For me, as someone that's been through it, and as someone that other people in my group of friends come to for help, the thing about exercise, cleanliness, and diet is that you're right, it is a hard lifestyle change. For most people. But I notice that almost everyone gets to a point when they hit their own personal rock-bottom, and they're willing to try anything. One of my best friends said something similar when we were talking about his wife, who suffers from PTSD and bouts of depression. He said she wouldn't want to try it because she is stuck in bed all day. And I told him to tell her that the change will be almost immediate, and it will keep up as long as she keeps it up. She got out of bed. Maybe some people don't want to change. But in the pits of despair that I have been in, and my friends have been in, people are willing to do almost anything to make the pain go away. Exercise, cleanliness and diet are not cures for everyone, but they do help, and they help immediately, for long enough to make it to your doctor's appointment. For some reason, I get pushback from people on the internet about this, but it works. The only cure for this is time, and that's just an unfortunate fact. But when people are told those things make positive changes immediately, almost everyone gets out of bed or off the couch to try it. It all comes down to whether or not the person wants the pain to go away. If they do, they'll make the change, even temporarily.
Much of that pushback is because that same advice can be twisted into a sort of "just will the depression away" suggestion that's kind of tone deaf and insulting to people suffering from depression. It's not uncommon for people to say exactly that, as if it's little more than a light switch that needs to be flicked off. And most of the time, those sorts of comments are pretty patronizing, along the lines of "just man up and get over it." Not yours, but I can see how people might interpret it that way based on the way others have acted towards them in the past; basically, your suggestions were judged by the words of others.
You're looking at exercise, social activity, and other lifestyle changes as a means of combating depressive symptoms. That's absolutely true, and there's a wealth of peer-reviewed evidence to support that. Almost anyone with a depressive disorder would benefit. For that matter, almost anyone would benefit. And the social aspect, with friends and family pushing and supporting you as you set out on those efforts, can absolutely play a profound role in mitigating those symptoms (assuming those around you notice; it's quite common for people even with severe depressive disorders to be able to mask their feelings from even those closest to them). But for the worst cases, and even many that aren't as severe, those first steps are the difficult on a level that those who don't suffer from depression can't really conceptualize.
Imagine a mental pain so severe that it cuts through to your very soul; an existential despair so pervasive that simply envisioning a life without it is nearly impossible. I remember a professor of mine discussing a former patient of his: the patient described her depression as an overwhelming hopelessness so great that even suicide was too much of an effort despite wanting to do just that. Obviously, she managed to get help at some point but I remember feeling goosebumps along my spine as those words were repeated to us. It was a chilling description of an inner hell that nobody realized this woman was living in.
At some point in their lives, almost every single human being will feel a sense of hopelessness, despair, sadness, etc. Even the shitty emotions are part of the human condition. It's when they start to interfere with your ability to function in everyday life, and/or they persist for a longer period of time, that you start to look at a problem beyond the norm. Depression isn't about simply hitting rock bottom; it's more about not being able to see anything but. But even that's a bit of a generalization.
This is the other thing I don't understand. People seem to have it all figured out, when it comes to other people's feelings. I'm not sure where in my description you get the impression that I don't know what depression is like. I wasn't hitting rock bottom after a bad week at the office. I was laying on my living room floor drinking for a couple of months after my fourth combat tour. When I tell people to try taking a shower, doing some laundry, exercising, and eating something healthy, it's because it works as well as anything that isn't time -- which, again, is the only real cure. It took four years for me to get back to a point where I could have a bad week at the office.
I'm sorry if I gave you that impression. Actually, I'm pretty upset I made you feel that way to begin with. Talk about ironic, given the point I was trying to make. I kind of took your comments as a segue to respond to the sort of un-thinking ignorance I mentioned your comments getting compared to/judged by/fighting against. It wasn't you I was suggesting don't know what depression feels like, but generic "suck it up" thoughts I was thinking about in response.
That said, I still absolutely agree with you. Lifestyle changes can have a profound impact on depression, and perhaps more importantly, can help support other behavioral changes long-term. They might not make the problems go away, but they'll absolutely help people get through the worst aspects, even if other treatments (medication, therapy, CBT, etc.) are needed alongside them.
The other problem with exercise as treatment for depression is that it's pushed as nearly magical cure that will strongly help everyone with depression.
It'd be easier to take the advice if it was pushed as "it helps some people a lot. It might help you, if only a bit".
