I&#x27;m very much in this category of depression. I have what is unfortunately termed &#x27;melancholic depression&#x27;. I should note that I&#x27;m very sceptical of the DSM &#x27;disease model&#x27; of mental illness, and am glad to see psychiatry and neuroscience beginning to converge. &#x27;Discrete disease&#x27; is a poor abstraction for most mental illnesses. A better term for my kind of depression would be &#x27;endogenous depression&#x27; (i.e. depression that comes from within). I have an objectively good life: I have a family that loves me, friends that care about me, and a job that I enjoy with colleagues I respect.<p>Yet I still have episodes where I sometimes can&#x27;t get out of bed, or can&#x27;t bring myself to leave the house. A couple of months ago I spent three days just sitting (and occasionally sleeping) in a chair, not even getting up to eat or shower. I just simply couldn&#x27;t do it.<p>While it&#x27;s true that people can experience temporary depressive episodes due to &#x27;exogenous&#x27; factors (e.g. the death of a loved one), it is very different to &#x27;endogenous&#x27; depression, and requires different types of treatment. While talk therapy and time can be very helpful for people to work through difficult and temporary &#x27;adverse circumstances&#x27;, it is of little help for endogenous&#x2F;biological depression.<p>No amount of &#x27;talk therapy&#x27; can convince my pre-frontal cortex to operate within &#x27;normal&#x27; parameters or to get my brain to produce appropriate quantities of neurotransmitters like serotonin, dopamine and noradrenaline. I&#x27;m reasonably sure this is a chronic illness that I will never be rid of (as I&#x27;ve learned from 15 years of failed treatment attempts). On the upside, there&#x27;s a good chance that there is some treatment out there, coupled with sustained lifestyle changes, that will allow me to stave off the symptoms so that I can live a relatively &#x27;normal&#x27; life. In some ways it&#x27;s similar to how type 1 diabetics can survive and live normal lives with regular injections of insulin.