Review

What to know if low

DEALING WITH DEPRESSION
Trevor Barnes, with the Samaritans
Vermilion, 1996, £8.99

This is another in the long line of self-help books, this time addressing the most widespread mental illness, depression. It has all the virtues and vices of its genre, hovering between a technical and a lay approach. On the whole it succeeds in talking to its intended audience in an approachable manner, while covering some quite difficult issues such as its discussion of cognitive therapy.

The personal accounts of various aspects of depression are often very moving, particularly those concerning suicide. Given that the book is in collaboration with the Samaritans, its rather heavy accent on suicide is understandable, although this might be an obstacle for many readers.

Barnes has an easy style of writing, if at times rather too chatty for this reader. His continual references to ‘as Dr Pidd/Tylee says’ reveal the limits of his sources: both are psychiatrists. There is little direct reference to any of the ‘talking therapists’ most depressed people encounter — CPNs, social workers and psychologists.

The discussion of the nature of depression is clear and well informed, although its emphasis on ‘reactive v. endogenous’ as the main classification of unipolar depression seems a little old-fashioned and not informed by the most recent views of stress-vulnerability. The discussion of life events is useful, although limited in recognising the effects of childhood experience on vulnerability to depression.

There is an appropriate emphasis on the combined approach to treatment emphasised in the ‘Defeat Depression’ campaign. He discusses the pros and cons of ECT, but almost entirely omits those of drug treatment. A lay guide is not the right place to go into great detail on the different drugs available but not to consider the different drugs and their side-effects is to miss a major area of concern for all patients, which significantly affects their compliance with treatment.

The role of relaxation and stress management are helpfully described; although there are a variety of ‘alternative therapies’ popular with sufferers which merit a mention these days: acupuncture, aromatherapy, hypnotherapy and so on.

The index has all the marks of one not compiled by the author: why else would the only entry for ‘sex’ be ‘taking refuge in’ when the characteristic issues of relevance are loss of interest, a history of sexual abuse or difficulty in having sex at all?

There are the usual lists of helpful addresses and further, general reading (why no Sylvia Plath?). Overall, this is a good example of the genre, with the reservations noted, which does not mislead and which many people will find helpful.