I was told for years that I couldn't have isotretinoin because of being prone to depression, but my current dermatologist is a consultant and has been part of academic research into possible links of isotretinoin to depression and assures me that actually it's a false correlation. Like me she thinks that it's the severity of acne that warrants treatment with isotretinoin (and the potential for it to flare up worse at the beginning of treatment) that accounts for most, not not all, experiences of depression while taking the drug. So if you're keen to try it then it might be worth searching around for a dermatologist who will prescribe it to people with a history of depression because they do exist.

As for other treatments, have you tried spironolactone? It's what I'm on at the moment and it's an anti-androgen that can only be taken by women but is a good one to try if you suspect your acne is hormonal and aren't ready to take the plunge and commit to isotretinoin. It does have to be prescribed by a dermatologist though as acne is an off-label use of the medication.