BREAKING THROUGH DEPRESSION

A leader in the field explains how the nightmare of depression is slowly being overcome.

Gold, who has worked at the National Institutes of Health since the mid-1970s, is an acclaimed expert in the treatment of depressive disorders. In this book, he looks ahead to an emerging generation of remedies. The author estimates that 15%-20% of the population suffer from depression in some form. For decades, depression was seen as an illness to be treated by psychiatric methods, but the past 20 years have seen the emphasis shift to biology. Health professionals now view depression as a neurodegenerative disease associated with the loss of tissue in key parts of the brain, resulting in chemical imbalances and synaptic failures. In particular, Gold believes that depression represents a stress response that has gone awry. Working from this premise, scientists have designed new drugs to help the brain rebuild pathways and repair damaged tissue. There is the possibility of treatments customized to the needs of different patients, and early research is promising. The author tracks the history of antidepressants, drawing on cases and clinical studies, including ones in which he was personally involved. Drugs like psilocybin and ketamine are now being used, and they have the advantage of taking effect quickly. Another area of research is targeted electrical stimulation of the brain, including repeated magnetic pulses. Researchers are also investigating the genetic aspects of depression, which might open the way for gene therapy and drugs to build resilience. Gold emphasizes that he is not against psychiatric treatment. In fact, he sees psychotherapy and biochemical therapy in combination as the most effective way to treat depression. The book could easily have become bogged down in technical jargon, but the author writes accessibly, making the book an informative, enjoyable read.

A fascinating look at a debilitating malady and the new wave of thinking and treatments.