BTRIPP (btripp) wrote,

a pervasive phenomenon ...

This one had a “meant to get into my hands” vibe for its route into my library. A month or so back, the author was being featured as a speaker at the DBSA meeting I attend down here, and he'd brought a few books with him, which he handed out to those of us who had gotten there early. I sort of connected with the author, as he grew up in a family business, had been in publishing (in fact, his family's business was publishing – the educational publishers Follett), and had struggled with depression. Naturally, Mark Litzsinger's Out of the Shadows: A Journey of Recovery From Depression is a look at that struggle. One of the things that he focused on in his presentation, which was only a small component of the book, was that, after various go-rounds with psychopharmacology and working with some of the top doctors at Rush and related hospitals, he ended up getting “cured” though ECT – electroshock. This therapy still has that “One Flew Over The Cuckoo's Nest” vibe to it in popular culture … but it appears that it's having (in its current, much less destructive mode) a significant resurgence, and the author had a really remarkable set of results which he claims had him operating on cognitively higher levels than he'd ever experienced before:
Within a year of starting ECT treatments, I was operating on a different, better level. Not only was I well, but I was thinking more clearly and interested in many more things. My mind was questioning, I could synthesize information very quickly, and come to deductions about personal and business decisions like never before. … After the treatments, I broadened my learning and interests to encompass new areas in life, including politics, world affairs, travel, culture, and entrepreneurship.
… which rather uncomfortably reminded me of John Travolta's character in the film Phenomenon! Speaking of pop culture connections, I was very surprised (given his obvious enthusiasm for the procedure) that Litzsinger had never even heard of The Ramones' song Gimme Gimme Shock Treatment, which is the only other 100% positive look at ECT that I've encountered.

The author is, clearly not (nor does he represent himself as such) an expert on mental health, but he's published this as something of a “public service” (including having all proceeds from it go to Rush's Psychiatry department) … he notes:
One of the goals of this book is to make depression seem normal. That might sound strange if you have depression, but I want to normalize the disease in a way that people – those who have it, those with family members who have it, and the public at large – view it as a relatively “normal” disease, one that can be beaten like cancer.
… and, elsewhere:
– increasing your knowledge and understanding of how depression impacts patients and family members, how the past has shaped current treatment methods, and what the future holds for those who suffer from this disease will provide a firm foundation from which to go forward. The goal of this book is to do just that – to give patients, family members, doctors, and others who wish to learn more a blueprint of the disease's history and treatments, as well as offer hope for a future in recovery.
I go into this here to provide some context for the caveats I'm going to throw out in following. I really wish that I liked this book better than I did. I get the sense that Litzsinger set himself a goal of doing a lot of research, and then brought in a writer (the co-credited Sarah Hamaker) to make a book out of it. There is certainly a lot of material cited (there are nearly 250 end notes for about 140 pages of text), but the book is structured very much like my college research papers … quote after quote strung together with just enough contextifying copy to keep it moving in the right direction. While this certainly lends a sense of “authority” to the material, it inherently creates a situation of very uneven tone in the text, with quoted elements showing up in the middle of paragraphs, or even in the midst of sentences. Of course, given the typical format of my reviews, this is something of “the pot calling the kettle black”, and the book would certainly be a choppy mess if all of those quoted passages showed up as blockquotes, but it makes the reading a less coherent experience than if these cobbled-together parts had been paraphrased and integrated into the narrative flow. Just sayin' …

I only had a handful of bookmarks in here, and most of those were pointing me at sections of the book to refer back to … one bit, however, stood out in the early parts of this, and that's:
… Depression affects the personal identity and social communication of the person suffering from it, which in turn can create difficulties in getting help, contribute to social isolation, and lead to distress. “It can lead to feelings of guilt, anger, and anxiety, and is a pervasive phenomenon …”
As someone who deals with depression, that quote is certainly on-target. This comes from the section on the stigma of the disease. I suppose it would be useful to take a look at the structure of the book … it is in four Parts, “The Disease”, “The Doctors”, “The Treatment”, and “The Recovery”, with “Disease” having four chapters, a history of depression, the chapter on its stigma, and a chapter each on its impact on patients and their families, and the “Doctors” having three chapters, one each on doctors, patients, and their families in relation to doctors and depression. The main part of the book is Part III, on treatment, with nine chapters: treatments in the 20th century, treatments in the 21st century, shock therapy, talk therapy, animal therapy, exercise, nutrition, and chapters on patients and families. The last Part looks again at patients and families, but in relation to recovery. The book wraps up with some very helpful bits, a resources section (including further reading suggestions), and a bibliography (which, admittedly, is mostly research papers).

Needless to say, the above represents quite a lot of material, which is to a greater or lesser extent interwoven with the author's own story, making it somewhat challenging to cherry-pick examples. One thing that I do think was very well done here is a feature of the “families” sections, which presents lists of action points (and paragraphs explaining them) this is from the “Families and Depression Treatment” chapter:

                  Realize depression is serious.
                  Know it's not personal.
                  Recognize the symptoms.
                  Encourage treatment.
                  Accept your limitations.
                  Get screened yourself.
                  Have patience.
                  Don't ignore suicide threats.
                  Keep the person involved.

A similar (albeit “wordier”) list is in the “Families and Recovery” chapter, which has at least one item that I felt was very important:
Remember that hopelessness, disinterest, anxiety, and anger are all depression symptoms.
Given that this sounds like my typical day … it would be great if everybody could keep in mind that the depressed person is not necessarily trying to be a pain in their backsides, or a major drag to the common mood!

The book wraps up with a “Conclusion” chapter that has some very interesting statistics (although the first two seem to be at odds), most shockingly are the figures of “suicide deaths related to depression” in 2013 – 41,149, and the “estimated yearly cost of depression in the United States due to health care and lost productivity at work” - eighty billion dollars (admittedly, this latter figure is from an article in the Huffington Post rather than from the CDC, like the suicide stat).

As noted, I had issues with Out of the Shadows, most as detailed above, although some might be due to my having read a decent amount in this field, and I might have been having a “yeah, yeah, yeah, tell me something that I don't know” curmudgeon reaction that others (approaching this stuff less data-burdened) wouldn't experience. The author is certainly targeting a wide audience (“the public at large”) with this, but I really feel that the optimal reader is a family member of somebody suffering from depression, as this would give them a substantial chunk of information, crafted to “normalize” the perception of the disease.

This is less than a year old at this point, so one might expect it to be available through your local book vendor … except that it doesn't have “a publisher”, with Litzsinger being listed as the publisher with no contact information … it doesn't seem to be a CreateSpace production (which would have bookstore sales available), so I guess the author must have tapped his family contacts to have this printed. It is available from Amazon (although not through, and that looks like it might be the only way to get your hands on it, should this be something you'd find of interest.

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Tags: book review
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