24 of 24 people found the following review helpful:
3.0 out of 5 stars
Sincere and empathic, but oversimplifies treatment issues, April 11, 2004
*More Than Moody* is an interesting and very readable book that should be very helpful to parents who want to understand the warning signs of depression in their teen or college-age kids. Depression is discouragingly common today among young people, and all too often parents--especially those with with ambitious, successful kids--refuse to admit their child might have a problem. This denial is understandable, but it often has disasterous consequences. Dr. Kopelwicz does a good job of showing that severe depression can strike any young person, often for no apparent reason, and that avoiding the problem is not an option.
This book's major failing is that it grossly oversimplifies the complexity of depression, and makes treating it look much easier than it often is. Dr. Koplewicz seems to believe--almost as an article of faith--that making a depressed teen well is simply a matter of getting them to take their Prozac, or possibly some other SSRI. This was his approach to Jesse, a high achieving college student disabled by persistent depression.
Jesse's case study was extremely interesting--particularly in showing the ways his successful parents dealt with their gifted son's increasingly severe decline. Jesse's story also revealed a number of problems with Dr. Koplewicz treatment philosophy.
Jesse apparently did better when he was on Prozac, but quit taking it repeatedly. Dr. Koplewicz blames the length and severity of Jesse's depressive episodes on his noncompliance, and his failure to see himself as having a diseased brain that needed drugs to function effectively. Koplewicz laments that it took Jesse six years to graduate from Duke because he wouldn't accept reality and take his pills, and takes some pleasure in reporting that at 30 and on Paxil, Jesse understands that he will need to be take his pills for life. At this point Jesse was supporting himself in the computer industry, but was having trouble with his girlfriend because of his difficulty connecting with her emotionally. (Incidently, emotional flatness [and male sexual dysfunction] is a common side effect of SSRI's like Prozac and Paxil, but Koplewicz declines to share this with the reader.)
Koplewicz doesn't seem to realize that for an adolescent attempting to find his or her own identity, taking a drug that alters personality could cause a frightening confusion over who he or she really was. By effectively forcing Jesse to take Prozac (under threat of hospitalization or expulsion), Koplewicz turned a simple treatment option into a terrifying assault on an immature young man's still-uncertain sense of self. A wiser psychiatrist would have ensured that Jesse had regular psychotherapy to help him with his developmental issues, and would have emphasized that medication was a tool for relieving symptoms, and that if Jesse had problems with one drug, they could try another, or see how therapy alone would work. Koplewicz's overconfidence in the SSRI's and denial of their side effects repeatedly turns his interventions with teenagers into power struggles, in which he becomes [in his young patients' minds] a hostile force determined to brand them defective and drug them into obedience.
Koplewicz simply doesn't seem to know much about how teenagers think. If adolescents feel that their feelings and concerns are being taken seriously, and that they have a choice of treatment options, they are much more likely to be compliant. Therapy is pretty much essential for teen depression--not only can it resolve many cases without medication--it can give a teen a way to work out their feelings and conflicts about using medication, making compliance much more likely.
In general, the reader should know that the SSRI's like Prozac do not work for some people and may have intolerable side effects, like feelings of unreality, emotional numbness, and for males, impotence. Many other drugs are available, though, and a good doctor will be aggressive in finding one (or a combination) that is effective and has an acceptable side-effect profile. If your teen is seriously depressed make sure (in addition to therapy) he or she is seeing a doctor who is comfortable prescribing the older antidepressants (TCA's and MAOI's). They remain the most effective antidepressants known, and can be lifesavers for those who don't respond to the modern drugs.
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13 of 14 people found the following review helpful:
5.0 out of 5 stars
A must read for all parents of teens, October 7, 2002
This review is from: More than Moody (Hardcover)
As a mother who has two children that have suffered from teenage depression, this book is a true breath of fresh air. Koplewicz sheds light to the distiction between regular behavior and clinical depression in an entertaining and informative way that I have not experienced after personally researching the topic for five years.
Thank you Dr. Koplewicz.
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10 of 11 people found the following review helpful:
5.0 out of 5 stars
OUTSTANDING RESOURCE !, October 6, 2002
By A Customer
This review is from: More than Moody (Hardcover)
"More Than Moody" is an outstanding resource for parents and others who are concerned about the emotional and psychological health of adolescents. The narrative provides lucid insights into the clinical presentation of depression and bipolar disorder in youth -- enabling parents to recognize the appropriate "red flags" and best interpret their child's symptoms. The book also provides readers with a clear and thorough understanding of the different approaches to effective treatment and resources that are available to them. The book includes many clinical case studies which serve to not only lend a personal perspective and add poignancy to the narrative, but further illustrate and reinforce the many key points of the author. As with Dr. Koplewicz's other excellent book (It's Nobody's Fault), this book is written in a style that is as easy to read as it is informative. "More Than Moody" is a "must read" for all concerned parents of middle school and high school students.
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