My Dear
Yes, hormone imbalance is one of the reason, which can occur naturally and cause depression. But remember life tragic/tough incidents are other reasons, which can contribute to existing depression or could themselves become cause of depression, like death of someone dear and near.
Right now we know very little about psychiatry. As they very rightly say, psychatriy is still a soft science, as compared to other fields of medicine. For example, if someone breaks his/her leg, we can immediately take an x-ray and show here is fracture, so a patient has fractured leg.
On the other hand side, in psychiatry, it is still difficult to prove disorder by such hard facts/tests as x-ray, though a little development has taken place. DSM-IV onwards are still paper, pencil and interview based diagnosis. This is one of reason, why psychiatry is open to abuse by a SMALL number of practitioners, for what ever reason, racism, pure dislike, hidden agenda etc.
No denying that Effexor- XL may have benefited you more than others. Same happens with almost all people suffering from depression, that one medicine suit them better than others, because of our different chemistry, tolerance, age, weight etc.
Dear, as far suffering from side effects of Effexor-XL are concerned, let the consultant take care of it. But remember for two years you have successfully combated some of its side effects along with evil of depression (the disease of soul), many of which never stop with passage of time.
As, I included the result of research located at following URL:
http://www.nlm.nih.gov/medlineplus/news/fullstory_31368.html
that changing anti-depressant or combining it with another one often beats the depression.
Normally you will have to get off Effexor-XL before starting another medication, but a consultant would know if he/she can start new anti-depressant along with tapering off Effexor-XL, they do it many a times, but only on consultant's instruction.
I am sure keeping the severity of your depression and history of hospitalisation, in view, no wise consultant, would keep you without medicine. I know its difficult to suffer from anything ill, when life has so many responsibilities of its own.
But at the same time your children should realise that you are not well, so they should not only take their own responsibilities more but should take your complete care as well. And I am sure they would like to see a happy, loving and caring mother like you around them and for that it is must for them to realise that at present you need their help and care more than other way round.
Last, I am sure a combination of therapies and new medicine as felt suitable by your consult would be able to treat your depression successfully.
I hope, I have answered all your questions. In case, if you still have any query , please don't hesitate to JUST ASK. Thank you.
Cheers!