Speaking of sadness.
Depression, disconnection, and the meanings of illness

David A. Karp

Oxford University Press Canada, 1996, 240 pp

Strengths

Excellent description of isolation and disconnection of sufferers. Excellent bibliography.

Weaknesses

Philosophical discussion might not interest everyone. Pharmacologic treatment and its outcomes need more discussion from patients’ perspective

Audience

Chronically depressed people, medical students, family practice residents, family physicians, and specialists

Depression is a terrifying illness and one that needs to be documented and understood from the viewpoint of the person suffering. As family physicians we see depressed people daily and often find it challenging to support them. The author has done an excellent job of exposing some terrifying experiences that chronically depressed people go through. The author explains the stages of the “depression career.” I found this very helpful.

I welcomed the discussion of how “infectious” depression is when depressed people are near anyone, but I found the discussion on the pharmacologic treatment of depression negative. I can understand the author’s frustration with the medication he has tried, but recent use of the newer selective serotonin reuptake inhibitors has made treatment much more effective.

A lot of what is written in this book should come as nothing new to family physicians, especially in Canada. The author has written this book from an American perspective, and I suspect the criticisms regarding psychiatric care might be justified.

The author’s objective was to write about depression as sufferers see it. I think he manages his objective very well. However, I think the philosophical discussions at the end might not interest everyone. But the concepts elucidated in this book could help family physicians manage chronic depression better.

Book “Speaking of sadness. Depression, disconnection, and the meanings of  illness” – amazon.com

Speaking of Sadness: Depression, Disconnection, and the Meanings of Illness

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