Experimental depression treatment is nearly 80% effective in controlled study

Background: after a difficult childhood, I did a therapy, discovered self improvement and lived a few years where I faced fears regularly and expanded massively. However, multiple debatable decisions built up to a point where everything broke down. Lost my job, hoped on 3 jobs even worse afterwards, was morally harassed, and the resulting bad mood and general negativity made me lose friends, and be even more vulnerable. Loss of confidence made me sabotage more or less voluntarily other aspects of my health, balance and projects. Therapists, SSRI, etc. no way to get out of it (just lots of money taken away => even more pressure/problems). It felt like death since I had to go through these many years, helpless, hopeless. It was worth than any experience in my childhood, and still traumatizing.

Now, the absence of "death" at an instant t when doing a "dangerous" action doesn't mean that death can't come later as a consequence (ex. tell your opinion at work -> doesn't kill you but if it leads to be fired later and start a cycle like above, it can be dangerous). Therefore there's never validation that my actions don't kill, they're just written on a list, with consequences pending, and the fear of the ultimate judgment is impossible to confront, unless it all happens again and this time I manage it. How would you confront this kind of fears?

A bed room theory is live small and grow through tiny risks. Small means your life is easier to secure and you can try stuff and fallback as soon as something goes wrong.

It's only a theory, that came up through the realization that a lot of pain comes from bad obligations. Too much mortgage, obligation to stay in a toxic job. Also contexts too large to really know if what you can do or not (such as politics at work).

Years ago I was recommended a book written by a Dutch psychiatrist who had developed depression himself. The tagline was sort of "here's a professional who suffers from it, this will be insightful."

I couldn't relate to his condition for one iota (let alone finish the book); as he had mostly feelings of guilt and shame, and dark, weird mental images.

I guess depression is a sort of blanket term by now for many things, which probably complicates diagnosis and most of all, treatment.

Plus, I recently discovered the term "sh*t life syndrome", which is apparently getting to be known as a well-known term in the US/UK psychiatrics system (at least it has a Wikipedia page claiming that). It describes people who are poor or lonely because of the system surrounding them (prime example: they live in an area with raging unemployment). In that case, it's argued, symptoms of depression might actually be the logical response to an outside stimulus (or lack thereof). Yet, it appears many of these people are referred to psychological treatment because, well, society doesn't come up with any better option.

But what rubicon33 describes is certainly one way of depression, and I think a common one. But I'd go one step further even: Yes, people lack that little "kick" to get them going and do something entirely. But I don't think that's the root cause.

The root cause, to me, is that this kick has been subconciously "unlearned". Because when people with this sort of depression DO force themselves to do some of these things (and man, do they need to force themselves, with rational arguments and all sorts of tricks), they are not enjoying it. To stick with the example of playing tennis: Non-depressed people come back and say: "That was fun! I powered myself out on the tennis court, maybe I even won, I feel good.". People with this particular sort of depression come back and say: "That was physically, but mostly mentally exhausting. I want to sleep or procrastinate now and reset my thoughts to the baseline of being emotionless."

Disclaimer: Yes, I think I can also kind of speak on this subject. I've been repeatedly diagnosed with childhood PTSD and depression possibly ever since that (which makes it 30+ years); which doesn't mean that I'm not questioning this all the time, because the biggest trick played by depression is to make you think that everything may be just normal sadness/exhaustion/"not trying hard enough" ...).

I have kinda the same problem. I've had depression for a very long time - stable, but consistently declining. I get the "... or I could just kill myself" xapata mentioned a couple times per week and the reasons I don't are basically "that sounds like work" and "that would make my mother sad". Which aren't exactly good reasons, I know, but so far I've done very little actual self-harm and I very much don't want to get involuntarily admitted. I really would like to get help to deal with depression. I've battled it out alone with it for 15+ years and I'm not exactly winning that fight. But- anyone that's qualified to offer that help is pretty much legally required to admit me if I answer their screening questions somewhat truthfully.

Damned if you do, damned if you don't.