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Book Reviews

Prozac Nation: Young and Depressed in America

by Elizabeth Wurtzel

Caring for the Mind: The Comprehensive Guide to Mental Health

by Robert E. Hales, Allen Frances, Dianne Hales

Listening to Prozac: A Psychiatrist Explores Antidepressant Drugs and the Remaking of the Self

by Peter D. Kramer

Stop Depression Now: Sam-e, the Breakthrough Supplement That Works as Well as Prescription Drugs in Half the Time … with No Side Effects

by Richard Brown, Carol Colman, Teodoro Bottiglieri

After spending an hour or so perusing the bookshelves at my local big-box, books-by-the-barrel bazaar (where, by the way, I am certain that the health categories into which the books are divided were selected by someone who has never had to look for a book), I am forced to conclude that if you aren’t already depressed when you go seeking books on the topic of depression, you might easily become so during the search. There are literally hundreds of books on mental health, psychological well-being, depression in its various guises, and self-help, and there is absolutely no way of knowing which to choose.

I ended my search by buying four books that seemed representative of the wide array available.

Caring for the Mind is certainly the biggest as well as the most “establishment” book in this bunch. The board of consulting editors is a partial who’s who of the U.S. psychiatric establishment, and the authors have relied heavily on the DSM-IV, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, a somewhat controversial compendium of almost 300 “psychiatric” disorders including such debatable conditions as the one that really riles this four-cappuccinos-a-day man – caffeine dependency.

Caring for the Mind is indeed what it claims to be: a “comprehensive guide to mental health,” although it probably offers most readers much too much information and is a bit heavy going in parts. However, if I were a novice starting to learn about depression this is certainly a book I would consult. The authors provide thorough explanations of depression, its causes, the differences between clinical depression and low mood, and what therapies the medical establishment has to offer. It also contains a very useful chapter detailing what one can do if a loved one is suffering from a mental illness.

My main criticism is that the book is too traditional. The authors are too ready to push conventional therapies, primarily drugs and psychotherapy, without enough regard to the problems associated with those therapies and without paying enough attention to more holistic approaches. The authors downplay, for example, the side effects common to antidepressant drugs, which cause a significant number of people to stop using them. There is also no mention of alternate approaches.

The most well-known book in this group is Dr. Peter Kramer’s bestseller Listening to Prozac. Strictly speaking, Listening to Prozac is not about depression, and the author is quick to state that it is not his intention to discuss Prozac’s use as an antidepressant but rather its use in “fairly healthy people” who are “transformed” (a word Kramer uses several times) when they go on it. Anyone who is depressed, however, will quickly find out about Prozac or one of its cousins and they will likely turn to this book for information.

Listening to Prozac is a rarity among health books: It’s well written and full of intelligent thoughts and stimulating ideas. Kramer certainly does a lot to explain what Prozac is and what it can do (although he does not, as he readily admits, spend enough time discussing its side effects or potential problems), and he is quite persuasive about Prozac’s potential benefits for people who are overly shy, or dysthymic (low mood), or anhedonic (unable to enjoy pleasure). Whether or not one buys Kramer’s thesis that even healthy people may have lots to gain from this drug, this is still a fascinating book. For a person who is mildly or moderately depressed, Kramer’s pro-Prozac arguments are very persuasive.

I picked up Stop Depression Now because I know that many people are taking SAM-e (pronounced Sammy) – the “breakthrough supplement that works as well as prescription drugs” – and I wanted to learn what the hype is about.

Stop Depression Now is written in a catchy, magazine style. The background material on depression – etiology, pathology, biochemistry, symptoms, diet, facts about antidepressant medications – is excellent.

Author Dr. Richard Brown is, according to the dust jacket, the leading authority on SAM-e (the acronym for S-adenosyl-methionine), and he is very persuasive about its benefits. He cites many studies as evidence of SAM-e’s antidepressant effectiveness, lack of side effects, and fast action, although few of the studies were double-blind placebo-controlled (the only kind that could actually prove SAM-e’s worth), and few were published in the kind of well-known medical journals where stringent peer-review could perhaps rip them apart. So as a cynical old family doctor who has seen too many “miracle” compounds over the years, I am not yet ready to endorse or embrace SAM-e, which can also, according to this book, prevent heart disease, slow aging, and improve arthritis.

First, I worry that people who think they’re depressed might pick up this book and follow its advice without first seeing a doctor. But I worry more about the lack of information of either SAM-e’s long-term effectiveness or its potential long-term consequences, and I would not recommend this or any other product without the benefit of those years-long studies. It pays to keep in mind the new rotavirus vaccine, which was recently taken off the American market because it was found to cause rare but major bowel problems in some kids.

I suspect that many people who suffer from depression want to read a personal testimonial, either an I-beat-this-and-so-can-you book or a this-is-how-really-really-bad-depression-is kind of book. Fortunately, there are many of these books on the market – all promoted as riveting, staggering, fascinating, wrenching, and important.

Prozac Nation: Young and Depressed in America does not disappoint: it is indeed a wrenching, fascinating, and riveting account of one extremely bright young woman’s battle with depression. Even though there is little strictly medical information in this highly personal account – Wurtzel describes her depression through a prism only of “me” – it is still an instructive book for anyone who’s ever been depressed and wondered if that “black wave” was unique to them, or worried that they could never describe their blackness to others, or felt that no one could really capture how hopeless it can feel.

I would make this book required reading for anyone who has ever smirked that beating depression is just a matter of will. “Hey! Do what I would do – pull yourself together, grow up, work harder, stop feeling sorry for yourself, exercise, go out more – and you won’t feel bad anymore.” This is a book that would humble most non-believers.