Sorry to hear of your continued struggles. It doesn’t sound as if the Emsam is really doing the trick for you.

I'd revisit your current recovery program from end to end. If you haven’t had a recent assessment from a clinical neuropsychologist I’d suggest that as a starting point, or a psychiatrist that has experience with PCS patients. They may want to try a different anti-depressant.

While quiet rest is important, and five kids plus the spouse may make this a challenge, I’m left wondering if the isolating is contributing to the depression. I’d look at the balance between your alone time and time with the family. This is an area where a psychiatrist or clinical psychologist may be of help. I’d also suggest mindfulness meditation in your alone time; rumination about things that aren’t positive may be contributing to your depression.

In what part of Indiana do you live? The clinical neuropsychologist who worked with me after my TBI is now in the Indianapolis area. If you are close to there and would like her name send me a PM and I’ll send her contact information.

Best to you as you recover.