Note that anti-depressants—at least in the case of episodic depression—are supposed to be used as a crutch, not as a "management therapy." You prescribe anti-depressants to someone who can't get out of bed to see a therapist, so that they will then get out of bed to see a therapist, where the therapist can then get them over their depression. Anti-depressants are not supposed to be used "mask pain" any more than crutches are supposed to be used to "mask pain" in your leg. They're supposed to take the pressure off a thing that generates pain, so that you can work productively on making your life better (healing the leg) so that you don't need the crutch.
Though, that being said, there's also a second, less obvious thing anti-depressants do: first-line anti-depressants specifically are hard to distinguish from placebos, but that's okay because first-line antidepressants are often prescribed by doctors who believe† that a placebo is, in fact, all a person might need in order to feel better. That's why they're given out so freely: placebos are pure benefit (no risks, possible reward) so it doesn't hurt to try them before doing literally anything else.
If the person doesn't improve under first-line placebos, then the doctor will move on to figuring out what "actual" medical interventions might help.
† This approach is doctrine among psychologists, but not necessarily what your average psychiatrist/therapist/prescribing GP will be thinking about. Prescribers "out in the field" are mostly following the DSM guidelines for first-line/second-line/Nth-line treatments of depression, which just say that the first-line pharmaceutical interventions are very well-tolerated and low-risk.
I can see how you were probably trying to say that these medications are supposed to be used to empower the kind of changes you thought I was talking about.
However, I'm actually talking about society in general being depressive. About it being difficult to socialize because of distance, economic/social divides (real or imagined), the time spent at work (duration and even sometimes just the conflict) or because transportion is so bad/costly. There are also those who are stuck in some rural/suburban desert of contact and opportunity.
My ultimate point is that the /depression/ might actually exist for valid reasons. That in a pre-modern society this feeling could be a survival trait in driving an individual to leave a bad or over-populated area for new/different grounds. However modern society has closed off these historic reactions and has not replaced them with modern equivalents. Thus the subjects experience learned helplessness, as there isn't any way out and they thus give up on looking for or taking opportunities to have a way out.
This same lack of a visible, viable, and valued escape trajectory can also explain other contexts where subjects act against the rational interests of themselves and the communities that they seek to remain part of. For example, when I was describing the above class of scenario victims of abuse from those close to them (parents/spouses/etc) come to mind.
Of course depression exists for valid reasons (I've heard good evo-psych explanations concerning adaptations to signal guilt in response to belief that one has been exiled from a tribe, etc.)
But it's also an extremely maladaptive state to be in—no matter the environment—and one we'd best force ourselves out of, even if doing so is "unnatural." There is just nothing good that comes—ever—from a major depressive episode. It makes it harder to gather the energy to do anything about whatever is causing the depression. It's a positive feedback loop.
Note that I agree with you fully that dissatisfaction or sadness or ennui or whatever else, is a perfectly valid—and useful(!)—response to being in a bad environment, one that drives people to change their life for the better.
But depression is not any of those things. Depression is—as the pharma industry explicitly defines it—the feeling lab rats get when they've struggled to get out of water for so long that they just can't stand struggling any more, and give up and float. (https://en.wikipedia.org/wiki/Behavioural_despair_test)
That state—helpless despair—is the thing that impairs feelings like sadness or ennui from motivating you to change your environment. Anti-depressants are targeted specifically at counteracting that feeling, so that negative emotions will be re-connected to motivation.
(Note that this is why anti-depressants always carry risks of suicide: suicide is one form of escape from negative feelings, and people suddenly motivated to do something to escape from negative feelings will have suicide suddenly pop into their heads as a strategy for doing so. Whether they consider it a valid strategy is up to the person's particular psychology, but they'll be itching to do something. I would guess that it's more likely they'll choose that option, the fewer other options they have.)
It's my personal opinion that these meds are better used as a crutch to help someone seek out therapy. I've seen people get trapped in their own psyche where, they are running in a closed maze of suffering, unable to find their way out of it.
I also think modern society is bat-shit crazy. It isn't just that depression has been dismissed as a survival trait, or even that it is demonized. There are aspects of modern society that induces much greater existential anguish which is then cleverly swept under the rug of "Progress".
Thank you for helping me see another way that Derefr may have mistaken my sub-topic. I can now see that I needed additional emphasis on "depression" and "sadness" being used interchangeably in modern conversation, and how treating the issues of both is complicated by the focus on just making a problem go away rather than identifying the true nature and causes of that problem.
People, doctors who should know better, and patients who should be better informed by (and listen to, and have //repeated// re-education by health professionals as the corrective actions enable them to think more clearly), will and do abuse the "crutch" as a "magic pill to make the problems go away". The for-profit nature of healthcare within the US also leads to a lack of appropriate balance in treatment and an over-reliance on pills.
I do not disagree that depression can be an irregularity within someone's body, but I am trying to convey that //sometimes// (unknown quantity, who even studies that?) the source of the problem is ultimately outside of the individual's body, and therefore the ultimate solution is also there. I worry that the reason people are loosing sight of "their true self" is that what should be a "crutch" has instead become a permanent mask that they wear as their only identity.
Modern medicine works by identifying symptoms and treating symptoms, far less often even identifying the underlying root cause(s), let alone treating them. This is great if the symptom is acute like a stabbing, gunshot, or heart attack. It's less so if the symptom is environmental.
Though, that being said, there's also a second, less obvious thing anti-depressants do: first-line anti-depressants specifically are hard to distinguish from placebos, but that's okay because first-line antidepressants are often prescribed by doctors who believe† that a placebo is, in fact, all a person might need in order to feel better. That's why they're given out so freely: placebos are pure benefit (no risks, possible reward) so it doesn't hurt to try them before doing literally anything else.
If the person doesn't improve under first-line placebos, then the doctor will move on to figuring out what "actual" medical interventions might help.
† This approach is doctrine among psychologists, but not necessarily what your average psychiatrist/therapist/prescribing GP will be thinking about. Prescribers "out in the field" are mostly following the DSM guidelines for first-line/second-line/Nth-line treatments of depression, which just say that the first-line pharmaceutical interventions are very well-tolerated and low-risk.