Depression
Resources

 email page    print page

All Topic Reviews
A Mood ApartA Sadly Troubled HistoryActive Treatment of DepressionAdolescent DepressionAdult Bipolar DisordersAgainst DepressionAgents in My BrainAmerican ManiaAmerican MelancholyAn Unquiet MindArtificial HappinessBeating the BluesBefore ProzacBeyond BlueBiological UnhappinessBipolar DisorderBipolar Disorder DemystifiedBipolar Disorder in Childhood and Early AdolescenceBipolar DisordersBipolar ExpeditionsBlaming the BrainBoy InterruptedBritain on the CouchCalm EnergyCase Studies in DepressionChange Your ThinkingChronic DepressionComprehending SuicideConquering Postpartum DepressionConquering the Beast WithinCry Depression, Celebrate RecoveryDamageDepressionDepression 101Depression and GlobalizationDepression and NarrativeDepression Doesn't Always Have to Be DepressingDepression FalloutDepression in ContextDepression Is a ChoiceDepression SourcebookDepression, Emotion and the SelfDepression, the Mood DiseaseDepression-Free for LifeDetourDiagnostic Issues in Depression and Generalized Anxiety DisorderDown Came the RainDowning Street BluesDysthymia and the Spectrum of Chronic DepressionsEight Stories UpElectroboyElectroshockEssential Psychopharmacology of Depression and Bipolar DisorderExperiences of DepressionFacing BipolarFast GirlFatal AttachmentsGetting Your Life BackGod HeadHandbook of DepressionHandbook of DepressionHello to All ThatHelping Students Overcome Depression and AnxietyHow Everyone Became DepressedHow I Stayed Alive When My Brain Was Trying to Kill MeHurry Down SunshineI am Not Sick I Don't Need Help!Journeys with the Black DogLeaving YouLet Them Eat ProzacLife InterruptedLifeForce Yoga to Beat the Blues--Level 1LifeForce Yoga to Beat the Blues: Level 2Lifting DepressionLifting the WeightLincoln's MelancholyLiving Without Depression and Manic DepressionLong ShotLucy Sullivan Is Getting MarriedMadnessMaking Sense of SuicideMalignant SadnessManiaManicManic DepressionManufacturing DepressionMelancholiaMindfulness for Urban Depression: Tools for Relief from Stressful City LivingMindfulness-Based Cognitive Therapy for DepressionMood GenesMoody Minds DistemperedMy DepressionNatural Healing for DepressionNew Hope for Children and Teens with Bipolar DisorderNew Hope For People With Bipolar DisorderNew Hope for People with DepressionNight Falls FastNovember of the SoulOn DepressionOn the Edge of DarknessOne in ThirteenOrdinarily WellOut of the BlueOutsmarting DepressionOvercoming DepressionPerfect ChaosPotatoes Not ProzacProzac and the New AntidepressantsProzac BacklashProzac HighwayProzac NationProzac NationPsychotic DepressionPuppy Chow Is Better Than ProzacQuiet Your Mind & Get to SleepRaising a Moody ChildReasons to Stay AliveScattershotSelf-CoachingSightlinesSilencing the Self Across CulturesSilent GriefSongs from the Black ChairSongs Without WordsSpeaking of SadnessSpontaneous HappinessStudent DepressionSubordination and DefeatSuicidal Behavior in Children and AdolescentsSuicideSunbathing in the RainSurvival Strategies for Parenting Children with Bipolar DisorderSurviving Manic DepressionSwing LowSylvia Plath ReadsTalking Back to ProzacTaming Your Inner BratThe Aesthetics of DisengagementThe American Psychiatric Publishing Textbook of Mood DisordersThe Anatomy of MelancholyThe Anti-Depressant Fact BookThe Antidepressant EraThe Antidepressant SolutionThe Antidepressant Survival ProgramThe BeastThe Bell JarThe Best AwfulThe Bipolar ChildThe Bipolar Disorder Survival GuideThe Blue Day BookThe Breakthrough Depression SolutionThe Clinical Science of Suicide PreventionThe CorrectionsThe Cruelty of DepressionThe Depressed ChildThe Depression CureThe Depression WorkbookThe Devil WithinThe Emotional RevolutionThe Family SilverThe Feeling Good HandbookThe Forgotten MournersThe Loss of SadnessThe Memory of LightThe Mindful Way through DepressionThe Mood CureThe Myth of Depression as DiseaseThe Naked Bird WatcherThe Nature of MelancholyThe Noonday DemonThe Pits and the PendulumThe Postpartum EffectThe Secret Strength of DepressionThe Van Gogh BluesThe Van Gogh BluesThe Weariness of the SelfThe Years of Silence are PastThirteen Reasons WhyThis Close to HappyTo Walk on EggshellsTreatment for Chronic DepressionUndercurrentsUnderstanding DepressionUnderstanding DepressionUndoing DepressionUnhappy TeenagersUnholy GhostUnstuckViniyoga Therapy for DepressionWhat Goes UpWhat the Birds SeeWhat Works for Bipolar KidsWhen a Parent is DepressedWhen Nothing Matters AnymoreWhen Someone You Love Is DepressedWhen Words Are Not EnoughWhen Your Body Gets the BluesWhere the Roots Reach for WaterWhy Are You So Sad?Why People Die by SuicideWill's ChoiceWriting Through the DarknessYou Are Not AloneZelda

Related Topics
When a Parent is DepressedReview - When a Parent is Depressed
How to Protect Your Children from the Effects of Depression in the Family
by William R. Beardslee
Little Brown & Company, 2002
Review by Jack R. Anderson, M.D.
Feb 12th 2004 (Volume 8, Issue 7)

This is an extraordinary book written by an extraordinary author. Beardslee shares with his readers the clinical insights he has gained during thirty years of psychiatric practice, but he doesn't stop there. He also explains how decades of experience with the inadequacies and inequities of the American health care system have led him to a set of core principles for changing our care system. Two of these principles are "…mental health care and physical health care are inseparable." and "…we must have universal access and universal coverage for both mental and physical illness, for all adults and children."

In his Introduction, subtitled "A New Way of Helping Families," the author stresses that the benefits of his treatment method are not achieved in one or two sessions, but instead by continuing the treatment program over a period of years. He describes a study of 275 youngsters from 143 families, in which most of the families were seen for four years and many for even longer. These studies of depression have convinced him that pessimism about family treatment outcomes is not justified. He notes: "Many children raised in the most challenging of circumstances overcome their difficulties and become remarkably healthy and happy adults."

Beardsley shares with us some personal history related to his interest in family treatment for depression. His older sister was profoundly depressed and committed suicide. In his words: "As I have struggled to help families make sense of their experience, I have also struggled to make sense of my own."

 

Chapter One, "Beginning the Journey" lists six steps or stages of family treatment:

1.      Sharing a history together

2.      Bringing knowledge about depression and resilience to bear on their own unique circumstances

3.      Addressing the needs of the children

4.      Planning how to talk to the children

5.      Breaking the silence together as a family

6.      Continuing the family dialogue

The next thirteen chapters of the book are devoted to discussions of these six steps and to addressing the problems that arise during the various stages as the program continues over the years.. In addition to the family sessions, Beardslee recommends other forms of concomitant treatment be considered; for example, Cognitive Therapy, Cognitive-behavioral therapy, Interpersonal therapy and medication.

There are no generalities in these chapters. They are filled with specific problems of specific children, and specific parents in specific families. I didn't count them all, but there must be more than fifteen different children discussed at various stages of their development, and nearly that many sets of parents.

 

"Resilience" is a word that occurs frequently throughout the book; Chapter five is entitled "Resilience in Action." My dictionary gives two meanings for the word: 1. "the capability of a strained body to recover its size and shape after deformation caused esp. by compressive stress" and 2. "an ability to recover from or adjust easily to misfortune or change." The author describes how the treatment processes he describes contribute to the development and strengthening of resilience in developing children. He lists some of the steps along the way to attaining resilience:

1.      Becoming separate. Children learned that they were separate from their depressed parents or siblings and were not responsible for their feelings.

2.      Putting experience into words. As they became able to verbalize their problems, they could better understand them and make realistic plans to deal with them.

3.      Developing relationships. As separate individuals, children were able to maintain their own points of view and at the same time appreciate the viewpoints of significant others.

Chapter Ten, "Jesse," subtitled "Becoming the Author of One's Own Story," illustrates the author's concept of how resilience develops over a long period of treatment.

Beardslee first saw Jesse when he was eight, one year after his mother's suicide. He had begun showing sporadic symptoms of inappropriate anger and his friends and relatives were concerned that this might be symptomatic of Bipolar disorder, the disease from which his mother had suffered.

For several years, Jesse would visit regularly with his therapist, but refused to talk about his mother's death. A year and a half after beginning therapy, Jesse became upset when he learned he needed glasses, and was able to link this to the fact that his mother had worn glasses and that both her death and the need for glasses made him feel he was unjustly singled out for adversity. He was able to talk about this sense of injustice and the verbalization gradually led to understanding.

His father remarried when Jessie was eleven, and Jessie had to deal with his step-mother's reorganizing and redecorating their house. Until then Jesse and his father had kept the house the way his mother had left it as a shrine to her memory. The changes made by his step-mother were difficult for Jesse to tolerate, but he learned to accept them and was stronger, more resilient, for the experience.

Beardslee continued to see Jessie until he was eighteen. During this time, many crises had to be faced and resolved, including a breakup with a young woman he had fallen in love with in high school. He gradually learned to solve these problems without therapy, by talking them over with himself and friends.

"How Jesse managed," writes Beardslee, "is not just the story of an individual but also of his family, his school and his community, all of which gave him a great deal." This is just one instance of Beardslee's messages that mental illness--and indeed all illness--is as much a concern of society as of the individuals within that society.

In his last conversation with Beardslee, Jesse said that he had made his peace with his mother's death and that the experience had actually toughened him. The fact of her death had forced him to mobilize his adjustment resources and made him a better person than he would otherwise have been. This insight of Jesse's reminded me of Scott Peck's discussion of "The Healthiness of Depression" in his book "The Road Less Traveled." Peck also believed that a patient's depression provided the therapist with the opportunity for helping the patient complete a growth process.

 

In two sections of the "Epilogue," Beardslee provides some cogent arguments for a complete overhaul of the American healthcare system.

In "The Need for Reform of Care Systems," he notes that our current system does not even cover all of our citizens; that a large percentage of clinicians' time is diverted from patient care to deal with over-regulation, for example negotiating almost daily with insurance companies over the number of days-in-hospital allowed; and that real spending on children's mental health declined between 1990 and 2002.

In "Core Principles for Change," he states "The fundamental commitments to equity, justice and fairness that bind us as a country should be reflected in the way we care for illness." He also reminds us that other countries who spend a much smaller percentage of their gross national product on health care than we do rank far above us in the health and longevity of their citizens.

Beardslee's arguments seem to favor some form of socialized medicine and will certainly not resonate with the huge, for-profit "mediglomerates" that control an ever-increasing portion of our current healthcare system. However, they will find support from many economists who believe that health care should be considered a public, rather than a private good, since we all have a vested interest in each other's health and continuing productivity. And economic principles specify that public goods should be regulated by the government, not by the marketplace.

 

I believe there is something in this book for everybody, whether or not we're depressed, and whether or not we favor socialized medicine. If we study Beardslee's words carefully, we will realize that we have more choices than we thought we did about who we are, what we do and--perhaps most important--even about how we feel.

 

 

 

2004 Jack R. Anderson

Editor's Note: This book was originally published under the title Out of the Darkened Room: When a Parent is Depressed: Protecting the Children and Strengthening the Family

Jack R. Anderson, M.D. is a retired psychiatrist living in Lincoln, Nebraska.


Share

Welcome to MHN's unique book review site Metapsychology. We feature over 7800 in-depth reviews of a wide range of books and DVDs written by our reviewers from many backgrounds and perspectives. We update our front page weekly and add more than thirty new reviews each month. Our editor is Christian Perring, PhD. To contact him, use one of the forms available here.

Can't remember our URL? Access our reviews directly via 'metapsychology.net'


Metapsychology Online reviewers normally receive gratis review copies of the items they review.
Metapsychology Online receives a commission from Amazon.com for purchases through this site, which helps us send review copies to reviewers. Please support us by making your Amazon.com purchases through our Amazon links. We thank you for your support!


Join our e-mail list!: Metapsychology New Review Announcements: Sent out monthly, these announcements list our recent reviews. To subscribe, click here.

Interested in becoming a book reviewer for Metapsychology? Currently, we especially need thoughtful reviewers for books in fiction, self-help and popular psychology. To apply, write to our editor.

Metapsychology Online Reviews

Promote your Page too

Metapsychology Online Reviews
ISSN 1931-5716