I'm not a psychiatrist. I'm not dispensing medical advice. I don't pretend to fully understand serious depression. But I can speak from my own personal experience dealing with depression.
The American medical model is pharmacological. It is reactive, rather than preventative. Doctors need to diagnose a disease and then they treat it (almost always with drugs). The notion of preventative medicine or maintaining optimal health is completely foreign to most American doctors. Bottom line: if you're depressed, chances are overwhelming that they're going to give you anti-depressants.
The question is—should you take them?
It would easy to say to yourself that whether you take them or not is not your decision. If a doctor prescribes something, you take it. Well, that may be comforting to you but it simply isn't true. The bottom line in all medical decisions is that you ultimately have the responsibility of deciding.
So you're depressed. Not just down for a while. You're really depressed. The doctor prescribes anti-depressants. What happens if you take them. What happens if you don't.
If you take them, you will feel better. At least for a while. But the problem is whatever is causing your depression is now going to be masked, buffered, slower-to-come-to-the-surface. And that fact means that by taking anti-depressants you are for all practical purposes extending your depression (perhaps permanently).
In other words, anti-depressants provide short term gain but long term pain.
And what happens if you don't take anti-depressants? You will not get any pharmacological relief of your depression. But you will also have a real chance to get at the root of what's causing your depression and eradicate it.
Depression happens for a reason. It's your life's way of telling you that something is very wrong—and that that something needs to be gotten rid of.. It's like when you have a pebble in your shoe and your foot hurts. Your pain is telling you something is wrong—and to get rid of the pebble. Take a drug to numb that pain and yes, you'll feel better, but that pebble is going to keep damaging your foot.
They say if Beethoven would have taken Prozac for his depression, he would've written jingles instead of the 9th Symphony. And that's the deal—you do have a lot of pain if you choose to battle through depression without drugs, but you also have the chance of doing something really great.
Take anti-depressants and you'll feel better. But really isn't the goal to get better?