A person's depression is usually caused by their circumstances. It's a catch-22 because depression saps your energy and makes you feel hopeless, making it harder to improve your circumstances and often worsening them, making you more depressed. Medication CAN make escaping the downward spiral easier, but ultimately the person has to put in the effort themselves to really see long term change. I'm sure as hell not going to hold my breath waiting for a fatty to put any effort into anything.