I was interested to read this book because it promised a different take on the much- quoted and rather gloomy statistics on the relentless rise in the prevalence of depression worldwide, and indicated it would provide a less reductionist view by suggesting that there might be evolutionary benefits to depression as part of the human condition. This was touched on; the premise being that low mood and withdrawal from testing or potentially dangerous situations may confer a protective benefit, as well as the argument that depressed individuals may have a better awareness of the reality of various situations, but these weren’t really explored as much as they could have been.
There were then chapters on depression in various animal species, the impact of bereavement, potential triggers for depression, and factors influencing the potential for recovery, but overall, I found this a rather difficult book to read. There were some interesting observations; for example, experiments suggesting that people with depression may show less emotional reactivity to both positive and negative stimuli and that those with the least reactivity when discussing sad events have the poorest prognosis. However, it was all presented in a rather jumbled and haphazard fashion, with patient stories and references to the author’s own past history of significant depression interspersed with references to scientific research in a way which I found quite confusing.
I think the most useful aspect of the book was how it emphasised the heterogeneity of the disorder in terms of presentation, duration, and response to treatment, but I wasn’t really sure who the target audience for this book should be. It seemed to oscillate between clinical descriptions, aspects of being a self-help guide, and detailed descriptions of academic research, but lacked a clear focus. The author is clearly very engaged with the topic, both from his personal and professional experience. I think the underlying idea of linking his own and other personal experiences of depression with more factual descriptions of current theories and research in the area was a good one, but unfortunately it didn’t quite work for me here.
- © British Journal of General Practice 2014