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A Cure for Darkness: The Story of Depression and How We Treat It

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A fascinating look at the treatment of depression, blending journalism, science, history, and memoir, by an award-winning science writer. What is depression? Is it a persistent low mood or a complex range of symptoms? Is it a single diagnosis or a diversity of mental disorders requiring different treatments? In A Cure for Darkness, science writer Alex Riley explores these q A fascinating look at the treatment of depression, blending journalism, science, history, and memoir, by an award-winning science writer. What is depression? Is it a persistent low mood or a complex range of symptoms? Is it a single diagnosis or a diversity of mental disorders requiring different treatments? In A Cure for Darkness, science writer Alex Riley explores these questions, digging into the long history of depression and chronicling the lives of psychiatrists and scientists who sought cures for their patients. Since 2015, Riley has received both cognitive behavioral therapy and antidepressants for his own depression. Throughout his treatment, he wondered—are antidepressants effective? Do short-term talking therapies actually work? And what treatments are on the horizon for those who don’t respond to these first-line treatments? Expanding from his own experience, he tracks treatments through history, from the “talking cure” to electroconvulsive therapy to magic mushrooms. With depression fast becoming the leading burden of disease around the world, the future of mental healthcare depends not just on the development of new therapies, but on increasing access for people who are currently without. Reporting on the field of global mental health from its colonial past to the present day, Riley highlights a range of scalable therapies, including how a group of grandmothers stands on the frontline of a mental health revolution. Weaving in personal and family history, A Cure for Darkness is a gripping narrative journey and a surprisingly hopeful work that delves deep into the science of mental health.


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A fascinating look at the treatment of depression, blending journalism, science, history, and memoir, by an award-winning science writer. What is depression? Is it a persistent low mood or a complex range of symptoms? Is it a single diagnosis or a diversity of mental disorders requiring different treatments? In A Cure for Darkness, science writer Alex Riley explores these q A fascinating look at the treatment of depression, blending journalism, science, history, and memoir, by an award-winning science writer. What is depression? Is it a persistent low mood or a complex range of symptoms? Is it a single diagnosis or a diversity of mental disorders requiring different treatments? In A Cure for Darkness, science writer Alex Riley explores these questions, digging into the long history of depression and chronicling the lives of psychiatrists and scientists who sought cures for their patients. Since 2015, Riley has received both cognitive behavioral therapy and antidepressants for his own depression. Throughout his treatment, he wondered—are antidepressants effective? Do short-term talking therapies actually work? And what treatments are on the horizon for those who don’t respond to these first-line treatments? Expanding from his own experience, he tracks treatments through history, from the “talking cure” to electroconvulsive therapy to magic mushrooms. With depression fast becoming the leading burden of disease around the world, the future of mental healthcare depends not just on the development of new therapies, but on increasing access for people who are currently without. Reporting on the field of global mental health from its colonial past to the present day, Riley highlights a range of scalable therapies, including how a group of grandmothers stands on the frontline of a mental health revolution. Weaving in personal and family history, A Cure for Darkness is a gripping narrative journey and a surprisingly hopeful work that delves deep into the science of mental health.

30 review for A Cure for Darkness: The Story of Depression and How We Treat It

  1. 5 out of 5

    Alex

    ‘A Cure For Darkness’ is a recently published blend of scientific theory and personal memoir. Written by Alex Riley, a science writer who’s struggled with depression himself, it is by no means a self-help guide, but an informative book that does exactly what it says on the tin: it tells the story of how our understanding of the causes and our approach to the treatment of depression (and mental illness in general) has changed over the millennia. Throughout the book, Riley highlights the complexit ‘A Cure For Darkness’ is a recently published blend of scientific theory and personal memoir. Written by Alex Riley, a science writer who’s struggled with depression himself, it is by no means a self-help guide, but an informative book that does exactly what it says on the tin: it tells the story of how our understanding of the causes and our approach to the treatment of depression (and mental illness in general) has changed over the millennia. Throughout the book, Riley highlights the complexity of this common, but still misunderstood condition, and discusses the various treatments that have been used since antiquity, treatments diverse, and sometimes dangerous, quite like depression itself. The book is divided into four parts, which are further divided into a total of 27 chapters. The first part, ‘Cutting Steps Into The Mountain’ is primarily focused on the work of Sigmund Freud and Emil Kraepelin, two leading figures of modern-day Psychiatry, two pioneers whose clinical and academic work contributed to our current understanding of mental (or psychiatric) disorders. Once we’re introduced to Freud and Kraepelin, Riley takes us back to antiquity and then to the Middle Ages before returning to the twentieth century. He shows how our approach to the understanding and treatment of depression throughout the centuries has followed a non-linear course; ancient wisdom and compassion gave way to a misunderstanding that led to the inhumane conditions of mental asylums, where patients were chained and bled. In the two middle parts of the book, the author discusses the development of the so-called biological treatments for depression (brain surgery, electro-convulsive therapy (ECT), antidepressant medication) during the twentieth century. He then talks about the psychological treatments (talking therapies), as well as the challenges of talking about, let alone treating, depression in the third world. The final part, ‘The Universe Within’, is about current practice, as well as cutting-edge research into the causes and treatment of depression. For example, here, Riley talks about the insights from recent neuroimaging studies and the little-understood links between depression, inflammation and diet, as well as the use of deep brain stimulation (DBS) and psychedelic drugs in the treatment of the condition. What Riley successfully demonstrates throughout this book is that depression is an incredibly complex and diverse clinical condition. He shows how our understanding of the biological, psychological and sociocultural mechanisms underpinning depression has improved, alongside the sometimes empirical, sometimes scientific treatments. By doing so, he sheds light on the reasons why successful treatment of depression can be such a huge challenge for clinicians and patients alike. As a Consultant Psychiatrist myself, I think that Riley does absolute justice to such a complex, diverse and ultimately misunderstood condition. His approach follows the holistic bio-psycho-social model (that Psychiatrists currently use) with regards to both causation and treatment of depression (and mental illness in general). Talking about the past, present and future treatments of depression, he offers a comprehensive overview of those, and overall he follows a well-balanced and rounded approach. As a reader, I found Riley’s writing engaging and I certainly enjoyed reading this book. I would definitely recommend it to trainee psychiatrists, as well as to anyone who wants to better understand the complex causes of depression and gain an insight into the challenges that clinicians face when it comes to its treatment.

  2. 5 out of 5

    Karen

    A CURE FOR DARKNESS BY ALEX RILEY The reason that I requested this was to learn and better understand depression, the best treatments for it, what if the treatments don't work and finally what is on the horizon for treatments scientifically or cutting edge. My oldest son who is 22 started to have a low grade depression and was seeing a psychologist. He didn't want to take antidepressants and wanted to work through it on his own utilizing exercise and a positive out look and solving it on his own. A CURE FOR DARKNESS BY ALEX RILEY The reason that I requested this was to learn and better understand depression, the best treatments for it, what if the treatments don't work and finally what is on the horizon for treatments scientifically or cutting edge. My oldest son who is 22 started to have a low grade depression and was seeing a psychologist. He didn't want to take antidepressants and wanted to work through it on his own utilizing exercise and a positive out look and solving it on his own. I thought by reading this I might learn something that I could talk to him about or at least understand what causes it. I was extremely disappointed that this book was not for me. It is very dense and starts out talking about Freud dissecting eels for testes. It slowly chronicles the historical dating back to the 1800's. I definitely think the author's audience is for a more scholarly background in such details that weren't helpful to me. I don't feel like it is accessible to the average reader as it records a lot of historical facts. The author, Alex Riley suffers from depression and in the very beginning he talks about going off his antidepressants. He is taking SSRI inhibitors which I understood and talks about the regimen of those along with talk therapy being what is commonly prescribed today. He mentions in the past using ECT. That I understood. I really think that this book could be so much more helpful to the everyday lay person if he didn't pack this with so much minutia about every single historical detail. I was hoping that this would be made to be much more accessible to people who just want to learn about how to be helpful and aren't clinicians which in my opinion is a better target audience for this book. I did learn that this can affect as many as 322,000,000 people today in the world. Also that fifteen percent of those who don't seek treatment are likely to be suicides. This just wasn't for me. I did find the work of Mayberg, a woman who published a paper of about six pages in length in the American Journal of Psychiatry of her experiments fascinating. I am summarizing here that her famous paper introduces an area of the brain mapped and called area 25. How when volunteers were asked to think of something painful in their pasts that they experienced and how on a PET scan it displayed a blue like pattern on area 25 on their brain's while parts of their prefrontal cortex switched off. The prefrontal cortex didn't show activity. How amazing it is that when these same volunteer's stopped thinking about a sad experience from their past Area 25 quietened. The frontal cortex where rational thought takes place jumped back to the previous homeostasis. Also revealing, that people with depression, this same pattern only repeated with subjects taking antidepressants. As Mayberg, reasoned that people who are depressed were stuck and couldn't switch off this "sadness center." It just kept firing, and firing. With such a constant barrage of painful signals, the circuitry within the brain starts to take on a different shape. Pieces start to malfunction. Parts of the cortex are silenced and pushed out of practice. Even after slight disappointments, full-blown depression becomes the normal. The brain settles into a disordered state that only medication can untangle. Area 25 is in the limbic system which is a key component that connects regions of the frontal lobe section involved in motivation, drive, and rational thought with those more central parts of the brain that are crucial to memory and emotional regulation. She also found a reverse of what she thought to be a common blueprint of depression by scans revealing that the prefrontal cortex displaying a sort of red blobs, where she previously understood the red like blobs should instead be blue. The volunteer's area 25 was quiet. What was reduced was increased making this raise the question of are there depressions that are different in nature? And if so, could this explain why some people respond to different treatments and might data from brain scans be used to guide treatment of depression? This was fascinating compared to the dense historical data that most of the book focuses on. There was a lot that I left out regarding her experiments and research for reasons of keeping this review brief. I did find her research and experiments interesting as someone who was a biochemistry major who changed majors once I found that I couldn't dissect a cadaver so my aspirations for becoming a psychiatrist were finished. I still find that I am interested in psychiatry even though I didn't attend medical school for the reason stated above. I like reading about contemporary psychiatry and biochemistry of the brain and enjoyed the book from this point onward. I was skeptical about requesting this because I am not a historian and didn't want to read a textbook about 1700's, and 1800's of densely packed details which are cited earlier in this review. I am interested in Freud and Carl Jung but not about Freud's use of the microscope dissecting eels testes. I am giving my opinion and do realize that doctor's and researchers and other's could find this meticulous research that this author has included enjoyable. I prefer to learn about contemporary material and am grateful that I stuck it out because there is much that is interesting that I learned from. Also the author suffers from depression and I admire his ability to write a book that encompasses the details looking at it from the point of view of a historian. I don't mind if people disagree with my opinion and wish the author the best of luck and good health. I keep editing this because I want to give credit to the effort that went into writing this. I did end up enjoying the biochemistry aspects and experiments and the efforts made to expand on contemporary endeavors. This will appeal to many reader's at this point in time more than ever. Publication Date: April 13, 2021 Thank you to Net Galley, Alex Riley, Scribner and for anybody who read this disjointed review. I apologize for my rambling on. All opinions are my own #ACureforDarkness #AlexRiley #Simon&SchusterScribner #NetGalley

  3. 4 out of 5

    Katy

    Readers looking for a fluffy self-help book need not apply. A Cure for Darkness is for readers seeking an in-depth history of how the field of mental health and depression came to be recognized by society. As a clinical psychologist, I found Riley's historical account of depression fascinating and inspiring. He paints the major players in mental health with beautiful color and depth to their lives, which brings much-needed personality to an otherwise dry topic. Riley leaves his opinions off the Readers looking for a fluffy self-help book need not apply. A Cure for Darkness is for readers seeking an in-depth history of how the field of mental health and depression came to be recognized by society. As a clinical psychologist, I found Riley's historical account of depression fascinating and inspiring. He paints the major players in mental health with beautiful color and depth to their lives, which brings much-needed personality to an otherwise dry topic. Riley leaves his opinions off the page and allows the reader to make up their own mind as to the ethics of certain figures and events. More research-based than pop-culture psychology and more engaging than a textbook, A Cure for Darkness is not meant to be a 'how-to' or memoir of the author's self-disclosed treatment of depression. I predict that this text will become required (or at least recommended) reading at many graduate mental health programs in the very near future. It is the best mainstream text of psychological literature I've read in a while, but again, I'm pretty biased as a clinical psychologist.

  4. 4 out of 5

    Paz

    This book was not what I expected. It had a textboook vibe, more informational and than a memoir. It needed more of a memoir feel. This book is great for someone who knows almost nothing about the history of depression./mental health. I do appreciate the small cultural piece that was in the book. Depression and mental health are broad and it was great that the author took this approach . Maybe this book wasn’t for me ...

  5. 4 out of 5

    Destiny

    This book is a history and science book first and foremost, so if you're looking for a self-help book, then this book likely isn't for you. A Cure For Darkness by Alex Riley is the history of depression, both the diagnosis and the treatment of it. Our understanding, and lack thereof, of this disease has changed greatly over the past 2000 years (and longer!). Alex Riley breaks all this information down while including his bits of his own journey with depression and his skepticism of antidepressan This book is a history and science book first and foremost, so if you're looking for a self-help book, then this book likely isn't for you. A Cure For Darkness by Alex Riley is the history of depression, both the diagnosis and the treatment of it. Our understanding, and lack thereof, of this disease has changed greatly over the past 2000 years (and longer!). Alex Riley breaks all this information down while including his bits of his own journey with depression and his skepticism of antidepressants but inevitable need of them. The scientific understand (and public understanding!) of depression has changed a lot throughout the history of mankind. Just the name itself has gone through a litany of changes, but not quite so much as the different branches of science that have argued over the cause: anatomy, genetics, gut microbiome, synapses, subconscious, consciousness, and the list goes on. Many scientists have had their fingers in the psychology pie over the years, and funnily enough, no one knows for sure what it is yet. Perhaps it's simply different strokes for different folks. The way these scientists have treated the disease has changed to. We've gone from bloodletting to "forced rest" to cocaine to electroconvulsive therapy to talk therapy (a multitude of different kinds: psychoanalysis, interpersonal therapy, behavioral therapy, cognitive therapy, psychedelic therapy), to experimental drugs, and peer counseling. Perhaps we've gotten better at it over the years, but one thing is for certain we can do more. Alex Riley touches on all of things, including the biggest things preventing broader steps forward in the psychology world: poor government funding and the outlaw of treatments that work(!) but are feared due to past abuse and poor regulation (hello electroconvulsive therapy and LSD treatments). These outlaws means studies and treatments are hard to come by, so what of the people who have gotten help through these practices when nothing else worked? And why do allow ad agencies to circumvent the FDA and tout something as a miracle drug when it isn't better than the next thing, and sometimes performs worse, like Prozac? All of this summary to say that this was a great read for someone who is always interested in psychology and isn't afraid of a bit of medical jargon in their bedtime stories. Definitely recommend!

  6. 4 out of 5

    Lauren Geier

    I express my gratitude both to NetGalley and the publisher for providing a free e-copy in exchange for an honest opinion. I was eager to read “A Cure For Darkness” by Alex Riley. An estimated 322 million people worldwide are living with depression. While the most common mental health diagnosis, there is still much to be learned about this illness. Riley’s exploration is not meant to be an introduction to depression and the fields of treatment but is, instead, a deep dive into many considerations I express my gratitude both to NetGalley and the publisher for providing a free e-copy in exchange for an honest opinion. I was eager to read “A Cure For Darkness” by Alex Riley. An estimated 322 million people worldwide are living with depression. While the most common mental health diagnosis, there is still much to be learned about this illness. Riley’s exploration is not meant to be an introduction to depression and the fields of treatment but is, instead, a deep dive into many considerations. He weaves his own experiences throughout the book but also relies heavily on scientific research and treatments. If the reader is looking for a definitintive solution to depression, this is not to be found within these pages, as it doesn’t exist. Riley approaches the subject as journalist and not a medical or psychological practitioner. However, sometimes the best content comes from outside the field. I recommend “A Cure For Darkness” to professionals in the field looking to have a deeper understanding of the disease and treatment trends and options. For the American reader, it is noteworthy that Riley lives in Europe and some of the treatments he mentions are not readily available in the states. My only complaint with this book is that it doesn’t explore cultural expressions of depression as much as I would have liked. For that reason, I prefer “Noonday Demon” as a resource on depression but this is a clear companion option.

  7. 5 out of 5

    Lori

    I had high hopes of insight into depression and maybe enlightenment of my struggles in the past, even a tidbit to take away to help guide or assist others with this oppressive illness. This book was more like a textbook on the history and hit and miss treatments over the years by professionals. Some extremely dangerous. Some successful. I did learn a lot but it wasn’t what I was looking for. I came to understand how far reaching this illness is and the vast volume of people who suffer from it. T I had high hopes of insight into depression and maybe enlightenment of my struggles in the past, even a tidbit to take away to help guide or assist others with this oppressive illness. This book was more like a textbook on the history and hit and miss treatments over the years by professionals. Some extremely dangerous. Some successful. I did learn a lot but it wasn’t what I was looking for. I came to understand how far reaching this illness is and the vast volume of people who suffer from it. The professionals struggle to understand how depression differs from one person to the next and is to this day still being explored. I made it through, (it’s not a book to breeze through) however, I’m glad I read it for a new understanding of how relatively new many treatments and medications really are. A new understanding that there is not one fix all answer, it’s a constantly evolving quest to help with differing theories and methods. I’m impressed with the research Mr. Riley needed to do to write this even during his own daily oppressive struggle with depression. The ups and downs, the search, for answers, and now the reason to keep fighting through this illness. Thank you NetGalley, Alex Riley and Simon & Schuster publishers for allowing me to read this eARC this is my honest opinion.

  8. 4 out of 5

    Ian Partridge

    This review has been hidden because it contains spoilers. To view it, click here. I was drawn to the book by a personal interest in understanding more about depression in terms of the evolution of the condition and its treatments. The book neatly summarised the evolution of the two schools of psychiatry and the corresponding development of new treatments for the condition. I found this very helpful in that the writers prose made the material very accessible. What lifted the book from the style of an historical narrative charting characters, events and progress in the science I was drawn to the book by a personal interest in understanding more about depression in terms of the evolution of the condition and its treatments. The book neatly summarised the evolution of the two schools of psychiatry and the corresponding development of new treatments for the condition. I found this very helpful in that the writers prose made the material very accessible. What lifted the book from the style of an historical narrative charting characters, events and progress in the science of the condition, was the inclusion of the writers own experiences of the condition. It turned what might on the face of it appear a dry narrative into a highly engrossing and vivid portrayal of a very personal journey.

  9. 5 out of 5

    Kristine

    A Cure for Darkness by Alex Riley is a free NetGalley ebook that I read in late March. While combing through the history of and the lexicon of treatments for depression, i.e. scientific, alternate, and talk therapies, Riley speaks of his own own experiences and the history is spliced with real biographical insight, early rudimentary medications, moments of real discovery and catastrophic drawbacks, cognitive science, global studies, and its influences on depression in the present day. It's depict A Cure for Darkness by Alex Riley is a free NetGalley ebook that I read in late March. While combing through the history of and the lexicon of treatments for depression, i.e. scientific, alternate, and talk therapies, Riley speaks of his own own experiences and the history is spliced with real biographical insight, early rudimentary medications, moments of real discovery and catastrophic drawbacks, cognitive science, global studies, and its influences on depression in the present day. It's depicted terrifically, though it can get a little bit lost in itself.

  10. 5 out of 5

    Sarah Boon

    A bit slow and slightly boring at the beginning but really picked up around the 1900s mark. A comprehensive look into the ways in which we diagnose and treat depression from Freud onward. Is it biological? Is it situational? Is it both? Riley even includes current research on using psychedelic drugs in depression treatment. I would have appreciated a bit of a wrap up at the end that addressed the social vs. biological aspects of depression.

  11. 5 out of 5

    David Nguyen

    Thanks for sharing a different perspective. African literally describe Depression as the state of rumination, or someone got stuck walking in a circle ⭕. So true! That's exactly what racial melancholia is about. A perpetual wound that never heal. Thanks for sharing a different perspective. African literally describe Depression as the state of rumination, or someone got stuck walking in a circle ⭕. So true! That's exactly what racial melancholia is about. A perpetual wound that never heal.

  12. 4 out of 5

    Gregg

    Good autobiographical story This is a good, first person autobiographical story of one person's journey in depression. The author never holds back, but depicts the reality of depressing sufferers. Good autobiographical story This is a good, first person autobiographical story of one person's journey in depression. The author never holds back, but depicts the reality of depressing sufferers.

  13. 5 out of 5

    Lisa

    I guess I’m not exactly sure who the audience for this book is - it doesn’t offer concrete answers. But, I learned a lot & im a mental health professional. Fascinating look at the history of depression interventions & where the field is going.

  14. 5 out of 5

    Dianna Dekelaita

  15. 4 out of 5

    Kieran Lane

  16. 5 out of 5

    Minh

  17. 5 out of 5

    Daniel

  18. 5 out of 5

    Sophie Holmes

  19. 5 out of 5

    Nicole Marie

  20. 4 out of 5

    Joseph

  21. 5 out of 5

    Leah

  22. 4 out of 5

    Siri Carpenter

  23. 4 out of 5

    Jim Kuhlman

  24. 4 out of 5

    E W

  25. 5 out of 5

    Dan

  26. 4 out of 5

    Elspeth

  27. 4 out of 5

    eClaireYmee

  28. 4 out of 5

    Anne

  29. 4 out of 5

    Simplificate

  30. 5 out of 5

    Snepi

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