Breaking Free from Depression: Pathways to Wellness. By Jesse H. Wright and Laura W. McCray. Guilford Press (2012).
Book review by Christine Guth. This is a preprint of a review that appeared in the Journal of Religion, Disability and Health (JRDH) ©2012 copyright Taylor & Francis; Journal of Religion, Disability and Health is available online.
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The authors of Breaking Free from Depression: Pathways to Wellness have done an excellent job of gathering and presenting valuable information and useful tools for persons coping with depression. Jesse Wright and Laura McCray, a father-daughter team of mental healthcare physicians, provide up-to-date information on depression and evidence-based treatment strategies. Recognizing the wide variation in reader experience and inclination, they provide readers living with depression an array of “Paths” to choose from that can help overcome persistent barriers to wellness.
The book includes just enough scientific evidence to engender trust in the validity of the material presented without bogging the reader down in technical language. The authors’ encouragement to use the book in collaboration with professional mental healthcare providers is appropriate, given that the illness may make it difficult for many people living with depression to motivate themselves to use the book effectively.
I found the section of the book focused on the Biology Path well-balanced and persuasive. Its chapter on antidepressants could benefit people like some I have known (including myself) who have prolonged our suffering by resistance to considering medications. Another strong section, the Thoughts-Action Path, provides an introduction to Cognitive Behavior Therapy (CBT) and a commendable set of tools for daily, practical use. Exercises and examples provide concrete steps with potential to break into the negative ruminations that plague many who live with depression. I found the book’s presentation of CBT strategies inviting and convincing enough to overcome my initial prejudice against CBT due to a prior bad experience.
Readers may be skeptical of all the worksheets and exercises. A few felt patronizing and trite. I was won over, however, as I made my way through the book. The strategies for breaking into automatic ruminative thinking seemed especially promising.
If you operate by the conviction, “Nothing about us without us,” this book may disappoint. The authors clearly view their readers as people with agency, capable of working toward their own recovery, but the book's acknowledgments ignore patients and their contributions to the authors’ knowledge. Another notable omission is the impact of trauma and post-traumatic stress on depression.
Readers may take interest in the book’s description of the Spiritual Path. In perhaps the book’s weakest section, the authors attempt to describe spirituality in a non-sectarian way. However, the resulting generic version has little to commend it or connect it to real faith communities and spiritual practices that readers find meaningful. Further, the book offers no caution about the burdens that religious traditions have at times laid on people with depression.
The book’s primary audience is people living with depression. Its clear connection to evidence-based practice will appeal most to readers who trust the scientific endeavor. It would be a good choice for persons living with recurrent or treatment-resistant depression, or those who know little about depression and its treatment. The book will be less helpful when depression is severe and has destroyed motivation for self-care. Its clear portrayal of the Paths as possibilities, no one of which is required, will appeal to people who have internal roadblocks about using a given approach.
Depression is marked by protracted stretches of agonized waiting: for a first appointment, for meds to kick in, for misery to end. With its many options for positive action, Breaking Free nurtures hope during the long wait.
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