Treatment of refractory depression should be programmed consistent with a comprehensive assessment of diagnosis involving subgroups of depression, psychiatric disorders and concomitant medical disturbances. In this regard, admission and treatment should be compatible with the content of the case history precisely taken. In this conjunction some reasonable treatment could be suggested to the patient and his family. Within the context of an active cooperation amon g psychiatrist, patient and family we delineate a holistic care package to provide maximum admission and promising prognosis.