understanding depression

This book describes the depressive in his or her natural habitat, studies the everyday problems that cause one’s depression, and develops treatment approaches directed to the depressive’s real-world plight. It explores the borderland between the sacred and the profane, the academic and the popular, the scientific but impractical, and the practical but unscientific. It relies as much on common sense, anecdote, and individual insight as it does on case histories and psychological test protocol.

The book is divided into four sections: description, cause, prevention, and treatment. The descriptive section presents the mental-status abnormalities in depression, includes a differential diagnosis of classic depressive symptoms, indicates when so-called classic symptoms of another disorder are in fact depressive, lists the physical complaints that are the product of depression, discusses normal depression, and touches briefly on hypomania. The section on cause recognizes that real troubles are common and chemical troubles rare. It suggests that people do not get depressed because they are under stress or they have suffered loss, but, in simple language, because their boss has threatened to fire them, their wife has threatened to leave, the cat has died, and other similar real-life difficulties. It faces the problems that therapists and patients alike find unpalatable, shameful, and threatening--the things that cause patients to close their eyes or speak in remote euphemisms. The sections on prevention and therapy are not attached to any one school of thought. They are formulated and expressed simply and humanistically, and offer common-sense solutions to the depressives’s everyday problems with themselves and their world.

MARTIN KANTOR is a psychiatrist in private practice in New York City and Bay Head, New Jersey, and Staff Psychiatrist in the Department of Veteran Affairs Medical Center in East Orange. He is the author of Determining Mental Status: The Physical Examination of Psychiatry (1988), Problems and Solutions: A Guide to Psychotherapy for the Beginning Psychotherapist (Praeger, 1990), and Diagnosis and Treatment of the Personality Disorder (in press).