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Nevertheless, this is an admirably well-written book, giving excellent
access to resources that people with depression need - not just from
various therapies but also from within themselves. It rightly points out
that even though most sufferers could respond well to effective
treatment, they do not get it - three out of every four cases are
neither recognised nor treated. That is often due to misdiagnosis by
healthcare professionals. But with many older sufferers, it also happens
because they make the completely unwarranted assumption that “sad
feelings” are a natural part of ageing and they therefore do not even
seek a diagnosis.
This book provides a first-class corrective to that. It contains good
advice for both sufferers and carers, genuinely helpful tips and tests
to promote recovery, illuminating case studies, useful information about
available drugs, exercises to train the brain to fight depression, and
self-assessment questionnaires to aid diagnosis.
The best bit, in my view, is a fascinating account of recent new
insights into the workings of the brain. These show that depression is a
physical illness or, more accurately, “a mind-body illness”, not to be
categorised, let alone stigmatised, as a “mental” or a “psychiatric”
problem. Triggered by environmental, genetic and chemical factors,
depression may be modified by changes in patterns of living and
thinking, helped by medication or therapy.
John Illman highlights cognitive behaviour therapy (CBT) which, a bit
sweepingly perhaps (he devotes an entire second section to it), he calls
“the most successful non-pharmaceutical treatment available”. Some
authorities take a different view. For them, CBT is merely a briefer and
therefore - crucially for purse-string holders - a cheaper alternative
to costlier approaches. Furthermore, some specialists doubt whether the
eminently sensible active principles of CBT - questioning negative
assumptions, finding alternatives to depressive attitudes, challenging
logical errors in thinking - are really what lead to change.
Still more controversially, though not unconvincingly, John Illman
advocates “CCBT”: computer-based therapy in place of face-to-face
contact with the old-fashioned sort of real, live human being - doctor,
counsellor or whatever. There is a lot to be said for this - the list of
pros here is longer than for cons - but will it appeal to those who are
old enough to remember when their calls were answered by people rather
than machines?
Interestingly, though, this raises the whole issue of “bibliotherapy”,
considered by medical writers themselves in the newsletter of the
Medical Journalists Association. ”While there may be no clinical trials
to prove it, the anecdotal evidence suggests that readers find medical
self-help books helpful – they sell”, says a recent issue. John Illman
argues that as there have been more advances in medical scientific
knowledge in the last 50 years than in the previous 2000 - driven by
technology, he emphasises - he has no need to make excuses for being “an
enthusiast for technology”. Well, it is not that long since the latest
wonderful technology gave us psychosurgical prefrontal lobotomies. These
gruesome procedures, hailed as technologically brilliant at the time,
are now thoroughly discredited as one of the ghastliest scandals in
medical history.
All in all, however, I agree with medical writer and GP Tom Smith,
himself the author of at least 20 self-help books, that Use Your Brain
to Beat Depression is something of a god-send at a time when family
doctors find it hard to give more than 10 minutes to any one patient.
Quite rightly, it has won the Medical Journalist Society’s annual award
for excellence. It presents the facts accurately in easily understood
terms and offers lots of sound practical advice.
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