I suggest that my clients also examine physical factors like sleep, exercise, nutrition, vitamin supplements, medication, and herbalism in addition to talk counseling.  Frequently I give referrals to other specialists with expert credentials in these areas (I’m the talk therapy guy).  Exercise early in the morning has research showing its beneficial effects on depression.  Helping clients return to a regular sleep pattern has frequently helped stabilize their moods.  Nutrition and herbs can play a huge role in depression (and most other problems).  Not everyone needs to do everything on this list.  I am not anti-psych meds although I am holistic in my approach.  Some people need anti-depressants or anti-anxiety medication.  I think talk therapy is critical in making the positive changes in mood stick.  I think alternative approaches to medication should be seriously considered whenever possible.  I often work with clients who which to avoid medication and try other routes instead.