Depression — A Potential Affliction, Suppressing Emotions

The introduction gives a brief history of depression: depression-like descriptions in the Ebers Papyrus and the Old Testament, Hippocrates' term melancholia, meaning «black bile», around 400 BC, and later classifications. Then comes the epidemiological picture: three-quarters of people seeking medical help are said to have a psychiatric problem requiring intervention, and depression is the most common psychiatric disorder. But the book's main weakness appears at once: DSM-IV is named as the most widely accepted classification (DSM-5 has been in force since 2013), and the World Health Organization's projection that depression would rise to second place «in 2020» is still given in the future tense in a 2025 edition.

Chapter one is the most useful part. It explains the role of substances such as serotonin, dopamine and noradrenaline, yet the book is measured: it says openly that it is not yet known whether differences seen in brain imaging are a cause or a consequence of depression. The list of symptoms is detailed — low mood, hopelessness, inability to feel pleasure, days that are worst in the morning, changes in sleep and appetite, forgetfulness and, in severe cases, suicidal thoughts. It also reminds readers that diagnosis is made through psychiatric examination and that some physical illnesses produce similar symptoms.

The chapter's most practical parts are two lists. The first covers common thinking errors in people with depression: selective focus, personalisation, overgeneralisation, arbitrary inference, «all-or-nothing» thinking, and minimising successes while magnifying mistakes — each with an everyday example (a friend who didn't say hello interpreted as «I must have done something to upset them»). The second is advice for families: remember that depression is an illness, not a weakness; avoid phrases like «what's there to be upset about, forget it»; avoid excessive criticism; never change medication without talking to the doctor; and take suicide risk seriously. This is the part of the book most worth recommending.

Chapter two lists the types of depression: major depression, where the risk for women is twice that for men, and its diagnostic criteria; atypical depression; postpartum depression (more common in women with a previous history, and its relationship with breastfeeding); melancholic, seasonal, psychotic and catatonic forms; and dysthymia. Treatment follows: situations requiring hospitalisation, antidepressants taking effect after 3–4 weeks and treatment lasting at least six months, the pros and cons of tricyclic drugs, electroconvulsive therapy as a life-saving option, and bright light therapy for seasonal depression.

This chapter contains some serious errors. Seasonal affective disorder is defined as a disorder «with periods of mania and hypomania», although the text itself goes on to describe it as recurrent depressive episodes. The sentence claiming that drugs given for catatonic depression «cause dependence as a side effect» and that patients need to «be freed» from them is unsourced and misleading — such a statement could encourage wrong decisions such as stopping treatment on one's own. The contradiction stands out all the more because elsewhere the book says medication should never be changed without consulting a doctor.

In the end the book is a short and generally responsible introduction to depression: the sections on thinking errors and advice for families are genuinely useful, and chapter three brings the different schools of therapy together in one place. But the information has not been updated, some sentences are wrong, and, as with other volumes in the series, much of the text reads as compiled from various academic sources. For a reader experiencing symptoms of depression, this book cannot replace professional help — which is, in fact, its main message.

• Four chapters with subheadings and bulleted lists
• Lists of diagnostic criteria and treatment stages
• Author's and translator's bibliographies at the end