I kind of agree with your analysis of the "chemical imbalance" theory. I think there is a lot of room to have doubts about that theory. I've dealt with depression of my own for a long time, and I've worked in healthcare settings dealing with depressed persons. In my experience, there usually is a trigger. Mounting frustration, however, can seem to just come out of nowhere. I don't believe it does totally come out of the blue. We are so emotionally responsive to so many things in our daily lives that, sometimes, we lose track of what threw us for a loop.

In the end, it probably doesn't matter all that much what led to the depressive episode. What we care about is "how do we get out of it?" I don't think we can totally, or even largely, rely on meds to help because I don't think "chemical imbalance" is the whole story.

I've gotten very frustrated talking to pdocs and therapists. It can be maddening. It's true that we didn't choose to have these challenges of recurring depression. Once, a pdoc said that her only advice was that I "keep on fighting the depression." That made me so very angry and frustrated. But you know what? After many years, I've discovered that what she said was true. There is no other way toward sustained recovery, but through arduous struggle. That sucks . . . but that is what I've discovered.

It's like a soldier coming home from war with a terrible disability that takes loads of rehab in order to get back basic abilities. Also, that rehab isn't a matter of therapists doing things to you. It's you doing things, like the soldier going to the gym to exercise. For me, it ends up feeling like I have to do pretty much all of the work. Sometimes, I've wondered what the pdocs and Ts are getting paid for. Basically, they just sort of cheer us on.