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If I recall, the current definition in the DSM V is a laundry list of symptoms with the proviso that they're not adequately explained by any other drugs or illnesses that the patient may be suffering. In other words, doctors know damn well that the symptoms are not unique and actually cross over with a bunch of other illnesses and interactions that are incredibly difficult to diagnose or detect.
But those are hard, and so the answer is diet, exercise and highly addictive pills that have about a 50% chance of working on the first try. Your chances of getting an effective medication goes up into the 90s if you get a doctor that knows the proper way to work through multiple medications, but I haven't met one yet. I had to teach myself and then teach them.
If anyone is curious, look up the STAR-D studies. There's a protocol that came out of that that's essentially the best thing I've found in terms of a rigorous and logically constructed treatment protocol.
And yes, god forbid you ever have moments where you don't feel that bad, or that you are able to act well enough to appear functional. It's almost impossible to convince even trained professionals that you know the inside of your head better than they do. Apologies if this is off putting to people thinking about seeking medical help. You still should, it's still better than not and I strongly suspect that my personal experience with doctors has been worse than most (based on other people that I've talked to in similar situations) but it's unlikely to be a magic bullet. You'll get a bit better, and then you may have to search more for the next bit.
There's actually a whole list of things you can't mention to a therapist or they'll have to report them. Particularly since terrorism became a hot topic, so beware talking about any violence in your past or violent thoughts/fantasies however far from acting on them you might be. Anything criminal or potentially criminal they have discretion to report, and can be forced to testify against you if it ever gets to that.
Frankly, I feel less safe being open with a therapist than I do with a complete stranger who doesn't know me from a bar of soap. The stranger you can just walk away from, the therapist has all your details and is duty bound to sell you down the river in order to protect their own career and livelihood.
Holy hell I've gotten cynical about the mental health support industry. They talk a good game when someone kills themselves or shoots up a school, but it's so lacking when it comes to actually sitting down and helping people deal with their **** and feel safe.
I think in part because to a large proportion of people you would talk to it's still not a real illness like measles or cancer. It's something that you get because you're mentally weak, or lazy, or whatever. They equate clinical depression with being "depressed", ie. when you've had a rough week and you're a bit sad. Which is obviously bollocks, but there's a remarkable amount of people who still think that people can not be gay if they only try harder too.
It's exacerbated by the fact that nobody really understands what depression is, physically. Not even medical researchers. It's incredibly hard to describe to someone who hasn't felt it, not helped by the fact that your ability to communicate clearly with others is often one of the first things to go. I've got a bit of a story that I use to describe one of the current leading hypotheses on the physical causes of depression and just treat it as if I know that's what I've got. I don't know and to date there's no real diagnostic test, but it helps people to have a description of something that more closely resembles a "real" disease that simply happens to affect the brain more strongly than the body. It makes it feel more like something they understand then, and they can use their normal coping strategies for when they meet someone who is sick instead of being unsure what to do with the "crazy" person.
Then again, I reckon about one in ten people that you talk to will either have been closely involved with someone who has mental illness or have been affected themselves. It's incredibly common, and even across the broader range of mental illnesses most sufferers can relate to each other enough to be helpful and kind.
) . . . as I said before sleep is magical. It's sexy. It gives you a break.
