A Depressing Review

First, if you haven't already, please consider casting a vote for my blog as Best Patient Medical Weblog or vote for one of the other fine blogs out there.

Second, here's an interesting, although wildly biased, review of Peter Kramer's Against Depression and Joshua Wolf Shenk's Lincoln's Melancholy. In it, Bruce Levine, the reviewer points out:

"It may surprise those Americans who believe that modernity is synonymous with progress that in 1860 the U.S. public and press had compassion—and even respect—for Abraham Lincoln’s depression. According to Shenk, Lincoln’s depression may have actually helped him politically more than it hurt him, as it gained him sympathy and drew people toward him. Shenk discovered that Lincoln’s depression 'seemed not a matter of shame but an intriguing aspect of his character, and indeed an aspect of his grand nature'.

Public compassion for Lincoln’s depression in 1860 stands in clear contrast to 1972 when George McGovern’s vice presidential running mate Thomas Eagleton was shoved off the ticket because of his history of depression. Today it continues to be unlikely that anyone with Lincoln’s temperament would receive a presidential nomination. One wonders whether the medicalization of depression—which the psychiatric establishment claimed would eliminate the stigma of “character defect”—instead created the stigma of 'biochemical defect'."

It's an interesting thought, flawed in one respect. Not only did our culture view depression differently by 1972 than it had in 1860, but much of the intense response to Eagleton's depression was because he had been hospitalized and had twice received ECT treatments. I suspect that if ECT had existed in Abe's time that he would've run into similar political problems. There is still much public distrust around people who have been hospitalized much less received ECT. That's just a fact.

In addition, Levine totally gets it wrong when he says "Kramer also attempts to revive the chemical imbalance theory of depression, specifically the serotonin-deficit theory, an idea that much of mainstream medicine now rejects." I would say that only a minority of mainstream doctors have rejected the chemical imbalance theory. If anyone can find me evidence that "much" has rejected it, let me know as it will be news to me. And, yes, I do find the fact that docs continue to cling to a still-unproven theory, um, depressing. Brain chemistry has something to do with it, of course, but the fact is that if it were a complete accounting of the source of depression then a) anti-depressants would work with a high degree of effectiveness and no side effects (sadly, they do not) and b) we'd all be cured. Which we are not.

Thanks to Sara for passing along the review.