PairOfFeet wrote:These articles seem to suggest that there is no such thing as a chemical imbalance

This is kind of true, but it's also a strawman. Mental health professionals don't believe that depression is caused by a "chemical imbalance" and instead that claim is made by laymen attempting to understand the science in the area. What we do know is that being depressed changes the structure, functioning and chemicals in our brain - like everything else. That is, when we choose to be a liberal, or theist, or go to college, etc, our brain changes in response to our experiences and various inputs. However, there are consistencies and correlations when it specifically comes to depression, which helps us identify what types of medication might help reverse, suppress or treat some of the symptoms.

In other words, there is no need to assume that depression is caused by a chemical imbalance, or even that depression has a biological cause, to understand that antidepressants can be useful and effective at treating people with depression. This is because our thoughts and behaviors come from our brain (unless we believe in dualism), and so changing that chain in the causal link can change our subsequent thoughts and behaviors.

PairOfFeet wrote:and antidepressants are no better than placebos, this being a profit scam for big pharma.

It's sort of true, sort of not true. Antidepressants in recent times have come under scrutiny, and recently it has been suggested that antidepressants for people with mild depression do no more than placebos. However, there has been no contradictory evidence (that I'm aware of) that suggests antidepressants are effective at treating people with major depression.

Part of the problem with these new studies though, is that the subjects used have become drastically different to the ones that participated in the earlier studies. Specifically, the early studies used in-patients who had been referred by psychologists, whereas the modern studies tend to use self-selected volunteers. The problem with this is that a lot of the volunteers don't have depression, or they participate in multiple trials without letting the researchers know. Neuroskeptic has a good article here:

Why is it that modern trials of antidepressant drugs increasingly show no benefit of the drugs over placebo? This is the question asked by Cornell psychiatrists Brody et al in an American Journal of Psychiatry opinion piece.

They suggest that maybe it's the patients fault:

Participation that is induced by cash payments may lead subjects to exaggerate their symptoms [i.e. in order to get included into the trial]... Another contributing factor to high placebo response rates may be the extent to which the volunteers in antidepressant trials are really generalizable to patients in clinical practice.
Since the initial antidepressant trials in the 1960s, participants have gone from being patients who were recruited primarily from inpatient psychiatric populations to outpatient volunteers who are often recruited by advertisements. At times, these symptomatic volunteers have participated in other trials. When we contact potential participants to schedule screening, they often ask to be reminded which trial we are screening for or mistake our research trial for a different protocol in which they recently participated.

They then recount the tale of two "professional subjects" who claimed to be depressed and enrolled in two antidepressant trials simultaneously, without telling the researchers; it only came to light when someone involved in both studies spotted the duplicate names.

PairOfFeet wrote:I find this hard to believe. I am a junior in high school and have been having episodes of depression off and on since eighth grade. The thing is, the events in my life dont seem to be strong enough to trigger such strong feelings of despair. And many people in my family history have had it.

I think you might be interpreting the environmental causes of depression as consisting solely of highly traumatic negative experiences which "trigger" the depression. In reality, they are usually just innocuous, but consistent, training which puts people in a mindset which makes it harder for them to deal with negative experiences. And for some people, their individual experiences, biology, and mindset has absolutely nothing to do with whether they'll develop depression or not - instead it's their support system. Otherwise normal people who experience otherwise normal, but upsetting and negative, experiences can become depressed simply because they lack the usual support system to deal with these things.

More simply, you could have been raised to take responsibility for your actions, and you might internalise this but extend it too far. This would result in you blaming yourself for things which are out of your control, which could spiral out of control and under some circumstances result in depression.

This isn't to say that your particular case is environmentally caused, but just that it's not necessarily excluded because you had no particularly horrible experiences. And as for family history, this falls into the same pattern where a parent will teach a child what they know, and if these things include behaviors that make depression more likely, then we'd expect to see a family history. This is why scientists use adoption studies and separated twin studies to make claims about hereditary factors.

PairOfFeet wrote:Between these times I have tried Seroquel, Trazadone, Celexa, Risperdol, Welbutrin, and am currently on Effexor and had to upgrade each ones doses many times. Usually I would feel better for a while, then feel worse, change the medication, feel better, then feel worse. I am currently doing well. Throughout this time I have been seeing a therapist, but tricks like mindfulness exercises didnt seem effective at all and felt like a waste of time.

It could be the case that you were poorly trained to use 'mindfulness' exercises, but realistically, 'mindfulness' is only one part of overcoming depression. Have you tried CBT?

And of course, even if the depression was biologically caused, it doesn't mean that therapy can't help. Autism is almost certainly genetically based, but the only current treatment for it is therapy. This is simply because, as mentioned above, we can change the functioning of our brain by changing the way we think. Not in a New Agey "The Secret" kind of way, of course..

PairOfFeet wrote:So is clinical depression really a disorder? Are psychiatrists really just trying to make a buck here? What does the science really say?

Clinical depression obviously is a disorder. Whether it's biologically based or not is another question, but a disorder is (simply put) any pattern of behavior or thoughts which significantly affects the happiness or functioning of the individual. When somebody reaches the point where they can't leave the house, have no interest in interacting with people, and try killing themselves, we can safely conclude that their thoughts and behaviors are affecting their functioning and happiness - thus it is, by definition, a disorder.

As for psychiatrists trying to make a buck, keep in mind that psychiatrists aren't the only people in the mental health world. There are psychologists as well, and they accept the reality of depression and still treat it with antidepressants. Now the interesting part here is that psychologists have no prescribing rights, and so there is no way for them to make money by putting a patient on antidepressants. So why do they do it if they can't be controlled by Big Pharma? Because the evidence says that a combination of antidepressants and CBT is the single most effective treatment for depression.

As for evidence, I recommend checking out the Cochrane Collaboration whenever you have a question like this, as they summarise all the available data from the best studies. Here are some:

Antidepressants versus placebo for depression in primary care

Antidepressants for depression in physically ill people

Is cognitive behavioural therapy an effective complement to antidepressants in adolescents? A meta-analysis

You'll find a lot of people claim that the use of antidepressants is rising, supposedly as evidence that mental health professionals are over-diagnosing in order to make some money. Ask them for evidence. They won't be able to provide any because the research shows that rates of depression have not increased in the last 10-15 years. Rates of antidepressants have increased, but for two reasons: 1) those diagnosed are increasing the number of their prescriptions, and 2) antidepressants are becoming used more for non-depression related issues. For example, one of the most commonly cited antidepressants is amitriptyline, however, this drug is rarely used to treat depression any more. This is because it is associated with a number of side-effects and newer, more efficient, drugs have made it obsolete. But, importantly, the drug has wonderful effects on chronic pain, so it is often prescribed for that. Amitriptyline accounts for around 20% of all antidepressant prescriptions.