Andrew Solomon offers this brilliant paragraph in his classic, “The Noonday Demon” about the relationship between medication and therapy, when we should make Herculean efforts to break free from depression or rather lie listless on our beds as victims of a loathsome illness:
The conflict between psychodynamic therapy and medication is ultimately a conflict on moral grounds; we tend categorically to assume that if the problem is responsive to psychotherapeutic dialogue, it is a problem you should be able to overcome with simple rigor, while a problem responsive to the ingestion of chemicals is not your fault and requires no rigor of you. It is true both that very little depression is entirely the fault of the sufferer, and that almost all depression can be ameliorated with rigor. Antidepressants help those who help themselves. If you push yourself too hard, you will make yourself worse, but you must push hard enough if you really want to get out. Medication and therapy are tools to be used as necessary. Neither blame more indulge yourself.
I’m indebted to him for explaining it to me that way because I’ve always been confused by the relationship between meds and therapy, antidepressants and cognitive-behavioral techniques … how much I need of one versus the other, and wondering if we all need a different mixture, or if a standard Package #3 could cover most depressives.