on depression

XXX finally joined FB, so I messaged him your post to get his highly qualified opinion (he's currently chief resident of psychiatry at XXX General Hospital).

Here goes:

Out of the erudite arguments of the post, I emphasise two things:
1) "we don't know what depression is..."

Depression is an overdetermined, multifactorial illness. There are probably a hundred different pathophysiologic conditions that are lumped together under the name depression. Kind of like how for what we call snow, the Eskimos have many more words. So it makes sense that any treatment for "depression" will treat only a limited percentage of users, and that the data for its efficacy will be controversial and mixed. I have seen antidepressants fail miserably. I've also seen them, and other related meds, literally wake people from the dead. I understand that human beings, and their biopsychosocial illnesses, defy any simple explanation or treatment.

2) Treating a psychological condition with medication is also one way of ascribing "meaning" to the condition. It medicalizes the condition; it pharmacologizes it. As you mentioned, it quantifies it on a scale of milligrams of drug. For many, having a medication validates that they are truly suffering--and that seems to be a response to a societal indifference to suffering we are all occasionally guilty of, whether you attribute it to the breakdown of the extended family, or breakdown of the tight-knit local community, or our generation of "narcissism combined with nihilism" as Al Gore put it. Depression is at its base a loss of hope--and meaning is the antidote to hopelessness. Sometimes a pill is both meaningful, and efficacious...