From my experience, we're in the stone age when it comes to treating depression without drugs as well. I reached out to my PCP at my HMO, they made me talk to a specialist who cleared me for treatment and referred me back to my PCP. My PCP seemed skeptical that anything was wrong and went against the recommendation that I had been given by the specialist office by strongly recommending that I don't try anti-depressants. He referred me to get therapy but the internal office is understaffed with a 3 month waitlist, so I had to fill out forms to try to find a approved out of network provider. I do all that to find out that I absolutely hate therapy (socially anxious and bad at discussing emotions). I'd like to try a cognitive behavioral therapist instead but it's really not worth the institutional barriers.
Meanwhile my cancer screenings for a large lump that required 4 visits were done in 2 weeks and super straightforward.
> I absolutely hate therapy (socially anxious and bad at discussing emotions). I'd like to try a cognitive behavioral therapist instead
Respectfully, please don't give up. Continuing to go to your therapist would be exposure therapy for your social anxiety, which _is_ a form of CBT. Maybe just switching therapists will work for you.
I'm waiting for the day that anti-psychotics and some SSRIs don't cause extreme fatigue. I have ended up using my drugs as spot therapy rather than continuous. It isn't necessarily safe but at least I can somewhat function during the day. Otherwise I become almost completely useless and is even with adding Adderall to keep me up. I fall asleep at my desk and only want to sleep when I get home. It gets to the point where the symptoms are better than the side effects, which is scary considering my symptoms are violent in nature.
Things do seem to be improving however. For example, second generation antipsychotics like aripiprazole seem to be a significant leap.