Eye-opening survey of the many shapes and forms of depression, from ancient history to today.
As science writer Riley notes in his concise, refreshing debut book, depression is a vastly complex collection of overlapping mental states, the product of genes, neurotransmitters, upbringing, health, trauma, diet, lifestyle, and other factors. Though the depressed state of mind has always been with us, under many names and guises, there are distinct moments when it has drawn particular attention. The author delves into these moments with notable vigor, insight, and scientific background information. Riley begins in the early years of the first millennium C.E. with Galen and his theories about the four “humors,” which would impact medical science for centuries to come, and then moves to the late ninth century and Abu Zayd al-Balkhi, who studied the effects of “negative thinking.” Little progress was made until the first asylums in the 18th century, which focused on “respect, leisure, diet, light occupation, and a gradual realignment with reason and reality.” As Riley moves into the formative work of Emil Kraepelin and Freud, he begins to weave in his own struggle with depression, effectively humanizing the narrative. The author provides a sturdy overview of the evolution of the psychoanalytical and biological worlds of psychiatry, from dementia praecox and manic depression to Freud’s mission to “find what his patients were hiding away, to fill it with color and meaning.” Treatments would rise and fall—e.g., various forms of lobotomies—and some would rise again (electroshock therapy). Riley discusses numerous studies and anecdotes to illustrate the positives and negatives of each approach to treatment, including modern-day investigations into cognitive behavioral therapy, psychoactive drugs (ayahuasca, LSD, etc.), and deep brain stimulation, often employed for patients whose “depression seemed intractable. A diversity of drugs—antidepressants, antipsychotics, tranquilizers, mood stabilizers—couldn’t budge their mental anguish.”
A welcome examination, both studious and intimate, of one of humanity’s great miseries.