Undoing Depression: What Therapy Doesn't Teach You and Medication Can't Give You
- ISBN13: 9780316043410
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Like heart disease, says psychotherapist Richard O'Connor, depression is fueled by complex and interrelated factors: genetic, biochemical, environmental. In this refreshingly sensible book, O'Connor focuses on an additional factor often overlooked: our own habits. Unwittingly we get good at depression. We learn how to hide it, how to work around it. We may even achieve great things, but with constant struggle rather than satisfaction. Relying on these methods to make it through each day, we depr
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Brilliantly insightful book!,
Dr. O’Connor served for 14 years as executive director of the Northwest Center for Family Service and Mental Health, a private, nonprofit mental health clinic in Litchfield County, Connecticut, overseeing the work of twenty mental health professionals in treating almost a thousand patients per year. He is a practicing psychotherapist, with offices in Canaan, Connecticut, and New York City. ….In his biography on this site, he states that he believes “depression can never be fully grasped by mental health professionals who have not experienced it.” In Dr. O’Connor’s case, as a therapist, he has a unique and powerful perspective because he is the son of a depressive who committed suicide, has suffered depression himself, and applied the insights presented in his book in his own life to heal his depression.
This book is very well-written, clear and accessible even when the doctor is talking about complex, professional issues in the mental health community. There is a thorough index and plentiful endnotes, as well as a very complete bibliography of recommended reading. The four sections of the book listed in the table of contents are: What We Know about Depression; Learning New Skills; Putting the Skills to Work; A New Synthesis.
I believe this is one of the top books ever written on depression. If you only have time to read one book on the subject, I would heartily recommend you make it this one, because it is utterly brilliant. I personally believe that one of the most profound things a theorist can do is synthesize seemingly opposing or unlike ideas, pulling them together in a comprehensible whole, which is what Dr. O’Connor does so very, very well here. He has thoroughly surveyed the existing information on depression, made clear what we know and don’t know about it, and what most often works, or doesn’t work, to treat depression.
In this regard, his discussion of why we don’t have a comprehensive theory of depression at the present time is wonderful. Within this discussion he states: “The Freudian theory of human functioning has been on its last legs for some time, and we wait for a new theory, a new paradigm, to replace it….[A]lthough there is a wish to achieve a biochemical theory of human behavior, our current knowledge leaves us far from it; and if we had it, it would not answer our most interesting human questions.”
He covers the effects of trauma on depression and the biological basis of mental illnesses such as schizophrenia, manic depression and major depression and how this conception removes stigma. Then he asserts that though symptoms of mental illness are “biochemically mediated, that doesn’t make [them inevitably] biochemically caused….” He is not anti-medication, but he states that medications can’t tell us how to raise healthy children, make difficult decisions, or help us find meaning in life. He believes that “both nature and nurture play a part in the development of depression”–and in its cure. He states that “in depression, you use medication to help alleviate the pain and suffering, but the patient may still feel a lack of confidence, be painfully shy, lack assertive skills, have a distorted self-image…procrastinate…be stuck in a loveless marriage or a dead-end job. The patient must address these kinds of issues…or else he may suffer less but still not be part of life.”
It is this issue that the book addresses very thoroughly: how to engage in a deliberate skill-building program in conjunction with medication (or without it if you are one of the unlucky, sizeable percentage of depression sufferers diagnosed with “resistant depression” because antidepressants do not work for you). In his skill-building program, the author covers emotions, behavior, thinking, relationships, the self, and aids to recovery. He then discusses how to put these new skills to work on the job, in intimate relationships and in the community at large.
An extremely thorough, comprehensive, invaluable guide!
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|Thoughts and Actions That Can Overcome Depression,
The author is quick the point out (and he is correct) that this book will not improve or cure depression by itself. You need professional help for that. Instead, the purpose of this book (which it magnificently addresses) is to describe what the depressed person and the depressed person’s family and friends need to be doing to provide the maximum likelihood of overcoming depression. That’s a reasonable promise and premise for a book on this important subject, and you can begin to overcome your ignorance (and the harm it can bring) by reading this book and acting on its advice.
First, the bad news. Depression is increasing. Worse still, the younger someone is, the more likely that the person will experience depression sometime. Even worse, many people are undiagnosed, and suffer alone with their affliction.
Second, the good news. Around 70 percent of all those suffering from depression will improve with either drug therapy or mental health treatments. Those who get both do even better.
Third, more bad news. Depression tends to recur for many people.
The voice addressing these issues is an expert one. He is a psychotherapist who runs a community health center. More importantly, he has suffered from depression himself. I doubt if you can get more direct access to what depression is all about than from Richard O’Connor. I admire his caring to share so much of his own pain with us, and respect him enormously for this gift he has given us all.
Depression is currently under reevaluation. No single paradigm seems to capture all of its elements. Undoubtedly, an improved scientific model for it will emerge. There are signs that it can have roots in disturbed relations between Mother and child, family dysfunction, possibly genetic disorders of brain chemistry (like using up seratonin too rapidly), other traumas, and poor thinking habits. Who knows what else may turn up?
Many people try to deal with this problem too much on their own. Families often put up with the depressed person’s behavior, not knowing what else to do. Others reject the depressed person, which will usually make the situation worse. O’Connor lays out common sense guidelines that should make a diference: for depressed people, for those who care about them, and for those who treat them.
The author sees depression as a disease and as a social problem, “an illness to be treated professionally and a failure of adaptation that we must overcome through self-determinination.” He outlines important principles for the depressed person: (1) Feel your feelings (depression is the suppression of feelings — acknowledging those feelings often causes depression to improve). (2) Realize that nothing comes out of the blue (your depressed state has a root cause that you should look for in an event or situation). (3) Challenge your depressed thinking by questioning your assumptions, especially ones that center on meaningless perfectionism. (4) Establish priorities so that your energies go into what will be on what’s most important to you. (5) Communicate as directly as possible to everyone around you. Depressed people are often poor communicators who don’t get their emotional needs served. With better communication, they can experience a more supportive emotional environment. (6) Take care of your self. Learn to enjoy yourself. (7) Take and expect the right responsibility for yourself — for your own actions. Depressed people often feel guilty about things that they have no responsibility for (like the death of a parent or the divorce of their parents). (8) Look for heroes. These role models can empower you to see the way to improve, especially if they were also depressed like Lincoln. (9) Be generous. Helping others puts your own situation into perspective. (10) Cultivate intimacy. This means letting down your defenses so people can see you as you are, and accept you for that. Depressed people often feel disgusted with their true selves, and hide that self from everyone. (11) Practice detachment. Depressed people are often overly critical and pessimistic. Seeing things in the proper perspective can heal a lot of inappropriate pain. (12) Get help when you need it. This may be the most important piece of advice since so many people do not.
The book is filled with personal examples and case studies of people the author has treated, which help make the points easier to understand.
I was astonished to realize that there is no self-help network like there is for alcoholics and those with other mental and behavioral problems. The author shares some experiences with having established such groups that can be a prototype for creating such a network in the future. I think that is an important priority for improving the mental health of our society from what this book shares.
Mental health professionals will find good advice for overcoming the parochialism of whatever discipline they originally trained in, to create links to the other treatments…
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|a good book to start with,
If you have just been diagnosed with depression, or someone who is close to you has, and you just want an overview of what depression is all about, then this is a good book to read as a first step. It brings together a lot of valuable general information and is written with experience and compassion. It will be of help to you if you are mildly depressed or even if you are merely unhappy with your life, but if you are a sufferer of major depression, this book is just not specific enough, it is too simplistic, and it does not contain anything new. There are chapters in the middle that discuss things like families, love, marriage, divorce, etc, that are in my opinion quite irrelevant.
The author admits that there is no one definite theory of the cause and treatment of depression, and so attempts to cover all the different approaches and put them together as package. This approach, whilst valid in theory, can be an overwhelming burden to juggle for a depressed person, who is made to feel that if he/she is not doing it all perfectly – keeping a mood journal, keeping a daily record of dysfunctional thoughts, eating well, in intense therapy, analyzing everything, etc – then he/she is not doing all they can to get well and this can make a depressed person feel a lot of needless guilt. I am very sceptical of this catch-all approach, it puts too much pressure on a depressed person for not nearly enough of a gain in their recovery. This approach will often make a depressed person feel that if they cannot manage all this constant self-actualization and exercises and analysis, etc (which they often can’t – because they are depressed) that it then must be their own weakness making them depressed; this is extremely counter-productive. It is also unfortunate because some of the techniques can be of some help, but not if they are simplified and all jumbled together.
Having said all this, I do appreciate what the author is trying to do. This book is useful if you take from it what you think can help you right now, doing only what you can and want to, leaving the rest for another time. It won’t change your life, but it will get you started and point you in the right directions for further help.
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