I don’t mean to attack MDMA. I think it’s great, and a lot of people could benefit from it. But I think this is a real issue if it’s easily available outside of a therapeutic context.
Does that mean you are now doing it more frequently than every 4 months? If so, how often are you taking it?
Antidepressants don't provide immediate relief. In fact, one of the major challenges with antidepressants is that they require time to work, some times as much as a month or more for full effect. They also don't directly induce "good" feelings, rather they work to dampen negative feedback loops and give the patient space to sort out their problems.
Another challenge with antidepressant treatment is that patients frequently fail to associate their improvements with the medication. It's very common for patients to discontinue their medication because they think they don't need it any more, only to discover that the medication was part of their recovery all along.
MDMA treatment, on the other hand, is solely about immediate effects. The patient feels the effects very quickly and there is no question about where those good feelings came from. The trap is that those drug-induced feelings are entirely unsustainable. MDMA is even notorious for extreme rebound effects, known as "suicide Tuesday". People who attempt to use MDMA frequently will quickly succumb to tolerance and dependence, becoming mentally far worse than when they started. The only reason it's being considered for therapy is that they're using lower doses relative to what most recreational users use, and the administration is limited to two therapy sessions under strict control. Users go into this with the expectation that they must use the drug as a tool to help their therapy work, not that they can use the drug as a go-to to fix their problems.
What's the difference between this and being prescribed an antidepressant? I'd argue there is no difference except that self-medicating is much less likely to work.