Again, Dowling (Perfect Woman, 1988, etc.) uses personal experience—her daughter's depression—as the springboard for her writing, this time arguing for the primary role of brain biochemistry in a large number of illnesses frequently considered biological in origin. Dowling believes, along with Hudson and Pope (Harvard psychiatrists who identified affective spectrum disorder) that the level of serotonin, a brain hormone, has as much to do with mental status as do environmental influences, and she urges medication for depressed patients to restore and regulate equilibrium. Having seen her daughter successfully treated with an antidepressant, she eagerly encourages others to seek similar relief for mood disorders, and goes on to examine the broad range of diagnoses- -bulimia, PMS, obsessive-compulsive disorder, addictions, kleptomania—that respond to these medications. Psychiatrists, she finds, often take incomplete family histories, miss cases of depression, undermedicate, or fail to recognize and treat dual illnesses (e.g., depression and addiction). Also, most people see mood as a matter of personal control and resist professional intervention. Dowling realizes that many will resist this point of view (``Life is flattened, we feel, by a one-dimensional, chemical approach to the brain''), and she tries to persuade with anecdotal case histories, always recommending psychotherapy as part of the process, not merely to monitor dosages and possible side effects but also, as one psychiatrist sees it, to learn ``to unravel what is normal personality from what the illness has superimposed upon it.'' No researcher, Dowling admits, has established a cause-and- effect relationship between serotonin and these mood disorders, just an association, so she does not insist that her argument is more than plausible. She does insist, though, some antidepressant will always relieve these conditions, a certainty many psychiatrists will dispute. As in Dowling's previous books, readers will recognize themselves, welcome the accessible vocabulary, and appreciate the balanced presentation of related issues (will people use PMS as evidence of inferiority or reason for discrimination?). Expect the warmest response from a nonprofessional audience.
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