I can't speak to meds.
As I am very much like you in that respect that I don't talk to or really go to doctors.
I can relate to how you feel though. It's no coincidence that I drink like a fish and morbid thoughts go through my mind some nights.
Existential angst and the feeling of nothing ever going right has me spinning some days.
You say your life is "almost perfect" right now... most folks would think that is reason to be happy and not have those kinda feelings.
My life is not perfect... never has been. Lotta dissapointments here. (relationships, family, lack of motivation to achive higher goals... the last perhaps a result of the first too... oh and did I mention I make excuses... hahar... )
Here is an idea... sorry I'm not as structured in my writing... but here it is.
Maybe these negative feeling should not be seen as a failure of you appreciating everything that is good right now in your life.
If your life is going well but you feel like... "what the heck what is wrong why do I feel like this" then you could try have to look at your whole life and consider all the built up baggage. Be happy about your good fortune but understand your life as a whole and don't put yourself into that space, saying "there's something wrong with me" Everyone has skeletons and furbies in they're closets. That's life...
I mean in my situation I'm not happy... but I sure as hell have less problems than a lot of folks out there... (other than being a super lush whose liver may one day pack its bags and go on strike... (need pot bad instead... though I am strangely proud of my intoxicating prowess...) and needing to move on sooner or later so I can find somewhere I feel I belong. :F)
But yea. I know with me a huge part of my meloncholia as I like to think of it is not necessarily the present situation but my past and baggage I have not let go.
Specifically... to give you an example. Two things will be with me till I die. My immediate family that is structured in a crazy uber religious/parents divorced/dad a flake and mom coo coo for cocoa puffs... (thats mean... sigh lol but damit I can't talk to the woman) "rolls eyes" and how that affected me from a young kid with depression... and second women... I gots problems with dem... There is always a girl after all...

... at least thats my case and a good reason for me to seek the untamed sea.
aaaahhhhh.... I wrote this part below here before I wrote that part above there...(told you I'm not structured... I'll add more below now...)
All I can say is that I choose to "put up with it".
I have not really had "male" rolemodles in my life. I certainly have not taken example from my lame ass father.
I had to do things on my own.
SO that is the mentality I am stuck with it seems.
So I can at least relate to you not going to doctors or seeking use of meds.
I really can't see myself on them either.
I understand pharma meds do help people and used corectly with proper supervison may be the answer. But I feel I have to be old school about shit.
As a matter of fact. The only thing I can relate to fixing my sense of well being and place on earth is to try search for happiness.
You say your life is near perfect. If that is so I truely commiserate with you. If things are going well and you still have these hopeless feelings, that is gonna be a huge challenge.
Maybe instead of medications just someone to talk to on a regular basis would help? If not friend or family then perhaps a therapist of some sort? I dunno how to run that as it sounds expensive unless you can get somekinda insurance to cover it.
I know I would't mind having a weekly session to unload some "feelings" with a sexy therapist... oh yea... lol (I'm fucking horrible I know...) I wonder if the red light district in amsterdam gives a discount for just "cuddles and chat". ::shy::
I don't know if anything I said makes much sense or if I even should be GIVEING advice but I hope the best for you.
And if all you need is to hear someone else relate to things or talk to then STP is here for you... As you can see there are folks aplenty willing to talk or listen.
Oh one more thought though... can't seem to put this in a sucinct way. But I have often thought and found. I am happy and don't dwell on things when I have my mindset back to those earlier days when I was a happier kid.
YOu know think of times when you were excited about life and exploration. I mean there is that saying "young at heart" and perhaps thats the secret to living a happy life.
I know the world is full of paranoid news broadcasts... folks do bad shit and hurt each other... and just someday it all seems like a big pile of doo doo.
But fuck it. Who cares. Fuck it right on. Remember being a kid and riding your bmx doing tricks on that set of chrome pegs you just bought. (i had a shitty bike spray painted gray...(did it myself) with red pegs. I used to take that fucker right down the church stairs and handycap ramp. LOLlolLO

)
ahh... see that made me feel better.
And if all else fails. I'll leave you with Jack.
::eyepatch::
ALso:... excuse my inordinate use of humor for this serious subject. I respect this is difficult for you... it's just ::meh:: it's what I do... not so much in person but deff here. "Shrugs"