Emotions are, quite literally, certain chemical states in animals with nervous systems of at least a certain complexity. That's where the "chemical imbalance" mantra falls apart - at best, it adds no information, and even worse, its used to peddle drugs which are developed without coherent and predictable models of the neurology involved in the symptoms/diseases they're supposed to treat.
Medical doctors get at least one objective measure of your blood pressure before prescribing blood pressure medicine. When was the least time you heard of a psychiatrist only prescribing meds after performing an MRI?
If I'm not mistaken, a person that is depressed due to environment will have similar fMRI as a person who has messed up biology (not just neurotransmitters btw).
Also, even with acute depression, antidepressants may help to get the patient on track.
The objective outcomes differ with different treatments even in cases of subjective success. The specific neurology (protein levels, chemical ratios, etc) should determine how exactly you intend to alter it.
It's easy to think of psychiatry being wishy-washy when all you're considering is mild to moderate depression and the like, but it becomes much harder when you consider the entire spectrum of mental illness. Full-blown mania, psychotic depression, or untreated schizophrenia scream illness in a way that is hardly subjective.
There is a whole arm of behavioral therapy based on the idea that trying to feel better, is a major cause of people feeling bad.
https://en.m.wikipedia.org/wiki/Acceptance_and_commitment_th...
Of course, it doesn't work for everyone.
Both can lead to a self-reinforcing downward spiral, but trying to fix the wrong half is likely to be ineffective.
Also, even with all the chemistry being fine, there can be certain receptors messed up, or parts of brain not functioning properly.
A story I read in "Listening to Prozac" was about a patient that for years couldn't get over his low self esteem issues. He worked through all of them, but the feeling persistent, and there were no other issues with his mood aside from that.
He was finally put on antidepressants, and that issue was fixed. Unfortunately, whenever he tried to get off them, the issue - and only that issue - kept coming back.
The theory is that something made that part of his brain resistant to serotonin. There are many kinds of serotonin receptors, and perhaps a genetic problem messed up one of them. Or there was an issue with serotonin not being delivered where it should've been. Or who knows what.
In the end, increased serotonin levels fixed that. A blunt tool, but no other one worked.
Similarly with attention deficit (which comes with anxiety and sleep issues quite often) - the original theory was that it was due to dopamine issues, because increasing dopamine levels helped most people.
The current theory is that in many cases it may a whole class of issues - from a mechanical damage to prefrontal cortex to allergies, magnesium processing issues, tyrosine processing problems, or even a deficiency in nicotinic receptors (where supplementing nicotine is really a solution!)
Also, in most cases it's probably more than issue at root. The problem is that it's difficult to figure it all out, and many cases medicine is simply not there yet.
My doctor actually recommended nicotine for that exact reason. My family's history with heavy tobacco use combined (my father in particular) and my experiences with nicotine in the past were positive, so the doctor suggested trying a strong nicotine patch for a while. It worked reasonably well, and more importantly it didn't have the (many) problems the usual SNRI or NDRI. Nicotine definitely does have its own problems, but it's an interesting option that deserves more research.
(We had also discussed briefly the idea of trying a very small dose of one of the acetylcholinesterase inhibitors used for Alzheimer's, but eventually decided against it, because they can be somewhat dangerous drugs.)
For decades, research on the nicotinic acetylcholine receptors was limited (probably tanks to the tobacco industry). Research in this area is improving a lot, but it will take time to make up for the lost time.
When I discussed the subject with two psychiatrists, they seemed unaware of how it connects to psychiatric issues.
I would say it's not about trying to "feel better", you can't just force yourself to not feel depressed, the brain is too complex for that. There are, however, many rigorously proven methods for tackling depression that can work in replacement of or in addition to medications. The one I think has the most merit is mindfulness based cognitive behavioral therapy. The idea is to build up a new set of habits, coping skills, and behavior patterns that let you life your life without getting sucked into depression. Depression is vastly more complex than simply "a flaw in brain chemistry", that's very reductive reasoning but it's been a relatively successful one for the psychiatrist business and pharmaceutical industry. That brain chemistry is as much a symptom as it is a cause though. And with enough work it's possible to make yourself more resilient to potentially depressing circumstances and thoughts. It's possible to train yourself to recognize and change the constantly running background narrative of negative self-talk that gets you down, the rumination, the trains of thought that seem so unavoidable, and so on. And then on top of that to build better habits, to tackle your problems, that you're in control of, and prevent them from growing out of control, to regularly exercise, etc.
Of course, it can be difficult if not near impossible to do all that, or, really, anything whatsoever, if you're deeply depressed. Which is why for many people it's necessary to begin anti-depressants before starting therapy, making behavioral/cognitive changes, etc. The problem the parent poster is talking about is the tendency today to just shove people into the top of the process and call that done. It's now expected that most people who have experienced major depression should just take anti-depressants for their entire life and that's the "cure" for their problems. With only a token concern for building up the skills, habits, and coping mechanisms that people actually need. You see the same thing with a lot of other things like ADHD or anxiety, with a tendency to look for the chemical answer first and foremost and call that good enough.