In his landmark bestseller Listening to Prozac, Peter Kramer revolutionized the way we think about antidepressants and the culture in which they are so widely used. Now Kramer offers a frank and unflinching look at the condition those medications treat: depression. Definitively refuting our notions of "heroic melancholy," he walks readers through groundbreaking new research—studies that confirm depression's status as a devastating disease and suggest pathways toward resilience. Thought-provoking and enlightening, Against Depression provides a bold revision of our understanding of mood disorder and promises hope to the millions who suffer from it.
Against Depression
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Book Description
Editorial Reviews
Amazon.com Review
Written as an answer to the question, "What if van Gogh had been on anti-depressants," Against Depression manages to be more of an exploration than a polemic, regardless of its title. While author Peter Kramer (Listening to Prozac) expresses a definite opinion--that disease of any sort should be treated as effectively as possible--he manages to express sympathy along with frustration about the recurring idea that soulful creativity often goes hand-in-hand with depression. Without ever being dismissive or particularly angry, his writing makes his point abundantly clear after the first chapter: The pervasive idea of depression serving a creative purpose is preposterous, as well as highly damaging.
While he draws from a number of recent studies on depression, the book is not meant to assist in the diagnosis or treatment of individuals, except in a very general sense. Instead, Kramer adds the findings of those studies into his thoughts on how patients modify medication doses for depression as they wouldn't for purely physical diseases, and looks into future possibilities of genetically modified stress hormone transmitters that could work to prevent a slide into chronic depression. In the arts, he examines the work of philosophers, painters and writers in relation to the reputation their personal lives have earned (critics and consumers alike believe that pain equals genius and lack of pain equals lack of depth). Adding Dineson, Bellow, Updike and Kierkegaard to the list headed by van Gogh, Kramer shows a variety of ways we live with the assumption that creative genius does not function without severe emotional strain.
While he does include a few stories from a patient to illustrate specific treatments, most of the book is slow and thoughtful, without ever being dry or pedantic. Useful to families or individuals who have encountered depression, this book offers excellent support for anyone--creative genius or otherwise--who struggle to define their talents as existing separately from their illness. Jill Lightner --This text refers to an out of print or unavailable edition of this title.
From Publishers Weekly
Starred Review. What is depression really, and how does society define it? Kramer, a famed psychiatrist and author of the 1993 bestseller Listening to Prozac, says he has written "an insistent argument that depression is a disease, one we would do well to oppose wholeheartedly." In making his argument, Kramer examines the cultural roots of notions about depression and underscores the gap between what we know scientifically and what we feel about the illness. Kramer traces depression from Hippocrates through the Renaissance and Romantic "cult of melancholy" to advances in medicine, psychiatry and psychotherapy, and at last to the disease we now know it to be. Kramer's curiosity drives the book forward as he ponders why we value artwork and literature built on despair: "certain of our aesthetic and intellectual preferences have been set by those who suffer... deeply." The book maintains the perfect balance between science and human interest, as the author details both psychiatric studies and personal experience. A comparison of the biochemical workings of depression with the physical and observable symptoms serves as an intellectual trip for readers and provides a thorough exploration of what Kramer dubs "the most devastating disease known to humankind." The book is rich with questions that engage the reader in an active dialogue: Why is society captive to depression's charm? And will this infatuation change with the emergence of more evidence regarding depression's severely disabling effects? Kramer leaves off with these questions to ponder. Resolute but not preachy, this book is an important addition to the growing public health campaign against depression. As for how we should define depression—perhaps it's best understood by its opposite: "A resilient mind, sustained by a resilient brain and body." One Spirit and Discover Book Club selections. (May 9)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to an out of print or unavailable edition of this title.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to an out of print or unavailable edition of this title.
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72 of 77 people found the following review helpful
Format:Hardcover|Amazon Verified Purchase
Dr. Peter Kramer was a general practice psychiatrist and philosopher who became intrigued and troubled by ethical issues proceeding from the introduction of SSRI medications in the 1980's. He cared enough about these concerns to pen "Listening to Prozac" in 1993, a best seller that, by his own exasperated admission, turned his own life upside down in terms of public perception. He was now "America's depression doctor," a position he neither sought nor relished. But, having been pushed up the steps of the bully pulpit, he decided to tackle his nemesis head-on, and the end product is our work at hand.
With his heightened sensitivity to depression, a new wave of depressed clients pounding his door, and countless speaking engagements and seminars, Kramer became aware that the medical condition of depression carried an aura of mystique and superiority that would never be tolerated in other disorders such as diabetes or cancer. Yes, individuals with painful diseases can grow in character through surgeries, chemotherapies, or deprivations. But no one actively cultivates the condition of cancer as an enhancement of the human situation.
Perhaps an irreverent title for this work might have been "A Tale of Two Prozacs," for the author divides his work into the misconceptions and canonizations of depressed mood, on the one hand, and the hard reality of this disease on the other. There is, he contends, a prevailing belief that mental health disorder and/or substance abuse unleashes creative energy and expands the life experience. As a psychotherapist myself, I do not need to revert to stories of Hemingway or Van Gogh. Nearly every teenager on psychotropic medication raises the question of whether "I'll still be myself." My reassurances that this is precisely our treatment goal are heard warily and with skepticism. They would probably agree with a doctor friend of mine who joked that if Prozac had been invented centuries ago, there would be no Irish folk music.
Kramer is fed up with the toleration of depression, particularly among adults, intellectuals, professionals, artists, and particularly some of his own colleagues. He assesses the false faces of depression, such as charm. He takes note of depressive stereotypes, such as the weak and sensitive depressed woman whose vulnerability presents an alluring attraction to men, or literature's subtle and continuous glorification of those who live as if life meant nothing. He decries the intellectuals' distrust of Carl Rogers for embracing enthusiasm instead of worshipping at the altar of alienation [100 ff.]
"Listening to Prozac" had been an excellent overview of the neurobiology of depression as understood in 1993, a time when the exchange of neurotransmitters such as serotonin dominated both conceptual thinking and pharmaceutical investigations. If LTP had been about a pill, AD describes what Prozac's offspring might look like, if they had been born yet. This of course is a major difference in Kramer`s two works: LTP begins with a pill, while AD begins with hypotheses. In this work Kramer examines more recent research that generally has not yet evolved into psychotropic medicine. One new source of depressive theory comes from Grazyna Rajkowska [52 ff.], an anatomist who explored the prefrontal cortex of the brain in autopsies. Under microscopic examination she found the cells of this region of the brain weakened, disorganized, disconnected, possibly but not certainly due to reduced blood flow to the region. Such a syndrome is seen in more intensive form in Huntington's and Alzheimer's Disease, a connection which, if continuously verified, would certainly lead to a paradigmatic shift in approaching the significance and treatment of depression.
Kramer does not discard the neurotransmitter model he described so eloquently in LTP. Present day treatment modalities, including Prozac, will continue to man the fort for the foreseeable future. But he argues persuasively that the theory is more complex than previously thought,. In his reviews of brain deprived neurotropic factor [120 ff.], 5-HTT genes as "stress police [130 ff.], Yvette Sheline's study of the hippocampus, and Fred Gage's theory of neurogenesis or the replacement of diseased neural cells, Kramer exudes less confidence that the secrets of depression will be unpacked soon, or that new generation miracle drugs will reach the corner pharmacy imminently.
Kramer's early concerns about depression medication as cosmetic have been replaced by concern and anger about the double standard regarding attitudes toward depression by the medical profession and the public alike. Kramer depicts depression as a killer, as dangerous as plague and prevalent in epidemic proportions. He argues that the disease must be attacked ruthlessly, and here he takes issue with what he sees as a somewhat casual approach to the disease by those who espouse psychotherapy as the long term answer, or those hesitant to medicate, or even those who consider the depressed state as a creative matrix or Nietzschian pose of alienation. Chapters 17 and 18 are perhaps the highlights of the work, where art, history, and culture come face to face with biology, in the philosophical style that made LTP such a pleasure to read.
LTP was a leisurely thoughtful work. AD is not. For the most part it is more scientific and certainly more polemical. LTP was speculative about the possibilities of psychiatry and medication. AD is acute in its assessment of the present, particularly regarding cultural attitudes toward this disease. I am struck by the impression that after over a decade as "America's depression doctor," the author is sounding more...well, depressed.
With his heightened sensitivity to depression, a new wave of depressed clients pounding his door, and countless speaking engagements and seminars, Kramer became aware that the medical condition of depression carried an aura of mystique and superiority that would never be tolerated in other disorders such as diabetes or cancer. Yes, individuals with painful diseases can grow in character through surgeries, chemotherapies, or deprivations. But no one actively cultivates the condition of cancer as an enhancement of the human situation.
Perhaps an irreverent title for this work might have been "A Tale of Two Prozacs," for the author divides his work into the misconceptions and canonizations of depressed mood, on the one hand, and the hard reality of this disease on the other. There is, he contends, a prevailing belief that mental health disorder and/or substance abuse unleashes creative energy and expands the life experience. As a psychotherapist myself, I do not need to revert to stories of Hemingway or Van Gogh. Nearly every teenager on psychotropic medication raises the question of whether "I'll still be myself." My reassurances that this is precisely our treatment goal are heard warily and with skepticism. They would probably agree with a doctor friend of mine who joked that if Prozac had been invented centuries ago, there would be no Irish folk music.
Kramer is fed up with the toleration of depression, particularly among adults, intellectuals, professionals, artists, and particularly some of his own colleagues. He assesses the false faces of depression, such as charm. He takes note of depressive stereotypes, such as the weak and sensitive depressed woman whose vulnerability presents an alluring attraction to men, or literature's subtle and continuous glorification of those who live as if life meant nothing. He decries the intellectuals' distrust of Carl Rogers for embracing enthusiasm instead of worshipping at the altar of alienation [100 ff.]
"Listening to Prozac" had been an excellent overview of the neurobiology of depression as understood in 1993, a time when the exchange of neurotransmitters such as serotonin dominated both conceptual thinking and pharmaceutical investigations. If LTP had been about a pill, AD describes what Prozac's offspring might look like, if they had been born yet. This of course is a major difference in Kramer`s two works: LTP begins with a pill, while AD begins with hypotheses. In this work Kramer examines more recent research that generally has not yet evolved into psychotropic medicine. One new source of depressive theory comes from Grazyna Rajkowska [52 ff.], an anatomist who explored the prefrontal cortex of the brain in autopsies. Under microscopic examination she found the cells of this region of the brain weakened, disorganized, disconnected, possibly but not certainly due to reduced blood flow to the region. Such a syndrome is seen in more intensive form in Huntington's and Alzheimer's Disease, a connection which, if continuously verified, would certainly lead to a paradigmatic shift in approaching the significance and treatment of depression.
Kramer does not discard the neurotransmitter model he described so eloquently in LTP. Present day treatment modalities, including Prozac, will continue to man the fort for the foreseeable future. But he argues persuasively that the theory is more complex than previously thought,. In his reviews of brain deprived neurotropic factor [120 ff.], 5-HTT genes as "stress police [130 ff.], Yvette Sheline's study of the hippocampus, and Fred Gage's theory of neurogenesis or the replacement of diseased neural cells, Kramer exudes less confidence that the secrets of depression will be unpacked soon, or that new generation miracle drugs will reach the corner pharmacy imminently.
Kramer's early concerns about depression medication as cosmetic have been replaced by concern and anger about the double standard regarding attitudes toward depression by the medical profession and the public alike. Kramer depicts depression as a killer, as dangerous as plague and prevalent in epidemic proportions. He argues that the disease must be attacked ruthlessly, and here he takes issue with what he sees as a somewhat casual approach to the disease by those who espouse psychotherapy as the long term answer, or those hesitant to medicate, or even those who consider the depressed state as a creative matrix or Nietzschian pose of alienation. Chapters 17 and 18 are perhaps the highlights of the work, where art, history, and culture come face to face with biology, in the philosophical style that made LTP such a pleasure to read.
LTP was a leisurely thoughtful work. AD is not. For the most part it is more scientific and certainly more polemical. LTP was speculative about the possibilities of psychiatry and medication. AD is acute in its assessment of the present, particularly regarding cultural attitudes toward this disease. I am struck by the impression that after over a decade as "America's depression doctor," the author is sounding more...well, depressed.
22 of 23 people found the following review helpful
By Bob P.
Format:Paperback
Kramer wrote this book after being deluged by stories of depression, depression research, and patients after he wrote Listening to Prozac.
While touring for his previous books, he would often be asked a question, "what if Van Gogh had taken prozac?" The real question he's being asked is whether depression should be cured, or whether curing depression would take away something that is an essential part of being human.
The book is really making the argument "against depression" - there is nothing romantic or especially meaningful about it.
He writes, convicingly, that depression is a disease that has specific physical indications. The physical causes of this disease are close to being understood.
He writes that other diseases - such as tuberculosis (then called consumption) - used to have romantic implications. They are now considered just ordinary diseases that need to be cured.
While making this point, he touches on treatments for depression - some of them incredibly clever - that may be coming out over the next 5 to 20 years.
If you have suffered from depression and are not sure how you think about it - along the lines of the book: "should I be cured, or if I get treatment will I lose 'part of myself'?" then I'd highly recommend this book. Also recommended if the underlying question is interesting to you - maybe you know someone who suffers from depression, or are just curious about the human condition.
While touring for his previous books, he would often be asked a question, "what if Van Gogh had taken prozac?" The real question he's being asked is whether depression should be cured, or whether curing depression would take away something that is an essential part of being human.
The book is really making the argument "against depression" - there is nothing romantic or especially meaningful about it.
He writes, convicingly, that depression is a disease that has specific physical indications. The physical causes of this disease are close to being understood.
He writes that other diseases - such as tuberculosis (then called consumption) - used to have romantic implications. They are now considered just ordinary diseases that need to be cured.
While making this point, he touches on treatments for depression - some of them incredibly clever - that may be coming out over the next 5 to 20 years.
If you have suffered from depression and are not sure how you think about it - along the lines of the book: "should I be cured, or if I get treatment will I lose 'part of myself'?" then I'd highly recommend this book. Also recommended if the underlying question is interesting to you - maybe you know someone who suffers from depression, or are just curious about the human condition.
22 of 23 people found the following review helpful
By A. Miller
Format:Hardcover
This is, hands down, the best book I have ever read about the multifocal and devastating effects of depression. It is extremely well researched, thoughtful, and is exactly the book that is needed to dispel the erroneous notions that persist regarding depression. There is nothing at all charming or intriguing about depression.
Most Recent Customer Reviews
3.0 out of 5 stars
One of the best descriptions of depression, but no new ideas for...
This book is one of the best descriptions of depression I have ever read. It is a disease and, in my opinion, a slight form of real madness, and I have always suspected real brain... Read more
Published 7 months ago by Whitaker
5.0 out of 5 stars
A Transformative Book: and Good Therapy
The book makes a strong and convincing case for the need to vigorously fight depression as an illness, and advocates a clinically-based combination of both cognitive behavior... Read more
Published 7 months ago by Movia
5.0 out of 5 stars
Are you worried about taking anti-depressants?
When I was diagnosed with clinical depression, and started medication, I felt lost and flustered. Would I lose my sense of self through anti-depressants? Read more
Published on February 24, 2011 by Jessica E Moss
5.0 out of 5 stars
Ambitious Book
Peter Kramer is a fallback to previous eras where enormously talented psychologists and psychiatrists ranged over broad material, both from within the discipline and from without,... Read more
Published on December 29, 2010 by Damon G. Labarbera
4.0 out of 5 stars
Against the myth of depression and artistic creativity
If you are looking for a source of practical information on the disease called unipolar major depression and are interested in learning about how this condition is medically... Read more
Published on August 8, 2010 by Alvin J. Martínez
4.0 out of 5 stars
Deeply humane
This is in some respects an uneven book, and I wonder whether Kramer's purpose wouldn't have been better served with a less overtly polemical approach. Read more
Published on June 16, 2010 by P. Stern
5.0 out of 5 stars
Reviewers, PLEASE
Have some respect for the authors and the people reading what you write, and please review a book on its own terms. Read more
Published on July 18, 2009 by Rhapso
4.0 out of 5 stars
Understanding is the first step to healing
Peter Kramer helps us understand our level of human suffering. There are not many of us who have never felt depressed. Read more
Published on February 12, 2009 by Jackie M. Sthilaire
4.0 out of 5 stars
Good research amidst the fluff
The fluff: Kramer indulges his avocational interests in art and literature by presenting a pet thesis that society is reluctant to cure depression because we've romanticized it. Read more
Published on November 3, 2008 by gotmojos books media
2.0 out of 5 stars
A Book for those Who Want to Be Fustrated
This author promises you nothing; worse, the best he can offer is like saying good luck after your house just burned to the ground. Read more
Published on August 26, 2008 by Steven Lance
Front Cover | Front Flap | Table of Contents | First Pages | Index | Back Flap | Back Cover | Surprise Me!
