re: Anyone been on SSRI's for 20+ years?

This whole subject is never going to go over well on a message board. You have people quick to throw out flame posts denigrating anyone taking anti-depressants as weak, and you have people who are taking pills and have found it to successfully help their anxiety/depression. That is a wide gulf to find common ground on.

A couple of points...

There is no objective physical test that one can take to read the brain chemistry and diagnose anxiety or depression. It is a clinical test that diagnoses anxiety depression.

Parts of our lives may be full of anxiety because life is a messy/chaotic thing at times. To feel like an immovable blob or unstable wreck is to be human at times. In the past we were more socially connected and connected more to institutions like our church or synagogue. This provided meaning and a feeling of connection in the middle of whatever chaos was occurring in our lives.

After our first and second babies, I am sure my wife would have been diagnosed as having postpartum depression. The tears and helplessness were pervasive over the first couple months. Years ago doctors would never have prescribed for such a temporary condition, but it is not uncommon to do so now. Of course many new moms are going to feel depressed after having a baby... life was just turned on its head on top of changing hormones.

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Or he is suffering from a severe mental illness that finally surfaced after he suffered from the loss of his home in 2016.

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This sounds like your grandfather was going through an existential crisis after a major life change. Medication might be effective, but therapy might be just as effective. There have been a couple meta-studies that show cognitive behavioral therapy as effective as medication at treating depression.

My takeaway is that medication may be helpful for many... I am not saying I judge people for taking medication to treat anxiety/depression. I think its possible that we are too quick to go to medication when other options are available that appear to be just as effective.

My problem with saying depression is purely a medical/physical condition like any other illness is this... If studies show that cognitive behavioral therapy is just as effective as medication, how can it be purely physical? If you could show that cognitive behavioral therapy was just as effective as chemo for treating cancer, then you would naturally conclude that there is something going on beyond what medication is able to treat.