As a person who has suffered some very severe bouts of depression throughout my adult life, I can say that what has worked best for myself is a
combination of medicine and therapy. I have been so depressed that I have considered taking my own life, because at those times I felt there was no
other recourse, no other way out from the pain I was suffering. Fortunately I recognized early on that suicide is a permanent solution to a temporary
problem.
And that is one thing I have learned about depression, and it is an important lesson. I know that the depression is temporary, that even though it
feels as though it will never leave, that I feel so hopeless and filled with despair, I know it is temporary. And its in those periods that I feel
the cognitive approach is very helpful. I do take a minimal dose of anti-depressant as maintenance, and I have found that I have not had a bout of
depression in 2 years. On the other hand, while depressed I found that certain thoughts would intensify and reinforce the depression. For example, I
would think, (for example) that I was a very ugly person. This thought would create a chain reaction of bad feelings within myself, rising to a
feeling of utter hopelessness and despair. However, I have learned to challenge these types of thoughts, and it helps greatly in fending off these
absolute bottomless feelings.
The bad thing though is that, as Estragon was pointing out, when you get depressed you dont get bumps on your forehead, or a sign around your neck, or
any visible diagnosible sign. So I suffered with depression for years, without it being diagnosed, through a combination of ignorance and the fact
that it crept up on me in my late teenage years, and soon I came to think that the way I was feeling was the way I was supposed to feel. It caused me
to develope many ingrained, negative false beliefs about myself. So by the time I was in my early 20's, I believed that I was an unworthwhile person,
that I wasnt attractive to anyone etc...
Depression is insidious in its approach. Also, for a long time there was a great stigma against any type of mental illness, at least where I grew up.
While depression is becoming more and more acceptable now, but this was not always the case. I cannot remember how many times as I grew up someone
asking me "What? Are you crazy?"
It was my sense of humor that usually caused these types of questions, but there was such a negative
connotation associated with being "crazy" that there was no way I was going to be "crazy". Thus I suffered for years before I sought treatment.