Beyond Depression

Abstract Is there an epidemic of depression sweeping the world, or are we radically altering our interpretation of normal human experiences? Do we need a dose of medication or a renewed sense of meaning? In Beyond Depression, Christopher Dowrick - an academic general practitioner - takes a critical insider's look at commonly held views about the diagnosis and management of depression. He argues that our belief in depression as a medical condition is based on some shaky theoretical and functional foundations. He shows how commercial, professional, organisational and cultural factors combine to sustain the popularity of depression as a concept, which is based more on our values than on science. He considers alternative ways of understanding the thoughts and feelings that we currently describe as depression, drawing on cross-cultural, religious, political and literary sources. He proposes a conceptual framework based on the central importance of purpose and meaning for understanding ourselves as active, creative and engaged. This framework provides a means of moving beyond depression as a medical concept and as a personal problem. When applied to encounters between doctors and patients in primary care it leads us towards enabling narratives, with an emphasis on listening and understanding rather than diagnosis and prescription. Beyond Depression combines a comprehensive analysis of current scientific evidence with an impressive review of linguistic, literary and philosophical perspectives. Moving seamlessly between controlled trials and Camus, from prescribing to Proust, the book is informed throughout by a series of sensitive case studies drawn from the author's personal experience.