I hope you got my email replies. I'm not going to repeat everything here, rather I'm just answering the question, from my own experience (15+ years of dealing with depression, dissociation, post-traumatic stress crap).
Medications *can* work. The catch is, for everything we think we know about the brain and how nerves operate, even the best doctors and scientists have to admit that they still *don't know more*. This is important. This can mean the difference between needing meds for a year or less, while you get counseling, or being stuck on them for the rest of your life because other treatments *aren't there* and the law *demands* you stay in a holding pattern to prevent your suicide.
To elaborate: No two people are alike. No two brains are exactly alike either. And depression, that *word* "depression" covers a lot of ground. It can be a symptom of a larger, more physical illness (like cancer, heart disease, or diabetes), or it can be an illness by itself. And there are lots of things, *lots of them* that can go wrong and lead to a depressed mood.
--It can be entirely biological for some folks. This does run in families. Not to mention, hormones, both endocrine ones (thyroid, insulin, estrogen and testosterone, pituitary), and stress-related ones (cortisol, norepinephrine--yes, it's a neuro-transmitter *too*, and oxytocin) play a *huge* role in moods as well. Not to mention *mast cells* and the whole anti-histamine reaction to allergens and stressors (the 2nd generation anti-depressants, the tricyclics, were *modified* anti-histamines originally meant to treat allergies) plays a role too.
So just saying "it's biological" doesn't quite get specific enough to nail it, and say *exactly* what's going on. Research also indicates a history of *concussions*, yes, being hit in the head, can also lead to depression.
--It can be about the lifestyle one lives too. Meaning, if you aren't sleeping, eating right, getting exercise, in touch with friends, family or people who care....it can wreck your moods too. Essentially, the lifestyle stuff boils down to three things:
1) Self care. This is where the eating, sleeping, exercise and hydration come into play....not to mention hygiene and giving yourself "down time" where you can relax and have fun. And this is also where *not* having addictions helps: not smoking, drinking, using illicit drugs, overeating, or having compulsive behaviors in shopping, gambling, or in your sexual life.
2) Social standing. Isolation is the big one here, the big killer. Just look at your average school shooter: when they isolate, and are all alone and *have no friends* to talk to, and trust *no one on earth*, that is when they really go crazy and *act on it*. Other things that matter too are: Being able to keep a job (in the sense that you can relate to others, and that they can relate to you--it's about having *life's work* as well as getting paid), maintaining proper grooming and hygiene and wardrobe (so as to be pleasing to the senses of other people), maintaining proper and appropriate *boundaries* (posture, body language, and ettiquette), and having "a life" (meaning pastimes, hobbies and the like, that you *share with others*--this is in shorter and shorter supply these days).
3) And finally...Locus of Control. How in charge of your own life are you these days? Do you have a say in how you live? If not, do you have *any hope* that this will get better? Basically, what it boils down to is: in much of this world, you either *do things* or have them *done to you*. Being passive in your life and just having things *done to you*, being a victim or an object of other people's behavior, is *not healthy* in the long term. It may seem like the path of least resistance, but the lifestyle is stressful and emotionally draining. And this is true regardless of the *source* of this: it can come from being dirt poor no matter what you do in life, it can come from being a victim of a violent crime, it can come from having friends and family *die suddenly*, it can come from losing your job for no good reason (outsourcing, downsizing).
In short you *need* to feel effective and in control of something in your life to make it worth living. Otherwise, the persistent trends in your life will be expressed in words like: "Nothing works," "I don't matter", "I don't fit in", or "I don't have a place." And the *words* are *not* the issue, the lack of control and effectiveness *is*.
So yeah, it can be "biological", whatever that means *this week*, or it can be a by-product of being *stuck with* an unhealthy lifestyle, in much the same way cancer, diabetes, and heart failure are such by-products. The key words are: Stuck With It. Meaning, it's long-term, and there's little to no hope of changing for the better. People can survive anything short term. It's being *trapped* in things that kills us.
And the meds? They *can* work, provided the doctor *Picks* the right one. And this is a HUGE issue. There is way *way* WAY THE HELL too much Trial and Error going on in modern medicine when it comes to treating mental illness. I think most of this is deliberate: Insurance companies profit *more* by this non-method, and there is the social factor, in that if you try and *fail* and try and *fail* again and again, it wears you down and makes you docile and dependent. Compare this to treatment of *diabetes*: There are specific tests you can take, we *know* how many versions of the disease there are, we *know* what treatment works for *what diabetic condition*. These are known things, because it doesn't make anyone any *money* to have folks *die right away* and to have families *sue*. Pardon my cynicism, but people in the mental health field compare depression to diabetes *all the time* in terms of having to be on meds *all your life*...but mention nothing about the *lack* of precision in mental health treatment compared to diabetic conditions.
And the sad part is...this trial and error business is *now a part* of the problem. Wearing people down does them no good, on principle. Destroying their Locus of Control guarantees their illness *will persist* for the forseeable future. And there's MRI and CT scan evidence that physical *brain structure* gets altered when you take anti-depressants, whether *they work* or not, whether they do the job or not. Regardless of what happens, the drugs leave a *mark* on your brain, permanently...so the trial and error business, arguably, could also be a slow burn lobotomy in disguise.
So, yeah...now you know. -_- Write me again if you want more details and specifics. And I am terribly *sorry* this is so long....but there's a *LOT* to cover. Really.
Thanks for your time and patience. God Bless.