For me, the difference is whether it seems temporary or more longer lasting.

I have clinical depression and need medication to feel better. When the meds aren't working, I feel terrible no matter what my situation is. It has made therapy difficult for me. I feel like therapists understand and know how to treat situational depression better. That has been my experience anyway.

Have you tried therapy or medication? Has one or the other made a difference for you?

Whatever the case, I'm sorry you feel so bad.