I live with depression, and have taken SSRI and SNRI medication for about 30 years. It took a very long time to find the drug and dosage and dosing regime that works for me. I still get way down, but not _too_ dark and since going on current meds 3 years ago have had no issues with suicidal ideation. Depression is a complex set of problems, and it is in my experience unreasonable to expect a "complete cure in a box" when dealing with Major Depression. In my case there is little doubt that my current SNRI is life extending.

To be honest, I sometimes think that maybe pointing out how weak the evidence is for AD meds in general may dissuade some people from trying them - and they may work, as may a placebo. I really appreciate the way you worded this, it's really rare to find a balanced and informed opinion like you have shared.