I am a future paramedic, and have been working in the psych ward in a hospital.
People in a psych ward are often on much larger doses than normally prescribed to someone like ivory.
People like paramedics go through extensive training, all the way from your nursing homes to ER and surgery. I have seen quite a bit of different use cases for antidepressants, and citalopram, and would say maybe 20% of them were successful/indicated.
The rest go from moderate to worse to trainwreck as doses are stepped up and medicines switched/added.
Antidepressants are like reverse withdrawal. You flood your brain with completely different levels of serotonin/noradrenalin, and then your body tries to figure out the new balance. After this 2 week - 1 month period when "the meds have started taking effect" your 'withdrawal' is over and you can begin to feel relatively normal again, and your emotional capacity is usually back close to normal. BUT when you decide that you have been "cured" from your depression and want to go off the meds, your body will again start the withdrawal process as your natural balance is reached by tapering down on the dosage and you are left where you started.
There are valid theories and methods of completing an antidepressant course, but it almost requires inpatient setting with extensive rehabilitation during the treatment. It is based on the idea i explained in the last paragraph, and combining to that behavioral therapy. As beneficial neural pathways are encouraged (exercise, social contacts, daily routines, healthy food etc.) and depressive ones are kept back, the dosing/withdrawal process can leave you with a more healthy neural map.
The thing is you do not need to poison yourself to achieve this change. The same rehabilitation and behavioral therapy will do the same changes on their own.
This is why i prefer especially Alprazolam over antidepressants. It starts acting immediately, it lowers inhibitions and calms the patient down, so even traumatizing experiences can be accessed without the patients ego shutting it out. It also has an unique serotonin modulating activity that is not found in other benzos. The downside is the extreme misuse potential. And if the dose is increased anywhere near the FDA approved maximum, alprazolam addiction may become far worse a problem than your depression ever was.