I wonder whether clinical trials can even select correctly candidates who are "depressed". I'm manic-depressive/bipolar and there's a clear behavioral marker t

I wonder whether clinical trials can even select correctly candidates who are "depressed". I'm manic-depressive/bipolar and there's a clear behavioral marker that doesn't happen as a result of despondency over negative life situations: mania. Clinical trials for manic depression are much better, and the gold standard -- lithium -- is known to work for most people. If you go back into the history of psychiatry, the touchpoint where it starts to sort of look like medicine is when Kraepelin develops a differential diagnostic method to sort out manic-depression from schizophrenia. It's very hard to see something like that for depression. To compound: American psychiatry is especially bad because it fell for psychoanalysis hard, to the point that it seemed like NYC had higher rates of psychosis than London because Americans had deviated from the standard definition of psychosis to use Freud's. Who knows what passes for "depression" in the US.