August 24, 2019:

My first experience with antidepressants was via my GP, who of course means well but is not expert in psychopharmacology. Typical of many nonspecialists he prescribed fluoxetine (Prozac), which for me had no effect of any kind. I took it dutifully for, I think, 90 days, until the bottle ran out. I chose not to refill the 'script, 'cos, pointless. As I say, for me it did nothing whatsoever.

In hindsight the correct conclusion was that my depression is not based in serotonin imbalance, so that the appropriate medication would have been dopamine enhancers such as bupropion (Wellbutrin) or perhaps SNRIs like venlafaxine (Effexor). Subsequently I've responded very well to bupropion. At the time though my conclusion was nevermind. I was under so much stress there wasn't opportunity for conclusions.

I was living with a mean drunk — a verbally and physically violent alcoholic who drank to blackout, then attacked. Where "attack" means: threw punches, threw heavy objects, screamed, writhed on the floor, spoke in tongues, playacted at possession by demons, tried to pull down bookcases, smeared walls with sticky food, wrote antisemitic slogans on walls in faux German with lipstick or ketchup, tackled me when I thought she was sleeping throwing me over the back of the couch and assaulting me with a fireplace poker, all the while screaming and spitting and throwing obscenities and punches, every night, night after night, until she passed out, often several times nightly, for three years. Over that time she broke my shin with a heavy pewter statuette of the Virgin Mary; bruised my kidney with punches; broke a tooth; broke my nose; and somehow detached both retinas, an injury that went undiagnosed for several years. She's a six foot former college basketball star with muscles who's capable of inflicting nontrivial damage if she connects. Usually she didn't, but sometimes she did. I've written in detail about this experience here.

I was in the grip of major depression or I wouldn't have connected with her in the first place. The immediate issue though wasn't medication but, obviously, lifestyle change. It was several years yet until my successful treatment with therapy and bupropion. Despite the ferocity of this experience I hadn't yet "bottomed out".