I'll say I was 100% guilty of thinking that every situation in life can be fixed by pulling yourself up by your boot straps, "manning up", reading your Bible, and getting over it.... until I went through it myself. For me personally, YES, I do think the long term solution was and is purely lifestyle changes. Problem is, I did not know that at the time, until I was too far gone. I had gotten to the point, that without some form of help, there was a much higher likelihood of me drinking myself to death or eating a bullet, then being able to sit here and have this discussion. For some others, it is clinical and they do need professional help or medication, likely indefinitely -- I truly feel for them, as that is a rotten hand to be dealt in life.
I can only speak to my situation, but I did not know what I did not know. When you get to the point of considering suicide, you are a fraction of your former self and it is a truly, grueling fight to get back to where you were. To put it in terms we all relate to, after a terrible accident or injury it's common to go on medication and see doctors about physical therapy so they can teach you what stretches or exercises you can do to help you get better. The same goes for your brain, except we still don't fully understand how it works OR what treatments OR medications help everyone. For some, one medication will help, for others the same medication can make it worse! I remember going my doctor to tell them what I was on was not helping, it's very defeating to hear; "OK, let's change up your medications, we'll need to wait 4-5 weeks to see if it's helping or hurting and we'll go from there." Doctor, "I don't know if I can feel like this for 5 more weeks...." Repeat that several times... it's terrible. For me, the devil was crushing insomnia -- I couldn't sleep. I finally found a combination that worked for me and started getting 2 hrs of sleep a night. Allowed me to barely function and I could start talking to a therapist, who taught me how to cope. More sleep. Then started exercising. And slowly but surely started climbing back out of it, dropping medications, and now I'm to a point where I'm not on any medication and purely lifestyle changes can prevent this from happening again. Definitely needed the help to get to this point, and I wouldn't wish the last two years me and my family have been through on anyone. Thank God, I came through with only about 40lbs of excess fat I need to lose. I have excellent healthcare and a great supportive family and still the whole process was a nightmare. It's much worse for many others.
We are just getting to the point where it's becoming more commonplace for people to do blood tests, etc at the beginning of this which can help identify what medications, therapies, or treatments will have better results on you. Just the fact that, that is necessary though shows just how much we do not understand about the brain.