The Art and Science of Overcoming Clinical Depression
Published by Weidenfeld and Nicolson 7 January 2021
217pp, Kindle, £16.99
Reviewed by N.J. Cooper
Oliver Kamm, journalist and columnist, had no idea what had happened to him when he suddenly found himself unable to remember his address or how to get home. This was only one manifestation of a serious depressive illness, which caused him extreme anguish and which took a long time to lift. Since his recovery he has explored the whole subject of depression, both through the writers and artists who have suffered from it for millennia and through the philosophers and scientists who have tried to understand it. He has also undertaken research into the various treatments that have been used, sometimes to dreadful effect as in frontal lobotomy, in order to offer his own experience of what actually works. I am glad that he points out that ECT still has great use in otherwise intractable depression and has been unfairly demonized through such means as the film of One Flew Over the Cuckoo’s Nest.
For anyone acquainted with this cruel disorder, the book offers no new fact. We know that it is an illness and that it is never the sufferer’s fault. (I learned to repeat both these truths to my mother, along with urging her to take her antidepressants, when I was about ten, more than half a century ago.) But there are still, as Kamm repeats, plenty of educated – sometimes medically educated – people who believe that depression is over-diagnosed and chiefly related to lack of resilience, that doctors hand out antidepressants like sweeties, and that patients should just get a grip.
His sharing of the work of writers who have given him comfort with their accounts of symptoms that matched his own provides many pleasures, both of recognition and enlightenment. But it is in his eloquently clear accounts of his own suffering and recovery that the book becomes most valuable. As he found, it is almost impossible to read when in the grip of severe depression and so I imagine that Mending the Mind will be of most practical use to the friends and relations of sufferers.
He writes of the anger and betrayal felt by many such friends and relations, but he does not address two of the symptoms that are hardest for carers to deal with and understand. One is the verbal aggression some sufferers display as they are descending into depression and again as they come out of the trench back towards normal life. The other is that all too many people with depression reject the pills that have been prescribed. Sometimes they simply refuse to take them; at others, they lie and pretend they are taking the full dose. Excuses – or reasons – for this include: ‘I don’t feel like me when I’m taking them’; ‘They take away my creativity’; and ‘They make me feel like a zombie’, to which the only response should be, ‘Isn’t it better to feel like a zombie than to suffer the anguish Oliver Kamm describes so movingly?’ It becomes hard not to think that something about this terrible condition must provide some illusion of safety, as though the responsibility of recovery is simply too frightening.
Kamm found, after a disastrous false start with psychodynamic therapy, that a combination of Cognitive Behavioural Therapy and Compassion-Focused Therapy, with an increased dose of antidepressants, eventually allowed him to think in different ways, to stop catastrophizing, and to train himself to carry out previously impossible practical tasks, such as opening his own front door.
In a way the process struck me as akin to physiotherapy: if you regularly and accurately perform the exercises your physio has prescribed, you will find your knee pain recedes and you can walk upright again in a way that prevents you doing yet more damage to the joint. Clearly CBT and CFT must be provided as readily as physiotherapy.With some missteps, Kamm gradually became aware again of the possibility of pleasure; he learned how to read for hours at a time once more; he found renewed joy in music. And he wrote this book.
I hope that those who doubt the existence of severe depression will be convinced by what he has told us, and I shall go back to many of the writers and thinkers whose work he has quoted because he left me wanting much, much more from them, but I still hope that someone out there, who understands the malady as well as Oliver Kamm does, will write a direct recipe book that can be of immediate use to those who are suffering now – and for those others who are doing their often thankless best to care for them.