As a Nurse and with the depression patients that I work with it is more of a despondent emotion setting. As if they are crushed under life and overwhelmed by their issues/situation and the seeming endless dullness that they experience. I know Big Pharma is BS about many things but seeing the difference in someone that responds well to a medication can make a huge difference. Venlafaxine helps many of those on my medpass, and if they run out within a week they are teetering emotionally and want to stay in bed and give up. They get back on it and boom, they are cheery and sweet again.