Turns out I just needed to succeed in life and suddenly I’m not depressed anymore. I was keenly aware of what a loser I was and through marriage and a small amount of amphetamines am doing pretty well now.
To non-psychiatrists depression is a synonym for sadness.
To a psychiatrist depression is more about the functional impairment (social occupational effects).
How sad you are is only a tiny part of how clinically "depressed" you are!
Check out how depression is graded in research and clinical practice.
* https://www.mdcalc.com/calc/10043/hamilton-depression-rating...
* https://www.mdcalc.com/calc/4058/montgomery-asberg-depressio...
* https://www.mdcalc.com/calc/1725/phq9-patient-health-questio... (sadness isn't even the first question for the PHQ9!)
You could have a wildly effective antidepressants that doesn't make you happy, or you could be crushingly sad and not depressed (subclinical depression).[0]
Here's a real mind bender. In social anxiety (at least), people on the same antidepressants will have detectable differences in neurochemicals based on if they were told the pills would work, or won't work.
Mind bender.
As an N=1 report, I've been taking the Zembrin supplement (per the Astral Codex guy) for about a year, and it does _seem_ to knock out the sadness component. But this leaves the "unproductive" component, which is sometimes just a small drag, and at other times leaves me almost catatonic. Alcohol mostly fixes that, but has other problems, and I've lately quit.
No specific advice other than to just keep reading and experimenting. And if you're in a bad life situation, try to get out of it.
I tried to remember what I was like ten years ago and was definitely “severely depressed”, the first link said that. I was constantly agitated and anxious, had insomnia, would call people crying at 3am, and was obsessed with thinking I had some terrible illness all the time.
Despite some mild anxiety the same rubric says I’m normal now, so that’s nice.
The Adderall doesn’t really improve my mood so much as it lets me accomplish the things I need to do in a day, so instead of having a bad feeling in the pit of my stomach like the sword of Damocles over my head, I can relax.
Most interesting to me is how I was completely self absorbed and only had myself to worry about, and now that I have a wife and kids, I was less depressed in the years we didn’t know if our young daughter would make it to adulthood due to illness. My remembered experience is that my mid-20s when I was flunking out of college and playing WoW 60+ hours a week was a way more painful time in my life.
When your life actually sucks, no amount of positive thinking is really productive. At some point trying to turn everything into some kind of positive is basically self-abuse.
Using medication to force your brain to stop being unhappy in truly crappy circumstances is more or less the same.
It's better for me, my wife, and the world around me for me to manage my sphere of influence and use it to make a space that is comfortable and fun for my family. Learning that I have the power to change some things I don't like is gratifying.
I do worry that practicioners jump too quickly to antidepressents versus attempting other interventions, but I've also seen practitioners fail to have even basic alternatives. To quote one MD, "Oh that sounds bad... uhm, maybe therapy?" No referral, nothing.
We are starting to see Cognitive Behavioral Therapy take flight not just as a guided therapy but also something where the patient can just work through a workbook solo and try exercises on their own.