HI - I wish i had found this site ages ago! I have been living with depression and anxiety symptoms since I was an adolescent, though it didn't getting diagnosed as such till my late 20's. I have now had at least two major depression episodes; i wasn't effectively treated after the first one. I think I have a degree of dysthymia pretty much all the time. I have found effexor keeps the weepy spells and intense hopelessness at bay, but still really struggle with motivation. To complicate matters, a couple of yrs ago I was diagnosed with a genetic disorder, the symptoms of which i have also been living with all my life. It didn't get diagnosed because it mimics a number of other disorders, but none exactly. it MAY be the underlying cause of my depression although at the same time I was diagnosed with ADD (also possible connected to this disorder) and have found the combination of concerta with the effexor really helpful. Fromdoing my own research, i understand depression can be a "side effect" of ADD, given the many frustrations and shear exhaustion involved in trying to focus with a galaxy of thoughts bouncing around in your head! I thought that was normal...I use mindfulness techniques to help keep me grounded in reality and have benefitted a LOT from CBT. I also find keeping myself engaged in activities i enjoy - even if i have to drag myself out - is helpful. and i have a dog and cats, which are so soothing, and force me to get out of bed! My dog get s me out walking as well, which has been extremely helpful, even though walking is sometimes difficult physically.