[p4wnc6]

I think this gets at a bigger philosophical question about depression that few seem interested in engaging in.

Sometimes depression is a correct, reasonable, and even necessary reaction to un-live-with-able life circumstances. It's a way of your body generating warning signals that others might see and then offer you help, not unlike shooting up a flare if you're stuck on a life raft.

If the circumstances truly are un-live-with-able, then medication that simply makes you superficially feel like the circumstance is live-with-able, when really it's just continuing to be destructive to your life in every single same way apart from your now-masked-with-medication feelings, then medication can be counter-productive.

Many people with depression don't actually have un-live-with-able circumstances. Instead, they have live-with-able circumstances and either they have medical issues preventing them from doing the actions necessary to manage that living, or else they have what I'll call psychological issues preventing them from it, where 'psychological' here is meant to mean the subset of mental health issues that are not well-treated by medication, but may be treated with counseling or changes to other life habits.

The problem I've always faced when seeking counseling or mental health help is that every single mental health professional I've ever interacted with, every single time across many years and highly varied geographical situations, has always, always, always dismissed completely the possibility that a person can actually have un-live-with-able circumstances within which the depressive reaction makes reasonable sense. Instead, they begin from a point of view fundamentally rooted in the belief that that cannot ever happen to a human.

I mean, if they were pressed to think about like a child soldier forcibly addicted to cocaine or something, maybe they'd agree people really can have circumstances such that depression is the correct reaction. But in general, with first world people, they just assume it's impossible and have a pervasive Occam's Razor sort of filter, before ever meeting you or even talking to you the first time, that, nope, you're wrong about how you view your own problems, that there's no way you could be thoughtful enough to have done meaningful introspection before seeing them, and that your circumstances are never a justifiable reason for feeling depressed.

And from this attitude, the next step is almost always to suggest medication right away. And any time I've tried to say something like, "well, I'll consider medication, but I'm not just going to jump right into it. I want to speak more about my circumstances and explain why I feel like it's a real life Catch-22 that truly, utterly is depressing, rather than the depression being a part of me as I respond to it," then it's like talking to a brick wall. The counselor / therapist / psychiatrist doesn't want to hear about about. They already know you need drugs within one 1-hour visit, and now that you're saying you won't just rush right out and get them, that means further that you are a problem because you won't just go get the drugs you need.

And what's crazy is that the underlying rationalizations from the different mental health professionals have been all over the place. One person thinks it's because I have issues about my childhood and my father. Another thinks it's because I grew up in a relatively more religious community. Someone else thinks I have PTSD from an abusive relationship in my late 20s. Yet another thinks that it's related to overwork and job stress.

All of these are important issues and some mixture of all of them is affecting me. But every counselor I see has their own colored opinion about which magic answer it is, all those magic answers are different from each other, and yet, every one of them thinks that drugs, drugs, drugs is what will magically solve the problem.

It really gives me no faith in the mental health treatment infrastructure, and causes me to be even more guarded about when or if I will consider trying anti-depressants.

From some of these statistics, it makes me feel like anti-depressants are way over-prescribed, and that counselors are just extremely lazy. They don't want to hear the whiny, tearful narratives of their hurting patients' lives -- just like friends and family also don't want to hear it. And so shoveling out some drugs is an easy way to focus on something different than the thing they find unpleasant (i.e. actually listening).

[xsmasher]

There's depression the feeling, which may be caused by un-live-with-able circumstances and serve as a stimulus to make life changes.

Then there is depression the illness, which and may or may not be brought on by some circumstances, but which is debilitating.

If it's serious enough, I'm not sure if it matters whether it is spontaneous or caused - you need to be brought out of it before you can deal with the un-live-with-able circumstances. Staying in the depression doesn't help you to take action at all.

[p4wnc6]

But the huge difference is that with truly un-live-with-able circumstance, the most important thing you need is help to alleviate the circumstance itself. Changing your response to it isn't helpful if it doesn't contribute to changing the underlying circumstance, and when the circumstances are things that you don't control which happen to you, especially when they are on-going and it's not so much about how you process them but actually stopping them, it's questionable what role medication really plays.

> Staying in the depression doesn't help you to take action at all.

It definitely can. Precisely when you lack the power to change your own extrinsic circumstances, and it is those circumstances causing the harm that leads to depression, then staying in the depression keeps sending out that distress signal for help. Taking you out of the depression without also addressing the circumstances makes it seem like you're managing it, when really you're still being harmed.