Severe symptoms of depression even on medication

Patient: Hi have suffered from major depression in past and have been hosptialised 4 times. at the moment i am feeling extremely exhausted all the time, no motivation, i get up in the morning with really good intentions, none of which materialise. i am currently on medication, mirtazapine 45mg, zopiclone 7.5mg , lyrica 100mg and seroquel 400mg, i also am suffering form low back pain which is constant and painkillers dont seem to help

Doctor: I do understand your concern and apprehension. It definitely seems that your symptoms of depression have worsened even a fter taking medication . I do understand your reluctance for seeing a doctor but it is important in your case to consult a a psychiatrist for adjustment of medication and psycho-therapy. I would advise that you continue taking your medication and if at anytime you have thoughts about hurting yourself, go to the ER immediately.