Depression is a chronic, recurring illness, one that affects twenty percent of the American population. Research confirms that the majority of people suffering from depression do not respond quickly to standard prescribed treatments, whether therapeutic or pharmacological in nature. In fact many existing treatments for depression actually exacerbate the disease. In this provocative book, Richard O'Connor argues that people with depression need a different approach to treatment than any available today. Active Treatment of Depression engages head on many assumptions surrounding depression -- that the new antidepressants are reliably safe and effective, that short-term cognitive and interpersonal therapy is adequate for most patients, and that most patients can recover from an episode of depression without lasting damage. The author argues that a new treatment for depression -- an active treatment -- is needed to help clients. Therapists will be forced to challenge some of their accepted ideas about patient care. Therapists must accept the idea that depression is a chronic disease, and then help their patients plan their lives accordingly. They must help patients learn to find more adaptive ways of functioning with the illness and the therapist must be willing to take an active role in treatment -- to be mentor, coach, cheerleader -- for the client. The book describes what it is like to live with depression -- the effects, the stigma, the difficulty in getting treatment -- and then introduces the "common sense" model of depression. This model emphasizes the multiple biopsychosocial systems involved in the illness. Next, the author outlines the "skills of depression," ways of being that reinforce depressed states. These include stuffing feelings, depressed logic, victimizing, passive aggression, and recruiting accomplices. The balance of the book is a detailed guide to the principles of active treatment. Here, O'Connor walks the reader through the steps of conducting a systematic assessment of the patient, engaging the patient's emotions in the treatment process, and the plusses and minuses of antidepressant medications. There is a thorough discussion of the therapist's need for flexibility in the use of his own experience with the patient. Throughout this practical yet personal book, the author shares his own experiences in battling depression and thus lends a valuable human dimension to the issues at hand.

Richard O’Connor, who lives in Lakeville, CT, also wrote Undoing Depression.

Tags: active treatment depression