Depression, the insidious mental disorder that affects nearly seven percent of Americans (National Institute of Mental Health), is notorious for both its prevalence and for how difficult it can be to conquer. The 10 Best-Ever Depression Management Techniques: Understanding How Your Brain Makes You Depressed and What You Can Do to Change It, bills itself as a how-to book for getting oneself out of depression’s clutches, complete with step by step instructions. Margaret Wehrenberg, PsyD and also the author of The 10 Best-Ever Anxiety Management Techniques, uses neuroscientific research to “provide a strategy-filled handbook to understand, manage, and conquer your depression” (back cover).
While the book is chock full of helpful ideas and detailed information on how depression works in the brain and what can be done to combat it, the method of communication is ultimately more useful for those who want to learn more about depression, not necessarily for those who are suffering from it.
The majority of the book is organized with one technique per chapter; however, the first section concentrates on providing the background and context of depression and treatment. The introduction includes data and statistics that show the effect this disorder has on the American population as well as an overview of treatment options, emphasizing that the range of choices is great, but can also be very confusing. It uses this view to clearly lay out the goal of the book: “…to offer insight into how the inner workings of the brain contribute to depression, and in doing so, shed light on how to more effectively control its symptoms” (p. 3).
Chapter 1 is all about the brain anatomy, mechanics, and neurotransmitters involved in the biology of depression. It is detailed, linking each part of the brain structure and each neurotransmitter to specific depression symptoms; for example, the anterior cingulated gyrus is responsible for rumination, worry, and inflexible attitude (p. 31). Chapter 2 continues with information on treating depression with medication. Note is made of the prevailing view that medication is most useful when combined with psychotherapy, and how each different type of medication affects different pathways in the brain is explained.
When introducing the concept of using the 10 techniques to manage depression, the author does include clarification on how to best work through the book. She advises starting with the techniques that most specifically match the patient’s most severe symptoms, and progressing from there. She also reminds the reader:
“These techniques are straightforward, proven ways to alleviate depression and are intended for symptom management. They can be done by anyone. They are not, however, meant to replace psychotherapy if depression is severe or recurrent. They will not relieve depression that is the result of trauma unless the trauma is resolved, nor will they take the place of long-term treatment for complicated mental-health disorders.” (p. 5 )
With those caveats, Chapter 3 is the first of the remaining chapters to detail the techniques one at a time. It starts the progression with “Identify Triggers, Plan New Responses,” which profiles the four main causes of depression and how these can be countered by stopping patterns of response. Chapters 4-6 , entitled “Start Where You Already Are,” “Mobilize Your Energy,” and “Cool Down Burnout,” are concerned with the lack of motivation and detachment from daily life that result from depression and suggest small changes in routine that can increase energy flow. This can then help with overcoming the other symptoms of depression, since there is more motivation to take action.
Chapters 7-9 cover the isolation, imbalanced priorities, and destructive behavior that comprise the depressive patient’s modus operandi, combating this cycle with strategies of encouraging connectedness and working with something greater than oneself. Chapters 10-11 start to focus on developing positive attitudes and behaviors, rather than simply ceasing the negative ones, and the list of techniques ends with #10, “Learn to Live Fully.” This final chapter addresses how:
“Recovering from depression isn’t just about getting rid of symptoms—it’s also about focusing on how to live in a different way[…] Living fully means embracing all that happens. You can be not only safe but much more resilient if you can fully appreciate all of the wonderful, delightful experiences that come to you.” (p. 247)
The book concludes with Appendices that include worksheets for both patients’ and therapists’ use in dealing with depression as well as an extended collection of recommending reading and resources for further research.
In reviewing the book, the first thing one notices is the title, which sounds more like a business or how-to book than a psychological self-help book. Depression is marked by a lack of energy and initiative, not to mention guilt for feeling that way, and this reader is concerned that the title makes recovering from this serious disorder sound easy—as long as you follow these 10 simple steps, you’ll be just like new! This could add to the discouragement and guilt already felt by those who are depressed, because if it’s really that easy, why aren’t they feeling better? It’s too much like the well-meaning relative who says, “Just smile more and you’ll snap out of it!”
To be fair, Wehrenberg emphasizes the seriousness of depression throughout the book as well as the biological factors underlying it; however, if all one sees is the title before reading through the entire book, it could give the wrong impression.
This reader could easily see the first, textbook-like section of the the book—the introduction and first two chapters—used in a college classroom. For some, the in-depth explanation of brain biology and neurotransmitters may be helpful in convincing them that depression isn’t a choice and needs to have its underlying causes treated. For others, though, looking for an easy-to-follow path out of the darkness, the density of content could be overwhelming. Two exceptions are the section in Chapter 1 that matches each neurotransmitter to the specific symptoms it can cause and the question section in Chapter 2, which is geared toward helping the reader determine if medication would be helpful or is necessary for them. This type of content, appearing from time to time throughout the book, is very useful and helps to keep the content relevant for the intended audience. The other tool the author uses that is valuable in helping with ease of understanding is metaphor:
“Even if the number of neurotransmitters and their transmission are fine, depression can occur if there are problems on the receiving end of the transmission. Just like a radio needs to be tuned to receive the signal, neurons need to be primed and ready to receive a neurotransmitter.” (p. 15)
Although most of the techniques in the book make a lot of sense and would definitely benefit a person with depression if carried out, some strike this reader as, well, just silly. Using superlatives in speech, as suggested as a part of Technique #8, is an example. Just because you say something is the “best ever!” doesn’t mean that it is, and could even throw into sharp perspective exactly how hopeless life seems at the moment.
The techniques presented later in the book tend to include step by step instructions for many of the processes that are beneficial in explaining exactly what needs to be accomplished in order to benefit as much as possible from each strategy. This eliminates some of the vague generality of the earlier techniques.
In conclusion, The 10 Best-Ever Depression Management Techniques is full of useful information on the biological causes of depression and how certain methods can be employed to alter brain chemistry to ultimately recover from the disorder. The way the book conveys these messages, though, seems more appropriate for a student or a patient’s relative rather than for a patient him/herself.