I can only base things on 37 years of bouts of depression and 20 years of treatment. And I mean 20 years of treatment that have nothing to do with meds. I have read more books on Buddhism than I can count and I have consistently practiced meditation for twenty years. The fist step in Buddhism is letting go of desire, expectations, and seeing things as they really are without judgement. Then there is the eight fold path for change, right thinking, right action, mindfulness and so on. I can honestly say I have tried very hard to put these tenants into practice. Along with this what I have learned from AA's twelve steps, what I have learned in therapy, CBT, prayer, etc, etc. I have done more searching and fearless moral inventories and tell alls than I would like to remember. I am not trying to brag, this is my truth. Yet I still suffer from depression on a consistent basis. This doesn't mean I have lost hope or given up or don't try. It means I have had to look honestly at my situation based on past history and figure out how to deal with it. I can't predict the future. I have just started therapy once again. Why would I do that if I had given up all hope. I am more realistic about it though based on all the therapy I have had in the past including group therapy. It may be that it just helps me deal with the consequences of depression for me and does not put it in remission. I suppose I could blame doctors and meds but that doesn't make sense to me since I suffered from it long before I ever saw a doctor or took a med. Seeing doctors has never stopped me from self help. Why do I still have depression? The chemical imbalance theory proposed by the drug companies may turn out to be a small part of it or may be totally false but that does not mean genes, mono amines, receptors, pathways of communication between parts of the brain are not implicated. Research long ago went in different directions from the chemical imbalance theory proposed by big pharma. That is how TMS came out. I will ask again. After all the non medical treatment I have applied to my depression over twenty years why do I still get depressed? I would really like to know.

As to fault. We have had this conversation. Believing it was my fault and that I was just a lazy no good bum who couldn't get out of bed just made things a ton worse. I was deeply ashamed of myself when in a depression and I didn't even know to call it that. I only knew I couldn't get out of bed and function so there had to be something seriously wrong with my character. I was just lazy and had no ambition compared to my peers. By eliminating fault and blame it allowed me to accept responsibility (big difference) for my life. The shame had me stuck. Eliminating shame allowed me to take action. It doesn't matter how the donkey got in the ditch just how are we gonna get him out. It also allowed me to be honest with others in getting help. Also causes are important if they can be identified. If my father sexually abused me then that might have something to do with it and may be something important in therapy.

People are very sensitive to how others perceive their depression because of the shame they already carry about it. They don't want to feel judged by others as it only adds to the shame. Most people tend to think there is some simple answer to why I am depressed. They ask why am I depressed and expect I will say something like my dog died or that my boss yelled at me last week. 99% of the people I have encountered are concerned and do want to help but they don't understand and don't know how to help. I would never give a snarky answer but I may want to avoid the topic altogether with them because I don't want to get into a big discussion about what it is really like. I have had many such discussions and even arguments. If I say "I dunno it just hit me out of the blue for no apparent reason" they don't see how this could be true. There has to be some concrete explanation that can be fixed. Or they may say "well if you just choose to be happy it will go away". Or they may say "Well everyone gets depressed sometimes." "Just get out in the sun and go for a walk". I have heard all these things and many more. I am not afraid to have those discussions with people because I have let go of a lot of the shame that I carried but it gets old. I want to increase understanding of what it is really like for me and people like me but it gets tiring and it is hard not to feel judged when they have some simple solution to "fix" you.