Beyond depression : a new approach to understanding and management / Christopher Dowrick.

Enhanced descriptions from Syndetics:

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 Beyond Depression, Christopher Dowrick - an academic general practitioner - takes a critical insider's look at commonly held views about the diagnosis and management of depression. He argues that our belief in depression as a medical condition is based on some shaky theoretical and functional foundations. He shows how commercial, professional, organisational and cultural factors combine to sustain the popularity of depression as a concept, which is based more on our values than on science. He considers alternative ways of understanding the thoughts and feelings that we currently describe as depression, drawing on cross-cultural, religious, political and literary sources. He proposes a conceptual framework based on the central importance of purpose and meaning for understanding ourselves as active, creative and engaged. This framework 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. Beyond Depression combines a comprehensive analysis of current scientific evidence with an impressive review of linguistic, literary and philosophical perspectives. Moving seamlessly between controlled trials and Camus, from prescribing to Proust, the book is informed throughout by a series of sensitive case studies drawn from the author's personal experience.

Table of contents provided by Syndetics

• 1 Points of departure (p. 1)
• Encounters (p. 1)
• This wan and heartless mood (p. 4)
• The Anatomy of Melancholy (p. 6)
• Mapping the journey (p. 11)
• 2 Depression as a medical condition (p. 15)
• Definitions (p. 16)
• DSM-IV (p. 16)
• ICD-10 (p. 18)
• ICHPPC-2 (p. 19)
• Natural history (p. 19)
• Prevalence (p. 19)
• Trajectory (p. 22)
• Impact (p. 23)
• Risk and resilience (p. 26)
• Medical management (p. 30)
• Detection (p. 31)
• Antidepressant medication (p. 32)
• St John's wort (p. 35)
• Psychosocial interventions (p. 36)
• Systematic approaches (p. 42)
• Conclusions (p. 44)
• 3 Disputed diagnoses (p. 55)
• The question of validity (p. 56)
• Border disputes (p. 57)
• Imperialism (p. 58)
• Integration (p. 60)
• Fundamentalism (p. 62)
• Comorbidity in primary care (p. 63)
• Back pain (p. 64)
• Heart disease (p. 65)
• Unexplained physical symptoms (p. 66)
• Social difficulties (p. 68)
• Biological bases? (p. 71)
• Family and twin studies (p. 71)
• Brain studies (p. 73)
• Biochemistry (p. 75)
• Gene identification (p. 76)
• The question of utility (p. 78)
• Detecting depression (p. 79)
• Antidepressants and placebos (p. 80)
• Training family doctors (p. 84)
• Disease management programmes (p. 86)
• 4 Drivers to diagnosis (p. 95)
• Depression as a commercial construct (p. 96)
• Depression as a professional construct (p. 99)
• The needs of psychiatrists (p. 99)
• The needs of general practitioners (p. 102)
• The needs of professional academics (p. 108)
• The needs of organisations (p. 109)
• An ethic of happiness (p. 111)
• Unwonted consequences (p. 115)
• 5 Broadening the mind (p. 121)
• Lost in translation? (p. 122)
• Etic and emic approaches (p. 126)
• 'Something bad is happening' (p. 130)
• Alienation and desire (p. 133)
• This vast panorama of futility (p. 136)
• 'The synne of accidie' (p. 136)
• The culture of ennui (p. 140)
• A view from the east (p. 145)
• 6 Conversation and meaning (p. 151)
• The coherent self (p. 153)
• Memory (p. 153)
• Desire, joy, and sorrow (p. 156)
• Curiosity and imagination (p. 161)
• The engaged self (p. 163)
• Webs of interlocution (p. 163)
• 'Vita activa' (p. 164)
• Encounters and hope (p. 170)
• The examined self (p. 172)
• The narrative self (p. 174)
• Leading a life (p. 174)
• Conversation and meaning (p. 176)
• Beyond depression (p. 177)
• 7 Encounters in primary care (p. 189)
• A role for doctors? (p. 190)
• Leavell's levels (p. 193)
• Enabling narratives (p. 194)
• Reconstruction (p. 197)
• Beyond determinism (p. 199)
• Into the future (p. 204)
• Limiting narratives (p. 205)
• Medical barriers (p. 206)
• Taking time (p. 211)
• Disabled narratives (p. 212)
• Research potential (p. 214)
• One more story (p. 215)
• Index (p. 221)

Author notes provided by Syndetics