“I didn’t say stupid, but perhaps uneducated. What degree of training do you have in Neuropsychology?”
I said in my first post I am not a doctor. What degree of training do you have in Neuropsychology?
Just as it makes sense to avoid fatty foods if one has a genetic predisposition to obesity, it makes sense to utilize some of the suggestions you gave in #15 in a relatively mild case of depression where situational factors and personality type are amenable to change. I myself know of a case where a rational/cognitive approach was quite successful.
The more severe cases of clinical depression, where hereditary factors are paramount and function is minimal will not respond to such an approach. They are no more able to change thinking style than a kindergartener is able to publish a dissertation. These patients are long-term unemployed, often sick with other chronic disorders, typically have no social network other than family, will agree to no significant physical activity and do not find any satisfaction in doing so, sometimes are catatonic, are suicidal to a greater or lessor degree all the time, and are in and out of therapy both outpatient and in. I'm sure you can readily agree that your suggestions are not realistic with respect to these patients and drug therapy is a given.
When I was in school MAO inhibitors and tricyclic antidepressants were the only choices. I was pleased to see SSRIs become available. IMO, it is easy to locate excessive hype both positive and negative concerning SSRIs. I really do see a lot of potential in SAM-e, as do many European practitioners, I guess, and it seems to me that if a supplement course could help a mild depressive case achieve your reorientation skills quicker it would be a good thing.