Most doctors, even those working with mental health, don't believe the chemical imbalance stuff. That's why recommended first line treatment for mild to moderate depression is a talking therapy.
(Though I agree that mental meds are fairly shitty overall. Particularly anti-depressants and anti-psychotics. And they're really heavy treatments with potentially horrible side effects, so a talking therapy makes sense as it won't, for instance, cause your skin to die and fall off unlike some meds. Docs seem sorta-OK prescribing amphetamines in combination, but vastly more hesitant to even consider opiate treatment for depression.)
The doctors I work with prescribe cognitive behavioral therapy as the first hand treatment for depression and antidepressant when therapy is ineffective (which isn't all that common).
One of the reasons that antidepressant are so widespread is that doctors are usually in charge of treatment and seldom perform therapy but are very used to prescribing medication.
Also the fact that millions of people are depressed makes it hard to give everyone access to therapy.
In my opinion it is much harder to treat a patient on antidepressant since they respond worse to treatment then a depressed patient who is not on medication.
Depression is a devastating disease but it is astounding how effective therapy can be for a lot of patients.
I regularly meet patients who are very depressed when we first meet who manage to overcome their depression in a couple of weeks.
Physical activity is also very good at treating depression.
http://www.tandfonline.com/doi/abs/10.1080/17437199.2015.102...
If everyone would exercise the demand for therapists would be much lower.
One mistake that many depressed patients make is holding a strong view that they are a person who suffers from depression.
This keeps the patient from realising that depression is a condition caused by their interaction with the environment and that it isn't personal.
I think one problem with the article is that it seems that the person still views herself in this way instead of fully realising whatever it is that is needed for keeping him/her from becoming depressed again.
I wonder, do opiates have any positive effect on depression? Short- or long-term? What about physical dependency? What about psychological addiction?
> Docs seem sorta-OK prescribing amphetamines in combination, but vastly more hesitant to even consider opiate treatment for depression.)
Ketamine is currently experimental for major depression and anhedonia.
Opiates are currently the med most used in death by suicide in the UK, (#1 opiates, #4 opiate and paracetamol combination) so it seems reasonable to be cautious about prescribing opiates to a group at increased risk of suicide.