Not sure what sort of studies you've been reading, but from the studies I've come across, results from SSRI's are quite often dubious. With a bit of searching you can find studies they didn't want to release/advertise, ample bias in studies.
The problem with people taking studies as fact is the fact they don't know how to analyze a study. Hell, I don't even know, I've just seen examples more knowledgeable people have pointed out which allows me to spot them.
It's not that you need to be acutely depressed to benefit from SSRI's. If you're feeling a lot of hurt, blunted affect is the solution.
Depression has shown to increase negative learning, and SSRI's have been shown to inhibit negative learning (
http://www.ncbi.nlm.nih.gov/pubmed/24065894) but the SSRI addled mind is no where near a "healthy" mind, with diminished learning in both regards.
This could account for it's treatment of OCD and anxiety disorders, but I'm not going there.
Depression has been proposed to be linked to both not enough and too much serotonin. Too much serotonin has somehow been proposed to be linked to suicide.
To be honest, we don't know shit as far this goes. We don't understand what causes depression, and this "chemical imbalance" theory has been shown to be ridiculous by both healthy and depressed people having varying levels of the chemicals we're talking about. The whole idea of targeting the brain on such a major scale is stupid, as these chemicals control many things, hence the very real effect of sexual problems (more common than a response as far as depression goes, too) among other things.
I mean look at tianeptine.
We do not understand the relationship between mood disorders and SERT/DAT/NAT in the slightest.
It's like making someone with a cut take a bath in anti-septic, only if the anti-septic had negative affects on the rest of your skin.
Of course there are severely depressed patients who don't respond to SSRI's, or many a/d's.
The differences between placebo and SSRI vary so much study to study, SSRI to SSRI, and realistically seems much lower than one would hope.
SSRI's will work just as well for depression that has been triggered by life changes, in fact I would go as far as to say it would be more effective.
Recommending benzos after a divorce is just absurd.
I don't think the question is a nonstarter at all, I think getting your answers on a screen is the nonstarter.
If they were proven to work, that is, put (and keep) a depressed person in remission, we wouldn't be having this conversation.
You keep harping on about acute and prolonged depression. Acute depression has more space to allow for improvement.
The very complaint of blunted affect goes to show how little people understand this shit.
These aren't happy pills. They won't stop someone from being unhappy.
They can supposedly dull immense pain, and take the edge off of the suicidal.
The person you should be asking is your GP/psychiatrist, because the only way you can find out what affect a drug will have on you is to try it.
Then again, with shit like low doses of SNRI's and stupid augmentation I feel it's wreckless to take drugs without first learning some fundamentals, like binding profiles, etc.
