The best-selling author of Listening to Prozac examines depression from a historical and scientific perspective, challenging cultural beliefs that depression is a noble or romantic disorder linked to soulful or creative achievements, and calling for a greater awareness of depression's devastating impact, as well as renewed efforts to provide curative treatments.
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Peter D. Kramer, a clinical professor of psychiatry at Brown University, is the author of Should You Leave?, Moments of Engagement, Spectacular Happiness, and the international bestseller Listening to Prozac.
Peter D. Kramer is a clinical professor of psychiatry at Brown University.
Starred Review. What is depression really, and how does society define it? Kramer, a famed psychiatrist and author of the 1993 bestseller Listening to Prozac, says he has written "an insistent argument that depression is a disease, one we would do well to oppose wholeheartedly." In making his argument, Kramer examines the cultural roots of notions about depression and underscores the gap between what we know scientifically and what we feel about the illness. Kramer traces depression from Hippocrates through the Renaissance and Romantic "cult of melancholy" to advances in medicine, psychiatry and psychotherapy, and at last to the disease we now know it to be. Kramer's curiosity drives the book forward as he ponders why we value artwork and literature built on despair: "certain of our aesthetic and intellectual preferences have been set by those who suffer... deeply." The book maintains the perfect balance between science and human interest, as the author details both psychiatric studies and personal experience. A comparison of the biochemical workings of depression with the physical and observable symptoms serves as an intellectual trip for readers and provides a thorough exploration of what Kramer dubs "the most devastating disease known to humankind." The book is rich with questions that engage the reader in an active dialogue: Why is society captive to depression's charm? And will this infatuation change with the emergence of more evidence regarding depression's severely disabling effects? Kramer leaves off with these questions to ponder. Resolute but not preachy, this book is an important addition to the growing public health campaign against depression. As for how we should define depression—perhaps it's best understood by its opposite: "A resilient mind, sustained by a resilient brain and body." One Spirit and Discover Book Club selections. (May 9)
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Some dozen years after his surprise best-seller Listening to Prozac Kramer returns to the subject of depression, revealing that much more has been learned about it, enough to power a polemic--this book. Depression, Kramer suggests, is a disease whose reputation resembles those of tuberculosis, epilepsy, and other maladies once thought to distinguish as well as afflict their victims. In the first part of the book, he examines the attractiveness of depression that he has noticed affecting some of his patients, both depressives proper and men involved with depressive women, and that surfaces in modern literature, art, and thought that valorize the sad, alienated outsider and grim, dolorous moods. In the midst of that discussion, Kramer presents evidence of depression's debilitating physical effects on the brain; this he uses to refute romanticization of the condition. The book's second part presents more research and theory about depression, including studies concluding that depression is the most prevalent and by far the most costly medical condition in the U.S. Kramer is an excellent writer who makes the technical second part about as painless to absorb as anyone could. Still, many will breathe easier when, in the last part, he returns to the cultural construction of depression. He relates some autobiography attesting to his appreciation of alienation, but he asks that appreciation never be used to condone, trivialize, or prettify the depression that alienation often cloaks. We may be on the threshold of regarding depression as no more glamorous than the formerly aestheticized tuberculosis. Kramer urges us to feel that that time can't come soon enough. Ray Olson
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