I think there are a lot of misconceptions about medications and people are pretty down on them, but they have been a literal lifesaver for me. For the sake of someone who may be considering medication, I'd like to share my experience.

I went through a pretty rough period of depression several years ago, but I realized later that I had cycled in and out of medium to mild periods of depression in cycles throughout my life. I wouldn't have said I was depressed at that time, because I had the common image of a person who can't get out of bed in mind. While that is certainly the case for some people, depression comes in many flavors. I was always irritable and had a hard time being patient for anything. I also experienced anhedonia, which is often described as "lack of pleasure." I feel like that is not necessarily the best description, and it's hard to describe it unless you've experienced it. It was more of an emotional flatness. Sometimes I felt like a robot: I sensed that it was a sunny day, food tastes good, but didn't have any positive feelings. It was like watching a movie that you're not invested in and don't care how it ends. While I didn't really notice it at the time (part of therapy is learning to pay attention to your thoughts more), I would also often ruminate on negative thoughts: how much I was disappointing people at work, how inadequate I was as a husband, father.

When someone talks about depression, well meaning people often suggest things like meditation and exercise. I don't think that is necessarily bad advice, but I do worry that this may trivialize how hard it is to climb out of the hole when you're depressed.

The one good habit I did have before and during the time that I was depressed was I consistently worked out 3-4 days a week, running, crossfit, lifting free weights. I would recommend exercise to anyone and I certainly think it helped me. But it wasn't enough to overcome my depression.

I was also meditating quite a bit at the time. I found a zendo near me and would often duck out during lunch time to sit for a half an hour. I also found the Headspace app really useful for short 10 minute sittings during the day. I would recommend meditation to anyone, but it wasn't enough to overcome depression.

At some point, I hit a point where everything seemed to be unraveling and I started talk therapy. I would say this is one of the most important things I've done in my life, as I realized I had a lot of maladaptive mental patterns. Therapy isn't an easy road. My first therapist was good, but not a fit for me. When you are in therapy for depression, often your assessment of how well therapy is going starts to factor into how you feel, and I began to become hopeless that I would ever feel better. After almost a year, I sent my therapist a text out of the blue one day saying I wasn't going to come any more, which probably wasn't the best way to handle it. Someone else who encouraged me to go in for a last session. The therapist and I both agreed it wasn't a fit. I found another therapist that was much more effective for me, and made a lot of progress. I got better at catching myself having negative thoughts or ruminating. But I still felt very flat. My therapist asked what I would do if I never felt good again. At the time, I said "I'm not sure I'd want to go on." But shortly after that, I accepted that this may be the way I would feel from then on, and, while I didn't feel great, it was, in some hard-to-describe way, better.

Finally, after several years of therapy, still feeling flat, I decided to try medication. The first one I tried was Wellbutrin, which has relatively benign side effects. I knew it could take a long time to find the right medication and dosage, so, while I was hopeful, my expectations weren't too high. When I first started taking it, I didn't notice anything, not even side effects. But one morning, after being on it for a while, I was driving my car to work in rush hour and suddenly realized that I felt at ease; I was enjoying the drive. It was so amazing I wanted to cry.

People like to describe these medications as "numbing," as if they were some sort of opiate, but that's not my experience at all (I'd add that I subsequently also added an SSRI for anxiety). They more shifted my perspective, gave me more space to be mindful of my thoughts and emotions. Some people have had very bad experiences with these, and I don't to minimize that in any way, but I'd also say medications are useful for some people.