You are very insightful.

As for myself, I have thought about what you mention for quite a long time. I have tried to introduce some element of clarity into my reflections and this is what I have come up with. Not sure it would be useful to you or anyone else though.

Generally speaking, in a depression I get "stuck" in a "could be better, but isn't better" frame of mind. I look at myself and think "could be better, but isn't better." I look at others and things and events in the world in the same way.

This "could be better, but isn't better" attitude has huge benefits. It creates a certain sense of dissatisfaction. Without that we wouldn't have cures for diseases, elevators, air conditioning, heating, refrigerators, airplanes and so on.

But "could be better, but isn't better" all by itself, if it is not relieved by anything else leads to chronic feelings of dissatisfaction, frustration, aggravation, anger, sadness and guilt. It would be odd if "could be better, but isn't better" didn't engender these feelings and moods.

But there is another attitude which provides balance. It is the attitude "could be worse, but isn't worse, thank goodness!" This attitude has certain benefits. It tends to produce feelings of appreciation, gratitude, peace and joy of living.

It could be that the "could be better but isn't better" is sort of humanity's default attitude. Without it, perhaps we would still be living in caves. Don't know.

A heavy "could be better but isn't better" attitude is sometimes called "perfectionism." It tends to equate goodness with perfection and denigrates anything that falls short of perfection as "bad" in some way.

One problem with this is it destroys the range of values involved in good and bad. For a perfectionist, getting a poor grade in school can seem to make that person "bad" and engender guilt.

But take, for instance, people like Adolf Hitler, Stalin and others who caused the destruction of tens of millions of people through genocide and campaigns of forced starvation. If only the perfect is good, then we lose the entire range of good and bad. It can seem as though getting a bad grade is just as bad as causing genocide, which it isn't.

Most human failures do not result in the destruction of tens of millions of people. But for perfectionists, good is never good enough. And the same level of guilt that we might expect a genocidal dictator to have can attach itself it us for things that are far, far, far away from the badness of genocide.

There have been some studies, limited* of course, that have linked the brain's exposure to excessive amounts of stress hormones to depression. We tend to think of stress in terms of traumatic events. But "perfectionism" is a huge stressor. None of us are all powerful, all knowing, all-seeing, all perfect, Infinite Beings. But the effort to be perfect can be hugely stressful on the brain.

Sometimes, I think, when we recover from an acute episode of depression, if we don't modify attitudes that got us into depression, we will slowly or quickly slip back into it.

One can't unlearn a lifetime of perfectionism in few days, weeks or months. I have little post-its all over my house that read "could be worse, but it isn't worse, thank goodness." By seeing these throughout the day I have a kind of balance against my perfectionism and it gives me some needed perspective and breathing room. This helps me.

Like I said, I don't know if this would be of any use to anyone but me.

I hope you find something that helps!

*Note: All medical research is subject to limitations, such as size of study, duration of study, quality of study, objectivity of study, cofounding factors, new discoveries and so on.