Worrying about fault and taking an adversarial perspective where you see patients as being stubborn or lazy and concluding that resistance to lifestyle changes is due to that is absolutely insane.
People are resistant to those things because they are being told - do all these things and make all these hard changes and you will feel better and have motivation and energy. While they are thinking, “but to do all those things will require a lot of motivation and energy”. So patients are being told to get the things they want, they need to already have them.
It doesn’t matter if depression is a chemical imbalance or whatever. The reality is people get stuck and medication is a very easy initial step that can get them moving. It’s well established that executive control varies among people. It’s not a moral deficit to be on the lower end of that spectrum and be unable to spontaneously will yourself out of a depressive apathy.
People are resistant to those things because they are being told - do all these things and make all these hard changes and you will feel better and have motivation and energy. While they are thinking, “but to do all those things will require a lot of motivation and energy”. So patients are being told to get the things they want, they need to already have them.
It doesn’t matter if depression is a chemical imbalance or whatever. The reality is people get stuck and medication is a very easy initial step that can get them moving. It’s well established that executive control varies among people. It’s not a moral deficit to be on the lower end of that spectrum and be unable to spontaneously will yourself out of a depressive apathy.