Why Antidepressants Only Work for «Real» Depression: The Method’s View

The word «depression» has become a basket into which everyone throws whatever they like. Dr. Saulitis’s method starts not with a pill but with a question: which depression exactly are we talking about? Without that conversation any treatment is meaningless — even the doctor’s own mind «stops», because there is nothing solid to comment on.

Illness or symptom — two different things

The doctor separates two entirely different phenomena. There is endogenous depression as a disease — a pathology of neurotransmitter function, an imbalance he ranks, in seriousness, alongside schizoaffective and schizotypal disorders. And there is depression-as-symptom: fatigue, lack of energy, what psychiatry would call asthenia, negative symptoms, or abulia. People confuse these terribly, mistaking ordinary exhaustion for the illness — and the illness for mere tiredness.

Why does it matter? Because the answer determines the mechanism of help. The illness of depression, by the method’s logic, «can be cured only with medication». The symptom is an entirely different kind of work.

Why the precise code is not bureaucracy

The method insists on asking immediately: which code in the international classification are we talking about? It may be an affective disorder, an anxious presentation, or a manifestation of an organic mood disorder. Everyday depressions — from overwork, after illness — may look identical to true endogenous depression, yet their nature differs. Without knowing which depression and which stage, treating the disease «with some words» is pointless.

The algorithm: medication first, words later

This is the core of the method’s view on why antidepressants work the way they do. For the illness of depression, treatment follows an algorithm: first the medication does its work, and only when the second or third phase of recovery arrives does psychotherapy come in — the rational-emotive, cognitive approach. Not the other way round.

An antidepressant is an amplifier. If there is no restored reality in the head, the amplifier simply amplifies the chaos. So the method speaks of first restoring homeostasis over three or four months, recovering a sense of reality — only then does the «amplifier» work like a fan, not a multiplier of disorder.

Caution as a principle

With antidepressants, the doctor stresses, one must be «very, very careful»: you must understand which specific disorder it is and what to do. An imprecise approach can only worsen the state. This is not a «mood booster», nor a reason to make a «circus» out of natural substances — even natural antidepressants have a powerful pharmacological effect.

Practice: questions before talking about «depression»

1. Before calling a state depression, ask: is this an illness or a symptom of fatigue?
2. Clarify with a specialist which disorder and which code is actually meant.
3. Understand the stage: in the early phase of the illness medication leads; psychotherapy joins later.
4. Don’t turn a powerful substance into «cartoons on a beanbag» — treat it as an amplifier.
5. Allow time to restore homeostasis before expecting the «right» effect.