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This book is a beautifully written and extremely moving account by a woman who herself suffered from clinical depression and whose teenage son then went on to develop such severe depression that he attempted suicide. The book is partly autobiography, partly the narrative of her son's ordeal and partly insights into all the major players in the family as well as the son's girl friend by means of their correspondence. The author is a member of the National alliance for the Mentally Ill, serves on the board of the American Foundation for Suicide Prevention, and has been a patient representative to the U.S. Food and Drug Administration's scientific advisory committee looking into possible links between antidepressant medication and teenage suicidal thoughts.
There are several strands running through this book which make it a genuinely useful source for several constituencies. Firstly, there is the strand about the biological causes of depression and thus the possibility of a tendency towards depression being passed on from parent to child. There are already some indications that depression does not pounce indiscriminately but does target families. This is a line of research that will almost certainly produce fruit probably within the next few years. Secondly, there is the strand about the problems of parenting. The author rightly points out that there is an American myth about the perfect family and its perfect children all graduating from high school magna cum laude, going on to the best colleges and universities, getting doctorates, marrying other highly successful people, holding down highly prestigious jobs and rearing more perfect children. As she emphasizes, real life is normally a lot messier than that; reality is not about perfection. This in itself is an important message as parents with depressed children often feel that they have failed. It is good for them to realize that very few people if any lead perfect lives, that we all make mistakes, that divorce happens, that kids do drop out of high school, etc. The third strand is about the dire condition that the American mental health care system is in. The author makes it abundantly clear that the Food and Drug Administration is basically a sham because it receives half a million dollars from the drug manufacturer every time it asks the FDA for approval and then the FDA relies almost entirely on the manufacturer's trialing evidence for deciding whether or not to grant approval. There is no real, entirely independent research done into the drug's suitability for general use. This means that quite unsuitable drugs may well be prescribed for depressed teenagers. In addition, the author makes it plain that the medical insurance companies are a nightmare. Many exclude mental health issues from their coverage and those that do not exclude severely restrict length of time covered, costs that may be reclaimed, etc. In other words, money and profit lie behind all the major decisions affecting the mental health care of America's young people.
The author retells the story of her son's suicide attempt and the long slow road to recovery with great feeling – so much so that it brought tears to the eyes of this reviewer on more than one occasion. For parents of children who are or who may be depressed this is an extremely rewarding read because they will feel that someone else, a real person, has trodden the same path they are on and they will gain many insights into the difficulties they will encounter along the way and the strength they will need to find.
There is an extremely useful list of organizational resources for the families of depressed teens near the end of the book and a very good set of endnotes which could serve as a bibliographical springboard if anyone wants to research further.
The author wrote the book to help others in a similar predicament. I am sure that many parents will be extremely grateful to her.
© 2007 Kevin M. Purday
Kevin M. Purday, Principal of the Shanghai Rego International School
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