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A review by rbruehlman
A Cure for Darkness: The Story of Depression and How We Treat It by Alex Riley
4.0
Engagingly written, taking care to discuss the history, epidemiology, and potential treatments in a human way. While a book on this topic could easily be impenetrably academic and dull, this book is not; it is informative and well-researched, yet accessible and easy to read. The book particularly shines in regards to discussing the history of depression and society's various interpretations of what it was caused by and how to treat it. As someone more well-versed in the psychopharmacology of depression, learning about its history over the years was new for me.
The book's strength was definitely in the history of depression. It explores (among other things) early conceptualizations of depression and mental illness and the evolution of psychiatry in Europe, taking particular care to explore the rich, interconnected academic world of European psychiatry and how different major figures (Kraepelin, Freud, Aaron Beck, etc.) learned from and influenced one another. I also particularly enjoyed the discussion of depression in other cultures, particularly in Africa; I've definitely read research to indicate depression is _less_ common in developing countries, but the author makes it clear some of this is just due to poor cultural translations--depression does exist, but you have to know how to ask about it.
I do wish he had explored the rising rates of depression in the Western World more, but can't win 'em all.
I gave this book four stars, however, because I felt the book was more comprehensive in _history_, rather than _treatment_, which is why I picked the book up. Much time was spent discussing, say, Freud's personal life, than new non-SSRI upcoming treatments. While I think overall the coverage of treatment options was good, some aspects of the field that I would consider important weren't mentioned at all, or got just a drive-by mention. For instance, the research on SSRIs is fairly discouraging, with efficacy not much better than placebo effect; while this was mentioned, this wasn't particularly emphasized, and instead SSRIs were discussed very positively (I suspect this might be because sertraline was so effective for the author). The author is clearly very enamored with ECT and spends a good deal of time discussing it, yet, surprisingly, he doesn't even mention transcranial magnetic stimulation (TMS). The biology of ketamine was not discussed at all, and genetic testing for SSRI metabolization (or lack thereof) wasn't mentioned either. All of it seemed like kind of odd omissions, given that treatment-resistant depression is discussed so much. I suppose I felt like the history section was very well-written, but the treatment section was rushed somehow?
I'd also have liked to have seen more discussion about the different types of depression. Seasonal Affective Disorder and dysthymia are not mentioned at all. Depression in the context of schizoaffective disorder and bipolar disorder isn't really explored either. While unipolar disorder is distinctly different from both of those disorders, it's also at the same time related (indeed, there is a nascent theory that unipolar depression is another form of bipolar disorder).
All in all, a well-written book, though.
The book's strength was definitely in the history of depression. It explores (among other things) early conceptualizations of depression and mental illness and the evolution of psychiatry in Europe, taking particular care to explore the rich, interconnected academic world of European psychiatry and how different major figures (Kraepelin, Freud, Aaron Beck, etc.) learned from and influenced one another. I also particularly enjoyed the discussion of depression in other cultures, particularly in Africa; I've definitely read research to indicate depression is _less_ common in developing countries, but the author makes it clear some of this is just due to poor cultural translations--depression does exist, but you have to know how to ask about it.
I do wish he had explored the rising rates of depression in the Western World more, but can't win 'em all.
I gave this book four stars, however, because I felt the book was more comprehensive in _history_, rather than _treatment_, which is why I picked the book up. Much time was spent discussing, say, Freud's personal life, than new non-SSRI upcoming treatments. While I think overall the coverage of treatment options was good, some aspects of the field that I would consider important weren't mentioned at all, or got just a drive-by mention. For instance, the research on SSRIs is fairly discouraging, with efficacy not much better than placebo effect; while this was mentioned, this wasn't particularly emphasized, and instead SSRIs were discussed very positively (I suspect this might be because sertraline was so effective for the author). The author is clearly very enamored with ECT and spends a good deal of time discussing it, yet, surprisingly, he doesn't even mention transcranial magnetic stimulation (TMS). The biology of ketamine was not discussed at all, and genetic testing for SSRI metabolization (or lack thereof) wasn't mentioned either. All of it seemed like kind of odd omissions, given that treatment-resistant depression is discussed so much. I suppose I felt like the history section was very well-written, but the treatment section was rushed somehow?
I'd also have liked to have seen more discussion about the different types of depression. Seasonal Affective Disorder and dysthymia are not mentioned at all. Depression in the context of schizoaffective disorder and bipolar disorder isn't really explored either. While unipolar disorder is distinctly different from both of those disorders, it's also at the same time related (indeed, there is a nascent theory that unipolar depression is another form of bipolar disorder).
All in all, a well-written book, though.