myself with kratom, phenibut and cigarettes (at least 0.0 alcohol since 2 years and no other drugs). My head and mind feel empty but at the same time over all the place. My hope is getting less and less since I'm fighting since I was 15. I know the reasons due to my depth psychological therapy so this is understood but still nothing changes.

Any suggestions or recommendations for me?

I will continue my behavioral therapy even if never go out with it with knowing something new that helps me. According meds I still have perspective as I think my brain chemistry is so fucked up because of all this years living and thinking like this because of depression and social anxiety. I also know that my depression fucked up my cognition so bad. I already tried: Venlafaxine (Effexor, Trevilor), Escitalopram (Cipralex), Seroquel (Quetiapine), Promethazine =&gt; those were the meds I tried without abusing any substance meanwhile. On daily alcohol abuse starting in the morning: Sertraline (Zoloft), Paroxetine (Paxil) =&gt; then slowly drifted to phenibut meanwhile on: still Paroxetine (Paxil), Duloxetine (Cymbalta), Opipramol, Moclobemide (Aurorix, an MAOI) =&gt; now on 4 months Kratom and 3 weeks of phenibut daily: Amitriptyline (a tricyclic antidepressant).

I also heard about amisulpride helping tons with social anxiety (which was the main source of my depression early in the beginning and it would help me tons with my depression if I didn't have social anxiety). My doc also mentioned pregabalin (Lyrica) and gabapentin at some of the last options but I know those are very addictive.

What other meds could I give a try the next time I'm at my doc? I also (naturally) want to quit phenibut and kratom after my traineeship ends in 2 weeks. I just need it for this time somehow. Phenibut I don't take at the weekends, only kratom. So is there any med that would help me with withdrawal and detox at the same time while improving my mood, drive, cognition and helping me with depression?

What is your opinion? Did most of these meds didn't work because of my abuse of other substances at the same time? Otherwise also the first 4 meds I tried didn't have any effect and I wasn't using any other substance than the antidepressant. I feel very bad about thinking this now, of course. My own fault but I just wanted to live at least 20% rather than 0% and these substances allowed me to do so.

I thank you for reading so far! I appreciate very help so so much and give you a big hug! Thank you!