I think, like with many things, there's a level of trying to sort out what's useful and what's not for yourself and also determining how it's useful.

For example, let's use myself. My depression is biological. This is really an undisputed fact at this point. We've found a medical treatment (ketamine) that works and it's so utterly put my depression into remission I realize now how helpless I was to change anything. There isn't a therapy on the face of this planet that would have fixed my depression. My T knew this. He's DBT trained and so I found and still find seeing him useful. Twenty years of depression and what he does is rooted in practical skills coaching. I know what I need and I find he helps.

Contrasting that with another example, my best friend had a chronic mild depression. It got worse for a bit so she tried Wellbutrin and stuck with it for about a year and a half before coming off. It fixed whatever was going on in her head and she didn't need it again, but she knows it's an option should it ever arise. Therapy on the other hand? Eh. She just needed a friendly ear and we're besties so I was more than happy to be that friendly ear.

My advice to people in general when they ask about mental healthcare is that I recommend skills based therapy and if they find that isn't enough to pursue psychiatric care. The reality is that a brain under stress *does* undergo chemical changes and a medication can help right those changes. Like my friend. She needed something temporarily, she took it, and then she didn't need it anymore. Why is that any different than needing an antibiotic or some other medication? Yes, it's trickier to sort out because we can't yet crack open the brain and know what's going on (ha! and in my case 20+ antidepressants and other meds never made a dent - ketamine grew pathways that apparently I was missing).

Long long long answer. Anyway, my point is, I think there are useful therapies and useful drugs but the brain is tricky and so are our personality and moods and so we have to decide what we're willing to live with. In my case, we were getting pretty desperate as my depression hovered right between "nightmare" and "a$s end of demon town."