My opinion on all of this is drugs in general are not inherently evil and can be used for some benefit but are inherently dangerous to differing severities and should be used with a great amount of caution that unfortunately is not a decision that can be left up entirely to the individual in question due to the real dangers of abuse and dependence, neither should the decision be left up to a for-profit medical industry that has an incentive to keep people as customers over fixing their problems.

I think many people correctly know that the reasons for the depression ultimately come down to the inhumane conditions imposed by modern urban lifestyles, but unfortunately the solution in some cases is not possible for someone who has already fallen into a depression cycle and is unable to pull themselves out of it so the drugs can be a lesser of two evils situation in those cases.

It's not that they don't work, it's more like they are the equivalent of telling someone that the solution to stop feeling unhappy is to go drink a bottle of whiskey. Works similarly. Changes your brain chemistry. Makes you numb to your situations and the problems surrounding you, and does provide you with a brief vacation from life and stress if done right.

But it's hardly good for your health and certainly not something you wish to use in lieu of actually fixing your problems.

I think the core of this like with other issues is people tend to take extreme positions and react to each other which obfuscates the actual more subtle and complex realities that are faced. There are many people myself included who are highly sceptical of anti-depressant use for very good reasons, but our side is mired by people who will go out and demonize and decry the people that use them with claims that they are weak or the drugs are completely unnecessary without understanding the subtleties and hopelessness that people with depression feel. Likewise people who have seen success with them rightly swear by them but their circumstances don't necessarily apply to everyone else and it can be easy to ignore the problems with them as like with any drug, they aren't without a cost.

But this is like demonizing heroin for hospice patients in a way. Heroin is something best avoided by all, due to the horrible risk of addiction and overdose shortening and eventually killing you. But if you're going to die soon anyway, the lifelong addiction to heroin that can be the result of heroin is only going to be a problem for a couple of days since you're not going to live long anyway, so it becomes ethically justifiable to give the hospice patient whatever eases their suffering since it won't create more later.

Anti-depressant are not much different. For most, change of environment, exercise, all sorts of lifestyle changes are the best option and can fix the problems without needing to resort to drugs, but once the depression reaches a point where it's truly beyond the person's ability to pull themselves out and the risk of suicide is paramount, then the anti-depressants are justifiable to use, they may cause some long term issues that will need to be sorted out but if the alternative is death then it's the lesser of two evils.