When is it time to try medication?

Dear Edahn,

I am needing some advice on a problem that has been eating away at me for the past few months: when should you accept that you need outside help, possibly even medication? I think I have been suffering from depression for a few years now, following what would easily be considered the most successful relationship of my life. I am over the relationship, and definitely no longer have feelings for the guy, but that is about where I can mark the beginnings of my feelings. I have never actually been able to call myself suicidal, as I do not want to kill myself, and I know that I probably never would. However, I do want to die. If given the option right now to be killed in some sort of accident, I think I would take it. Because of this, I react very calmly in emergency situations. Not much fazes me. I almost don't even have a flight response, I feel like I should just let whatever happens, happen. I even take unneccessary risks. Oddly enough, I've never so much as gotten stitches in my life, go figure lol. 

I spent a year or two with that being almost my only symptom, sure I had ups and downs but it didn't seem to stand out from your average person. However, during the past six months or so, it has worsened. There are weeks where I cry daily for hours at a time, I feel hopeless, and I am extremely irritable which is not even close to the person I used to be. I currently have no set job, and don't care to find one. I sleep all day, y'know, the usual. I can't decide if the reason this has all taken a turn for the worse is situational or not. There are definitely obvious causes, but I don't seem to be able to get by them. Recently, as in the past few days, I've felt I have a bit more fight in me, and I want to be happy again. I have been changing my life around bit by bit, and trying to eliminate the things that get me down, but I am struggling with one decision. In the summer, this depression landed me in the hospital for a day, and it was suggested I go on antidepressants. I refused, I was never one for meds. However, I have a few friends who have tried it, and it seemed to really help them. I am considering trying it, but am still uneasy with the decision. When should you accept that you need help to pull yourself back together?

Well it sounds to me like you're focused on all the stuff that is defective in your life and in yourself, and that that's causing you to feel destroyed and empty. On the other hand, there is something very special going on inside you. For the first time in years, there's an impulse to build something beautiful. It may not be strong -- it doesn't have to be strong -- but it's beeping inside you like a faint signal. 

That's something you should cherish and listen to. If it's telling you to start growing and make changes, then work with it. The changes you choose to make are up to you and with all the suffering you've endured 1) no one really has a right to tell you what's appropriate and what's not, and 2) I think you should trust yourself. Suffering creates depth of character and a certain intimacy that's hard to acquire by other means.

What do you think is the right move for you? Meds? A therapist? A new lifestyle? A new approach to handling yourself? More care? More attention? Listen to that impulse. I have a lot of faith in you.