Posted by: counselorcarmella | July 19, 2012

Counselor Carmella Comments on “Against Depression” by Peter Kramer

When I ran across the title, my first thought was that this would be abook  about why depression is not a legitimate health issue. I expected that it would be a lot of uninformed ranting by  someone who’s credentials were in some sort of spirituality or  alternative medicine field. I was wrong on both counts. “Against Depression” is actually written by psychiatrist Peter Kramer, best known as the author of “Listening to Prozac.” If you are  someone who has experienced depression, there’s no one you’ll  want in your corner more than Peter Kramer. He is passionate about   this topic. When Dr. Kramer says he is “Against Depression,” what he  means is that he is opposed to people having to experience true clinical depression in any of its various forms. He doesn’t think it is acceptable that so many people are   struggling and miserable because of this disease.  He believes it should be  diagnosed and treated very proactively to minimize the damage. He hopes that   there may  come a time when  it can be prevented in many cases.  At the very least, Dr. Kramer  believes   medications and therapies should be more effective in terms of timeliness and outcome than they usually are now.
He doesn’t come across as critical. He just  believes we can and should do better. He believes we will be able to do better as we are more and more able to study the brain and  understand how  depression effects it. The more we know, the more  quickly  and accurately we can diagnose and treat. He acknowledges the progress that has been made, but  insists we still have a long way to go.  The topic of depression needs more research, more awareness, and more   attention.  In order for that to happen, it has to be taken seriously. Getting depression the notice it deserves means making sure correct information is more widely available so that it is seen for what it truly is. I agree and appreciate his passion.  That’s why I read the entire book. 
“Against Depression,”  as I understand it, is largely his effort to  respond in more detail to many of the issues  that have been raised since “Prozac” was published and to address   related  topics he sees as important to the discussion. I’ll admit I haven’t read that book.  I know  it got a lot of  publicity and is still talked about quite a bit.  I didn’t know these two books were written by the same person when I  started reading”Against Depression.”  Once I realized that, though,  it did make me more interested in finding out what he had to say.       
I don’t know what his writing style was in “Prozac,” but “Against Depression” was challenging to  slog through.  It is not a light and easy read full of  quotable quotes and soundbites by any means. Neither is it a pleasant read.   Some of the research on what depression  can do, especially to the brain,  is downright scary. This is not a self help book full of case study examples or insightful suggestions. Dr. Kramer does not provide simple answers or “How to make yourself undepressed in 10 easy steps.”
In fairness, he does share a few case examples, as well as  some brief information about his own history and some of the  conversations that came about as a reaction to  “Listening to Prozac.”  Those personal details are when the book gets the most reader friendly to me.  He has not experienced depression himself but has spent years  researching it and treating it. He clearly knows the topic backwards and forwards.   He has done his homework. This is not just a book full of personal ideas or opinions. He describes relevant, often disturbing,  research about what depression does to the brain and body.  He provides information.  He ponders, asks questions, and expands on possible answers.  Some questions just lead to more questions. Kramer challenges the reader to really think, to have  greater perspective and more understanding about  all aspects of depression.       
I believe this “good doctor” cares a lot about his depressed patients and what happens to them.  Their suffering  effects him and motivates him to want to do all he can to  improve  their care.  He wants to  see them truly well, not just partially well.  He wants to figure out more and  more about the  neurological and other  factors that lead to and are a part of depression.  He wants to   provide the most efficient and effective ways  to treat this illness. 
He insists that we not glamorize or romanticize depression or any of its symptoms.  He doesn’t want us making friends with any aspect of  the illness of depression. He wants us to confront its devastating realities. It ruins people’s lives and causes  tremendous unnecessary suffering, he says.  We should not seek to find the good in it.  We should try and get rid of it.      
It is important to point out that Dr. Kramer is not talking about  grief, or  expected feelings of sadness or stress related to life transitions or losses here. He is talking about clinical depression, whether it is episodic or chronic. He isn’t suggesting that everyone should be happy all the time.  He doesn’t want us to medicate normal emotion so that we are all a bunch of  numbed out robots or so that we are all more perky and extroverted. He calls that “cosmetic psychopharmacology” and it s a concern he  raised in “Listening to Prozac” and continues to  raise in “Against Depression.”  Dr. Kramer  believes emotions are important. If we don’t have any, we’ll miss out on a vital source of information and    cut ourselves  off from the range of  feelings that make us alive and  responsive to our world and other people. He makes a clear distinction between  what can be considered normal  emotional  reactions and   diagnosable types of depression.  He lays out criteria for distinguishing one from the other.  This is important because how to help and support someone through   grief or sadness related to life events is  not the same as  the treatment for  true depression.
I also want to caution that, if you’re currently experiencing depression, this may not be the best read for you.  You might want to seek out something a little more supportive and  easy-to-read,  a book that  has suggestions for  coping.  “Living With Depression” by Deborah Serani is one suggestion.   
I know Dr. Kramer  encouraged us to listen to Prozac. I’d like to suggest that someone write the book “Listening To Dr. Peter Kramer.” He has earned the right to  be taken seriously  in his field.  “Against Depression” is a valuable  and thought provoking addition to  the reading materials available on the subject.   It is a serious and substantial work of nonfiction. I feel sure  Dr. Kramer will continue to conduct research and publish in medical  journals and peer reviewed professional publications. I hope he writes more books.  I hope he eventually writes a book specifically  for those who are currently experiencing depression.  I’d like to see his passion and sincere concern come across  the way it must to his personal psychiatry patients.

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