Review of "Depression"
By Mary Jane Tacchi and Jan ScottOxford University Press, 2017
Review by Daniel J. Dunleavy on Jan 16th 2018
Depression is among the latest contributions to Oxford University Press?s A Very Short Introduction series. It is written by practicing psychiatrist Mary Jane Tacchi and Professor of Psychiatry Jan Scott (Institute of Psychiatry at Kings College London). Like all entries in the series, the book provides a brief overview of the topic (typically around 120 pages of text), offers recommendations for further reading, and is written for a general audience (i.e. no background knowledge is presumed). In this review, I will describe each section of the book, provide critical commentary, and give an overall impression of the book?s value.
Depression is divided into 7 chapters. Chapter 1 gives a historical introduction to the concept of depression going back to the Ancient Greeks, through the Middle Ages, and leading up to 19th & 20th Century conceptions by Western society. Chapter 2 picks up where the previous chapter left off, examining more modern conceptualizations and designations of depression. Tacchi and Scott detail various attempts to classify and diagnose depression, such as Freudian, Kraepelian, and DSM-based classificatory schemes. Chapter 3 explores various sociodemographic factors associated with depression. These include differences across age, race, class, marital status, and culture, among other factors. The authors conclude the chapter with a nuanced and thoughtful discussion around the issue of suicide and problems related to researching/understanding the phenomenon. Chapter 4 expounds upon classical biological, psychological, and social models of depression. The major etiological hypotheses are discussed, including the moanamine imbalance hypothesis and Beck?s cognitive model). This discussion is complemented in Chapter 5, which examines various attempts throughout history to treat depression, from early sedatives (e.g. opium/morphine) to shock therapy (i.e. electroconvulsive therapy) to the various classes of antidepressants and psychosocial interventions (e.g. Cognitive Behavioral Therapy). Chapter 6 discusses current controversies around overdiagnosis, antidepressant efficacy, alternative medicines/therapies, and newly proposed etiological models. The book concludes with Chapter 7, which vacillates between a discussion about the global burden of depression, the stigma of depression, and the relationship between depression and creativity. This chapter, due to its brevity and seeming lack of coherence, is in my opinion, the weakest. The book concludes with some helpful recommendations for further reading. Having provided a brief overview of the book?s content, I now turn to a few (hopefully constructive) criticisms of the information presented.
While the book serves primarily as an introduction to the topic, time is well-spent throughout going into detail on specific topics (e.g. the monamine and neuro-endocrine hypotheses of depression discussed in Chapter 5 and current investigations into the role of inflammation in causing or contributing to depression in Chapter 6). As such, it is puzzling that the authors do not go into greater detail (or in some cases leave out details all together) regarding diagnostic reliability/validity and antidepressant treatment effects.
As described earlier, Chapter 2 discusses the evolution of various classifications for depression. This includes a discussion about the DSM diagnosis of Major Depressive Disorder (MDD). Instead of going into detail regarding the reliability of the diagnosis, the authors acknowledge the malleable nature of psychiatric classification systems and compare the fuzzy boundaries of psychiatric diagnosis to that of general medicine (e.g. the continuum of blood pressure scores, p. 26). In doing so, the authors minimize the epistemological/ontological questions surrounding psychiatric diagnosis and neglect pragmatic problems, such as clinical reliability of MDD. A deeper discussion would acknowledge the ?questionable? reliability of adult and child MDD in the DSM-5 field trials (see Regier et al., 2013 for reported Kappa values) and criticisms that MDD is not a consistent syndrome (see Fried & Nesse, 2015); to speak nothing of disparate attempts to measure the phenomenon (Fried, 2017). Such issues are important to acknowledge when discussing depression, its diagnosis, and how it manifests in society (problems left unexamined in Chapters 3 and 6, which treat depression as a reliable and uniform phenomenon).
Another issue unsatisfactorily covered by Tacchi and Scott regards antidepressant medication effects. While the limitations of antidepressant efficacy are acknowledged (e.g. p. 89), the impact of adverse effects, especially among the SSRI class of antidepressants, is only discussed in passing. Little or no mention is given to the issues of antidepressant-induced dependence (and associated abstinence syndromes; Fava et al., 2015), sexual dysfunctions (Montejo, Montejo, & Navarro-Cremades, 2015), or agitation/suicidality (Bielefeldt, Danborg, & Gøtzsche, 2016; Healy & Whitaker, 2003; Sharma, Guski, Freund, & Gøtzsche, 2017). These adverse effects, in part, explain why users are, ?not always good at sticking with a medication regime[n]? and the returning or intensification of symptoms upon withdrawal, a problem the authors incorrectly dismiss as merely signifying ?relapse? (p. 84).
With these issues in mind, I can recommend Depression as a short, but helpful introduction to the concept of depression, it?s various interpretations, and treatment efforts. It is recommended to the interested lay-reader, high school or bachelor?s level college students interested in mental health, and practitioners/consumers in the mental health field. Its biggest strengths are its clear writing-style, succinct delivery, and scope. The authors have endeavored to capture the broad range of issues surrounding depression within a little over 100 pages, and have arguably succeeded, without much loss of depth or accuracy. Its biggest weaknesses are in its presentation of particular issues (e.g. reliability/validity of diagnosis; antidepressant effects). New readers to the subject will want to complement their reading with accounts featuring a bit more depth. Tacchi and Scott make two good recommendations in their Further Reading section; historian Roy Porter?s 1987 Mind-Forg?d Manacles and Edward Shorter?s 1997 A History of Psychiatry. To provide a more well-rounded account, I?d suggest Shorter?s 2013 How Everyone Became Depressed and psychiatrist David Healy?s 1999 The Antidepressant Era as well; in addition to any given introductory psychiatric textbook.
References
Bielefeldt, A. Ø., Danborg, P. B., & Gøtzsche, P. C. (2016). Precursors to suicidality and violence on antidepressants: Systematic review of trials in adult healthy volunteers. Journal of the Royal Society of Medicine, 109(10), 381-392.
Fava, G. A., Gatti, A., Belaise, C., Guidi, J., & Offidani, E. (2015). Withdrawal symptomsafter Selective Serotonin Reuptake Inhibitor discontinuation: A systematic review. Psychotherapy and Psychosomatics, 84, 72-81.
Fried, E. I. (2017). The 52 symptoms of major depression: Lack of content overlap among seven common depression scales. Journal of Affective Disorders, 208, 191-197.
Fried, E. I. & Nesse, R. M. (2015). Depression is not a consistent syndrome: Aninvestigation of unique symptom patterns in the STAR*D study. Journal of Affective Disorders, 172, 96-102.Healy, D. & Whitaker, C. J. (2003). Antidepressants and suicide: Risk-benefit conundrums. Journal of Psychiatry and Neuroscience, 28(5), 331-337.
Montejo, A. L., Montejo, L., & Navarro-Cremades, F. N. (2015). Sexual side-effects of antidepressant and antipsychotic drugs. Current Opinion in Psychiatry, 28(6), 418-423.
Regier, D. A., Narrow, W. E., Clarke, D. E., Kraemer, H. C., Kuramoto, S. J., Kuhl, E. A., &Kupfer, D. J. (2013). DSM-5 field trials in the United States and Canada, part II: Test-Retrest reliability of selected categorical diagnoses. American Journal of Psychiatry, 170(1), 59-70.
Sharma, T., Guski, L. S., Freund, N., & Gøtzsche, P. C. (2016). Suicidality and aggression during antidepressant treatment. Systematic review and meta-analyses based on clinical study reports. BMJ, 352: i65.
© 2018 Daniel J. Dunleavy
Daniel J. Dunleavy, M.S.W., Doctoral Candidate; Florida State University, College of Social Work
Resources
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Articles
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Introduction and Types of Depressive Disorders
- Major Depressive Disorder and Related Conditions
- Classic Symptoms of Major Depressive Disorder
- The Development and Course of Major Depressive Disorder
- Differential Diagnosis and Specifiers of Major Depressive Disorder
- Prevalence and Co-Occurring Conditions
- Disruptive Mood Dysregulation Disorder
- Persistent Depressive Disorder (Dysthymia)
- Premenstrual Dysphoric Disorder
- Related Disorders / Conditions
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Biology, Psychology and Sociology
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- Psychology of Depression- Psychodynamic Theories
- Psychology of Depression- Behavioral Theories
- Cognitive Theories of Depression - Aaron Beck
- Cognitive Theories of Depression - Ellis and Bandura
- Cognitive Theories of Depression - Seligman
- Sociology of Depression - Effects of Culture
- Social and Relational Factors in Depression
- Lifestyle Factors and Environmental Causes of Depression
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Treatment - Medication and Psychotherapy
- Treatment: When to Seek Professional Help and Where to Find Help for Depression
- Measuring Depression
- Clinician-Rated and Self-Report Questionnaires/Tests for Depression
- Types of Treatment for Depression
- Types of Treatment Continued
- Medications for Depression
- Antidepressants for Depressive Disorders
- Mood Stabilizers for Depressive Disorders
- Non-Medication Medical Therapies for Depressive Disorders
- Psychotherapy - Evidence-Based Treatments for Depression
- Cognitive Behavioral Therapy for Depression
- Cognitive Behavioral Therapy for Depression Continued
- Interpersonal Therapy for Depressive Disorders
- Behavior Therapy for Depressive Disorders
- Psychodynamic Therapy for Depressive Disorders
- Group, Family and Couples Therapy for Depressive Disorders
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Alternative Medicine and Self-Help Resources
- Complementary and Alternative Treatments for Major Depression
- Major Depression and St. John's Wort
- Major Depression and Exercise
- Major Depression and Omega 3 Fatty Acids
- Major Depression Serotonin Precursors: SAMe
- Major Depression Serotonin Precursors: 5-HTP
- Acupuncture for Depression
- Music Therapy and Relaxation Therapy for Depression
- Self-Help Methods for Major Depression
- Community and On-line Self-Help Resources for Major Depression
- Depression Reading List
- Special Issues
- References
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Introduction and Types of Depressive Disorders
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Questions and Answers
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- What Is The Difference Between Mental Illness and Depression?
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- I am Terrified of Death.
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- My Father, The Sociopath...
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- Depressed 19 year old college student
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- Will I ever feel normal?
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- Counting ritual - Zami - Aug 30th 2008
- dont understand me
- Exercising violence in dreams
- Swallowing fear
- My husband wants to leave me
- Is there help for a person who has always been a 'little depressed'
- Depression Treatment
- Please help.
- Lovely, however... - Julie C. - Jul 14th 2008
- I am really worried about my mental health (19yr old female)
- Am I depressed?
- Identity Confusion: I don't know what personality disorders I have
- Do I Have Bipolar Dsorder?
- Is there something wrong with me?
- Will I Ever?
- Worried about my son
- Is There Help Out There? Lonely Mother of Three
- Am I Depressed?
- Help?
- Major Depressive Disorder Severe with Psychotic Features
- OCD- No feeling
- Help!!!: Laci
- Is the memory of my father dooming my relationship?
- Worried about thoughts
- How long will i be on medication for treatment of my depression
- My Mother Won't Go For Depression Treatment!
- Where do i start to get on the road to recovery
- What is wrong with me?
- Stuck in an on-again, off-again relationship for 10 years
- Depression Treatment
- How do I get my dr.s to understand and help me?
- STUCK IN A RUT
- What treatments are available after you've tried the medicines of last resort?
- no one will help!
- Should I seek help?
- A fighting couple
- Do I have a mental health problem?
- Whats wrong with me?
- depression and employment
- how do you treat depression in teenager males?
- Is it ok to feel this way?
- Have DID: Getting Worse Not Better
- Can we contact my mother's doctor?
- anxiety or going crazy?
- ADD, Tourettes or both?
- Depressed
- I think i'm lost?
- Don't want to take meds
- Will this ever end
- Get Supported
- Stages of Depression
- Is there any help?
- Can you help?
- Dark Fantasies
- Blood tests
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- should a depressed person marry?
- Dementia and Depression
- Anger?
- What type of exams can proven that a person has bipolar disorder?
- Stuck in a mental rut...
- Loss of Patience
- i can't seem to get over any of this
- Intrusive humiliating memories
- Is there some way to deal with depression without meds?
- losing personality wholness
- What is the point of life?
- No change is normal mood (e.g., Depression)
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- Diagnosing Depression
- Does untreated depression pass on to a fetus?
- A Request for Help
- Regular thoughts of killing myself
- How do I help my depressed, unemployed mother
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- I become very hostile towards myself
- Coming to Terms With My Own Pathetic Existence
- Do environmental factors hold a person back?
- Tired of this Depression
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- An Empty Shell
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- A Wonderful Man
- How Can I Become Less Depressed?
- 18, Sad and Hopeless
- Should I Continue With Therapy?
- Childhood Depression
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- Approaching My Tightly Wound Depressed Attorney Brother
- Brain Injury and Depression
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- Pleasure-blind
- Do People Recover From Depression?
- Shy Dancer
- Crying Is Behavior
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- Medicine Doesn't Work Anymore
- Depressed
- The First Time
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- Two Clinicians
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- Depression 101
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- Are These Just Mood Swings
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- Drinking. . .
- A Mother Struggles with Depression
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- Beautiful Dreamer
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- Unhappy and In Therapy
- He Won't Tell Me Why...
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- Lonesome
- My Children Aren't Speaking..
- My Wife is Depressed
- My Boyfriend Is Depressed
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Tests
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Book & Media Reviews
- A Heart of Stone
- A Mood Apart
- A Philosophical Disease
- Active Treatment of Depression
- Adolescent Depression
- Against Depression
- American Melancholy
- An Unquiet Mind
- Beating the Blues
- Before Prozac
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- Beyond Blue
- Blaming the Brain
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- Conquering Postpartum Depression
- Conquering the Beast Within
- Cry Depression, Celebrate Recovery
- Damage
- Depression
- Depression
- Depression 101
- Depression Doesn't Always Have to Be Depressing
- Depression Fallout
- Depression in Context
- Depression Is a Choice
- Depression, the Mood Disease
- Depression-Free for Life
- Doctors of Deception
- Down Came the Rain
- Dysthymia and the Spectrum of Chronic Depressions
- Emotional Claustrophobia
- Essential Psychopharmacology of Depression and Bipolar Disorder
- Everything Is Fine
- Experiences of Depression
- Handbook of Depression
- Handbook of Depression
- History of Suicide
- How I Stayed Alive When My Brain Was Trying to Kill Me
- In Pursuit of Happiness
- Journeys with the Black Dog
- Killing the Black Dog
- LifeForce Yoga to Beat the Blues--Level 1
- LifeForce Yoga to Beat the Blues: Level 2
- Lifting Depression
- Lincoln's Melancholy
- Lucy Sullivan Is Getting Married
- Malignant Sadness
- Manufacturing Depression
- Mindfulness-Based Cognitive Therapy for Depression
- Mood Genes
- My Depression
- Natural Healing for Depression
- New Hope for People with Depression
- On Depression
- On the Edge of Darkness
- Ordinarily Well
- Out of the Blue
- Outsmarting Depression
- Overcoming Depression
- Potatoes Not Prozac
- Prozac and the New Antidepressants
- Prozac Backlash
- Prozac Diary
- Prozac Nation
- Puppy Chow Is Better Than Prozac
- Quiet Your Mind & Get to Sleep
- Raising a Moody Child
- Reasons to Stay Alive
- Self-Coaching
- Songs from the Black Chair
- Speaking of Sadness
- Spontaneous Happiness
- Student Depression
- Subordination and Defeat
- Sunbathing in the Rain
- Swing Low
- Talking Back to Prozac
- The American Psychiatric Publishing Textbook of Mood Disorders
- The Anatomy of Melancholy
- The Anti-Depressant Fact Book
- The Antidepressant Era
- The Beast
- The Bell Jar
- The Breakthrough Depression Solution
- The Corrections
- The Cruelty of Depression
- The Depressed Child
- The Depression Cure
- The Devil Within
- The Emotional Revolution
- The Family Silver
- The Feeling Good Handbook
- The Mood Cure
- The Nature of Melancholy
- The Noonday Demon
- The Postpartum Effect
- The Secret Strength of Depression
- The Van Gogh Blues
- The Van Gogh Blues
- This Close to Happy
- Undercurrents
- Understanding Depression
- Undoing Depression
- Unholy Ghost
- Unstuck
- Viniyoga Therapy for Depression
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- When a Parent is Depressed
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- Why Are You So Sad?
- Writing Through the Darkness
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Links
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Videos
- Behavior Therapy for Depression
- Depression - Let's Talk
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- The Age of Depression
- Transcranial Magnetic Stimulation Therapy for Depression
- Beating the Holiday Blues
- How to get stuff done when you are depressed
- Antidepressant Medications
- Tell Me About Depression
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- Let’s talk about depression – focus on older people
- Depression: More Than Just the Blues
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- Can people with depression harm themselves?
- How to Ask if Someone is Suicidal
- Seasonal Affective Disorder (SAD)
- How to Know if You Have Seasonal Affective Disorder
- Kids and Depression
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- Groundbreaking Research Into Postpartum Depression
- What Are The Signs of Depression in Teens?
- Alternative Treatment for Depression
- Seasonal Affective Disorder: One Woman's Story
- Postpartum Depression
- The Link Between Stress and Depression
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- Adolescent Depression
- Behavioral Activation: Treatment of Adolescent Depression
- Managing Holiday Depression
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- Depression and its Treatment
- Treating Depression in Youth
- The Mindful Way Through Depression
- Depression, the Secret We Share
- The bridge between suicide and life
- No More Shame: My life with Anxiety and Depression
- Depressive and Bipolar Disorders
- Adolescent Depression and Anxiety
- #StrongerThanStigma - Wayne Brady: Why I Waited to Talk About My Depression
- Down in the Dumps or Depressed?
- What is Depression?
- What Doctors Miss When Treating Women With Depression
- It’s Bipolar Disorder Not Depression
- What About Alternative Depression Treatments?
- Self Help and Therapy for Depression
- Dealing with the Stigma of Depression
- What is Treatment Resistant Depression?
- Do I Have Depression? Common Symptoms of Depression
- Postpartum Depression: What You Need to Know
- Depression and Your Family Doc
- New Treatments for Depression
- Transcranial Magnetic Stimulation for Depression
- Postpartum Depression - Not Just the Baby Blues
- "Baby Blues" -- or Postpartum Depression?
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- Dealing with Depression
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- Interpersonal Psychotherapy for Depression Video
- Cognitive Behavioral Therapy for Depression
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