Hey Mafioso. I have pretty limited experience with antidepressants, but here's what you asked for:
I've been on mirtazipine 30mg for 6 weeks, then 45mg for another 3 weeks. Also Seroquel (off-brand, the drug name just won't stick in my head) "as required" for anxiety for the last 4 weeks. The Seroqel's done 3 fifths of fuck-all, ymmv.
Brief ("psychosocial", they call it) history - I've had bouts of depression regularly since I was very young. On average, 6 of every 18 months. It's hazy but the feeling, that heavy thickness in my chest, the sense of being different and isolated, echos back into my earliest memories. Shy, withdrawn, aversion to novelty, self loathing, no 'personal' relationships ever, a little sex mostly prostitutes, the others lovely women I got scared of and ran from and lied to and hurt. Lies, lies, lies and avoidance are essentially the summary of my life. Why? Hard to say but both parents had severe depression, mother very protective, father withdrawn, habitual liar, traded his young-time heroin addiction for alcoholism (he was a Sydney kid in the 70's, got on junk to get out of the Vietnam draft, I'd have done the same). Had three kids, didn't mean to, he did it (I'm assuming based on me being just so fucking like him) because my mother loved him and is a wonderful, beautiful, caring, intelligent, capable woman and he didn't feel he had the right to hurt or disappoint her...
Fuck. Brief, you said. I'm not great at brief, sorrry man (madame, sir, baby, child, whatever...).
So to the point - recently, on the urging of my social worker (I'm in New Zealand, socialised medicine and that. Lucky motherfucker.) and by the prescription of my GP (Indian dude, he's a good guy and he cares but very distant and his catch-all solution for depression is "Get another job, get night shifts, if you work you have no time for be depressed...)
Ah parentheses. I live in them.
So to the point, for real this time. I've been taking Mirtazipine, tapered up to 30mg/day (bedtime dose), then increased to 45mg on recommendation of my GP.
My experience has been that for the first 2-3 weeks (after starting to take, and after increasing the dose) my mood has improved fairly steadily, while my anxiety has stayed basically unchanged (my anxiety runs DEEP, it is the foundation on which my world-view is built). Self harm has decreased in frequency, but increased in severity when it does occur. My sleep has improved slightly (using the Sleep As Android app, specifically the goal-setting options, has improved my sleep more than the mirtazipine), but when I miss a dose I don't sleep at all and my mood plummets while my anxiety skyrockets (how much due to the chemicals, how much the lack of sleep and consequent 8-hour rumination bouts, I don't know). My 'objectivity' (my ability to see my problems as problems, things that can be solved or at least changed), has generally increased, but it seems to me that on the days when I backslide (like today, near-irresistible suicidal ideation, uncontrollable self-harm, rage, hate, hopelessness)... Today it feels like not a fucking thing has changed.
But I have to admit that, if I'm objective, I have fallen less far than I otherwise would have. To be completely honest, today I didn't drive my car top speed into a power pole, although I was desperate to and had many many opportunities. I haven't hung myself although I can't think about anything else but how sweet and safe and comforting the noose would feel.
And. And. And...
Fuck. This is my own, unique, personal set of hang-ups. And maybe what's kept me alive tonight is not the mirtazipine but knowing I have an appointment with my social worker in 36 hours. But. But. But...
I don't know, Mafioso. I don't think I'm in a place where I can give you an objective answer to the question you posted. But my best guess, I think the mirtazipine has helped. How much of that is the effects of the drug, and how much is the effects of having contact with medical personnel, with objective people who are trying to make things better for me without actually caring who, specifically, I am... I just don't know.
Brief? No. Specific? No. Helpful? Fuck...I don't know. I hope so. Like Mr.Heffo94 above me, this is just my opinion, my experience. I really can't give you any useful advice, but here's the only two pieces of that stuff that have ever meant anything to me:
When it feels like you're going through Hell, keep going. (Sage Francis)
Persevere. (The motto of Leith, in Edinburgh, Scotland. Spud, of the Irvine Welsh novels, told me.)
I love you, human. I hope shit works out ok.
-Daniel