Beyond Depression: A new approach to understanding and management / Edition 2

by Christopher Dowrick

Overview

Is there an epidemic of depression sweeping the world, or are we radically altering our interpretation of normal human experiences? Do we need a dose of medication or a renewed sense of meaning?

In this second edition of Beyond Depression, Christopher Dowrick—an academic and general practitioner—takes a critical insider's look at commonly held views about the diagnosis and managmenet of depression. He argues that our belief in depression as a medical condition is based on commercial, professional, organizational, and cultural factors which combine to sustain the popularity of depression as a concept, which is based more on our values than on science.

Based on the best contemporary evidence available, this second edition includes new research findings on the management of mild and recurrent depression, the possibility of a genetic basis to depression, and extended arguments on the limitations of screening, and the placebo effects of antidepressant medication.

The author considers alternative ways of understanding the thoughts and feelings that we currently prescribe as depression, drawing on cross-cultural, religious, political, and literary sources. He proposes a conceptual framework that provides a means of moving beyond depression as a medical concept and as a personal problem. When applied to encounters between doctors and patients in primary care it leads us towards enabling narratives, with an emphasis on listening and understanding rather than diagnosis and prescription.

Product Details

ISBN-13:	9780199545292
Publisher:	Oxford University Press
Publication date:	09/14/2009
Edition description:	New Edition
Pages:	256
Product dimensions:	5.40(w) x 8.40(h) x 0.60(d)

About the Author

Christopher Dowrick is Professor of Primary Medical Care in the University of Liverpool, and a general practitioner with the Aintree Park Group Practice. He is a Senior Investigator with the National Institute for Health Research in England, and a Professorial Fellow with the University of Melbourne, Australia. He is editor of the international journal Chronic Illness. His research expertise is in the field of primary care mental health, with a portfolio of grants and over 100 publications on depression and medically unexplained symptoms. He leads a major NIHR R&D programme (2007 to 2012), designed to increase equity of access to high quality mental health services in primary care.

Table of Contents

1. Points of Departure2. Depression as a Medical Condition3. Disputed diagnoses4. Drivers to Diagnosis5. Broadening the Mind6. Coherence and engagement7. Encounters in Primary Care

Editorial Reviews

Reviewer: Brett C. Plyler, M.D.(Northwestern Memorial Hospital)
Description: This book is an attempt to reframe our understanding of depression and its treatment as a concept based on individual patients and their unique circumstances.
Purpose: The purpose is to approach depression and its treatment from a moral, philosophical stance rather than from the disease model that is common to western medicine.
Audience: Although physicians are the primary audience, anyone from therapist to clinician to layperson should be able to read and understand this book.
Features: The author begins by providing a basic understanding of depression and the current modalities for treatment. He then breaks down the validity of depression as a functional entity by examining the research surrounding it and goes on to discuss the cultural, political, and financial interests involved in keeping depression a diagnostic category. He recommends a radical overhaul of the ways in which we evaluate depression and encourages readers to consider each individual patient as a unique problem. Finally, he puts forth the idea of a self and how physicians can alter their understanding of patients in light of this concept.
Assessment: The author's objectives are noble and good — depression should be seen as unique set of problems for each patient and not a one size fits all diagnosis. I also agree that physicians should not be handing out antidepressant medication each time a patient has complaints that resemble a depressive illness, and that the western world is unduly focused on the idea of happiness. I disagree with his contention that the current model of depression is completely flawed and should be just thrown out. Furthermore, his concept of self is not new and has been a part of the psychoanalytic literature since the beginning. Lastly, his constant references to classic literature or philosophers became annoying and broke the flow of his arguments. I would recommend this book with some reservations and I think there are better books out there on how to truly understand depression.

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