You go from being sad to just not caring. That very much does not make you happy, but it might make you stop complaining.

There’s a comic where the doc then says “good enough!” and that’s supposed to be funny. Ha ha ha. Same reason I stopped reading Dilbert: it’s not really funny when it’s an accurate account of what really happened.

What’s important to understand is that Depression isn’t “sadness”. It a dead feeling.

It’s not a dead feeling because of anything particularly bad happening. But it is a dead feeling that isn’t fixed by pills. But pills are, in some cases, a requirement for even being able to start trying to fix yourself.

Your brain has two positive reinforcement tools, Seratonin and Dopamine. Both of those work together. Dopamine affects how we respond to things, both good and bad. Seratonin affects mood, motivation, energy levels.

So when we say that “Depression isn’t sadness”, for example, we mean that we lack the dopamine to even think about things in terms of good or bad. They just…don’t…matter.

That leads to a kind of spiral. Things kind of fall apart when they just don’t matter to you. And as things fall apart, you start to feel like a failure and a piece of shit because things are spiraling, which just adds to the lack of dopamine and it keeps going down and down and down until you’re body is quite literally just not capable of producing those two chemicals naturally. They kind of forget how.

As cliche as it sounds, both Seratonin and Dopamine are boosted by “thinking good thoughts”. And I know that that sounds like bullshit, but it’s true. That’s why the fix (there is no cure) for depression is C.B.T (Cognitive Behavioural Therapy). It’s things like, keeping a negative thought challenge notebook, where whenever you have a negative thought, you write it down and you challenge it; actively asking yourself why you think that. If something good happens, but you always think “Oh this isn’t going to last”, you ask yourself things like “why do I think that?” and “What are the other possible outcomes”. Or writing down “three good things that happened to you that day”, for example. Cheesy things that your depressed and negative mind is likely to dismiss as “hippie bullshit”, but they work.

CBT is also about making habits. As things fall apart, as things don’t matter, dishes might not get done. Lawns may not get mowed. work might suffer because of lack of focus. And you wake up every morning and all of those things not being done, just make you feel like more of a piece of shit and drop the spiral further. And so you say “Okay…I’m never going to go to bed with dirty dishes in the sink. I’m going to walk my dog every morning. etc…” Small things. All of those things slowly but surely start to build the Seratonin back in your system, and the Dopamine starts regulating properly again. Thinking good thoughts, having a sense of pride and accomplishment, having fun…all of these things are what create your Seratonin and Dopamine.

But the kicker is, that when things have *not mattered" for such a long time. When you’ve lacked any of those things for such a long time, even starting to practice CBT sounds like utter bullshit. It’s cheesy at best. Worthless and pointless at worst. And so the drugs are there to act as sort of a tow truck that you call in to give your battery a boost so that you even have the motivation to start down the path of actually “battling”.

This Blog Post is what finally made me realize that I was indeed depressed, after denying it for many many years. I consider it a must read, not only for people to understand depression, but to understand me.

https://hyperboleandahalf.blogspot.com/2013/05/depression-part-two.html

I’m on Wellbutrin and for me, it makes it easier to dismiss intrusive thoughts. Instead of having to say “no” to the same thought every two minutes for hours, I can just kinda say “no” to it once and not have to deal with it again for a day.

It dampens the extremes. So you have enough mental energy to seek other help.

Just as a clarification; depression isn’t sadness.

Depression is the lack of anything, it’s feeling every moment of your existence scrape by while nothing seems worthwhile or interesting.

Replying as someone with diagnosed depression (“Major Depressive Disorder”, isn’t as bad as it sounds) which apparently first started in teenage years

For me “talk therapy” (such as CBT) has never been ineffective, but not effective to the extent that I considered my depression “managed” so to speak. I’d always have negative thoughts, bad feelings, etc… I was reading The Feeling Good Handbook and became open to the idea of medication, so I was put into contact with a psychiatrist a few years ago who decided to put me on a very low dose antidepressant (10mg fluoxetine/Prozac per day), later upped the dose (20 mg/day, still low)

A week or so after being put on antidepressants (a very low dose, mind you), a large part of my depressive symptoms just… went away. I’m no way near being “constantly happy” or anything; it’s just that the depressive thoughts left. And it was significant enough because I don’t think I’ve ever achieved that with talk therapy

There was an extended period a year and a half ago when I stopped medication due to relocation, and depression came back after like a month or so, but it could have been compounded by the fact that I got a bone fracture back then & was not in a good mood in general… but the symptoms went away again after a week or more of me restarting medication. I stopped medication again 3-4 months ago for another relocation, and depression hasn’t come back for me yet

My understanding is that antidepressants, depending on the type, alters the body chemistry… so depending on where someone’s depression comes from, antidepressants is sometimes the most effective treatment out there (for many others, talk therapy is the most effective). Since it appears that my source of depression is due to losing the genetic lottery, antidepressants probably was the perfect solution. But realistically psychology/neuroscience don’t have enough research funding despite how important and interesting they are, so we don’t actually know that much regarding how antidepressants work… just that they work quite well for some people

And to answer your question: no not really. It just “treats” depression and is not always effective. Happiness seems like something very much separate, but can probably be induced by certain controlled substances (which are highly addictive and bad for you)

Nobody knows. See https://en.wikipedia.org/wiki/Hard_problem_of_consciousness

They don’t make me “happy” but I’m also not simply “sad” without them. They stabilise my mood, they prevent the big dips, the deep abysses, where everything is stupid and bullshit. They enable me to deal a little better with bad shit happening so that not every little fuck-up makes me crash.

Some people might call that “dulling” or similar but I really prefer this over despairing at every little thing.

However, it’s worth noting that, especially in case of psycho-active drugs, everybody reacts differently to them. Most people try a handful of different drugs before they find one that fits. That’s to be expected so if the first one doesn’t work or causes intolerable side-effects, there are plenty alternatives.

For me it sort of stimulated my brain and got it going again.

I had a bad bout of depression in my early 20s, and the first time I took antidepressants I remember noticing how vibrant all the colours were, how much sound there was. It was like everything had been dulled and a veil had been lifted.

However it was not an instant cure - the first effects just showed how bad my depression was. It took weeks and months for things to gradually improve.

The next thing I actually noticed changing was my motivation to do things started lifting. For me it was a positive, if slow process. But it can be a negative thing ironically - people can be motivated to commit suicide and it’s why it’s one of the ironic risks of antidepressants at first. Take antidepressants under close medical supervision.

But eventually my mood did lift. It was very gradual. And I didn’t really notice it until moments of laughter came back or I found joy in my hobbies and interests again.

I would say antidepressants don’t just lift mood in one go. I’d think it move of mood swinging up and down around a centre. When you’re depressed your mood is centred at very low, and swings around very low and a bit less low. What antidepressants do is gradually move that centre up back toward normal. So at first you swing between very low and a bit less low, then between quite low and low, then a low and a little low, then a little low and normal and eventually you’re centre hits normal. Then you swing between a little low and a little high.

The antidepressants keep you at that level - they don’t make you endlessly happy, they just return your centre to where it should be. (For.some people they can tip into mania and over but that’s uncommon).

I stayed on antidepressant for nearly 2 years and finally came off. That’s when things got better - the antidepressants did the lifting but I also learnt the warning signs of depression and could be vigilant in the future. Coming off antidepressant when I was ready, the centre of my mood was in a good place but swings up and down were bigger/back to normal so I could have really good times again, but also some bad times. The difference with the bad times was they didn’t last, plus they were “appropriate” to life’s events and struggles. I didn’t need the antidepressants to.maintian that. But that is just for me - I know some people stay on antidepressants for life to achieve the same outcome.

I also knew when to ask to go back on antidepressants. I needed short courses of 3 months or so a couple of times. I actually had a terrible episode of depression again for over a year after a traumatic life event and the doctor denied me the medication saying I was just “grieving”. I had a terrible bout of depression lasting nearly 2 years and nearly killed myself. That depression thankfully finally lifted itself but it really damaged my trust in the medical profession (and I’m a doctor myself)

For me antidepressants work. They’re not a magic wand and they’re not the whole solution however. Sadly people don’t get access to other useful parts of the solution like CBT (cognitive behavioural therapy) - I didn’t for example. But you can learn strategies to cope, prevent your mood dropping so low, and recognising when your mood drops. For me a the antidepressanrs were a tool to get me back to a normal centre ground/baseline while I learnt how to manage things. And they were and are a tool I’m prepared to go back to should things ever go bad again.

It makes them ignore what causes their depression.

When I was on them, it just kinda made most things feel more “worth it”. Like before I’d make myself food and just think, “this tastes like crap, it’s barely filling, and took forever, why do I even bother making myself food” whereas the same meal on antidepressants still had me feeling like I’d accomplished something, even if it wasn’t Michelin star worthy.

Mine don’t make me feel happy. They just make me feel not depressed and kind of “blah”.

It’s not great but it’s better than feeling depressed all the time.

I can only explain it from my point of view but it was almost like the fog lifted from my brain, so that I could think more clearly.

Inside Out is actually an excellent depiction of depression, where regular emotions are absent or suppressed.

Anti depressants can reduce the severity of the depressive influence and provide space to address the underlying stressors.

It keeps me from “spiralling” when I get caught up in negative emotions. It can also do the same for positive emotions as well, so I take a mood stabilizer to help smooth things out on both ends.

I’ve been on Citalopram for a long time. I still get happy, sad, angry etc. Though I never got back into the black holes I sometimes got before I started taking it. Only downside is I sometimes have nocturnal bruxism, but that’s a trade I’m happy to make.

Edit: spelling