From a clinical perspective, the modern anti-depressants, which mostly fall into the category of Selective Serotonin Uptake Inhibitors (SSRI), appear to be mood dampeners, rather than actual anti-depressants. This is the effect that patients most commonly report. There is evidence that the majority of the effect of these medications may be due to non-specific symptomatic effects. The mood containing or dampening effect can be useful as it can take the edge off of intense feelings, allowing an individual to better deal with life. In other people this effect may lead to complacence in addressing important issues. Certain individuals may find the experience of intense feelings being suppressed from reaching the surface of awareness uncomfortable.
If the mood dampening effect appears to be central to these medications, why has there been no research to date on this issue? A large part of this problem is the growing divide between clinicians and researchers, with many clinicians feeling obliged to take their lead directly from research without proper clinical interpretation. Research is usually done these days to prove that a particular treatment is useful for a particular DSM diagnosis. The issues of what a medication may actually do, is not seen as a priority in most research. Efficacy, that is showing that a medication is better than placebo or other treatments, is often researched way before the actual effectiveness of a treatment is explored.
The crucial issue in prescribing medication is that the various effects of any medication need to be properly understood by the clinician. It is inadequate to just view modern anti-depressant medication simply as mood elevating or anxiety controlling drugs. The particular way in which the medication may be helpful, or problematic for a patient needs to be understood within the context of the various symptomatic effects, or side effects, of the mediation. This is especially important as the majority of people who are prescribed this medication probably do not match the criteria for which these drugs have been tested.
While the research have tended to show that SSRI's are only marginally better than placebos, the mood dampening effect of these medications can be very helpful when used in combination with proper therapy. This effect can wear off over time, leading to people being switched from one medication to another. Often over many years people are tried on multiple medications which may all seem to work for short periods. This does not indicate that a person has a "resistant depression", but may be a limitation of the mood dampening effect.
SSRI's can have intense withdrawal effects, but people will also experience resurgence of intense feelings that have been supressed. This can be highly destressing, especially as people may fear, or be told, that their "disorder" is returning. When one is withdrawing from these medications, a period of increased emotionality is to be expected, and needs to be dealt with appropriately by the treating practitioners.