David Burn\'s Feeling Good: Depression

In the book Feeling Good , David Burns, MD, the author, outlines
certain cognitive techniques an individual suffering from depression could use
in combating the disorder. He begins the book by briefly describing the
pertinence and the prevalence of depression. The author captures the audience\'s
attention in the first paragraph: " In fact depression is so widespread it is
considered the common cold of psychiatric disturbances" (Burns, 1992) p. 9.
Burns(1992), continues to suggest that the difference between the common cold
and depression lies in the fact that depression is lethal. Irwing and Barbara
Serason (1996) suggest that at least 90 percent of all suicide victims suffer
from a diagnosable psychiatric disorder at the time of their death. Irwing and
Barbara Serason (1996) also state that one of the risk factors in committing
suicide is the presence of mood disorder. Silverman (1993) states that suicide
among young people 15 to 19 years of age has increased by 30 percent from the
years 1980 to 1990.
In my opinion David Burns brings up a valid issue in addressing the
pertinence of depression as it pertains to peoples tendencies of committing a
suicide; other academics have agreed with the same findings. However these
academics have not specifically stated that depression is the only risk factor
of committing a suicide. They did not even suggest that depression is the
heighest weighted risk factor in committing a suicide. The impression the
reader gets after reading the introductory paragraph of the Feeling Good book is
that severe depression will inevitably result in suicide unless it is cured.
Implying that if a person has a depressive disorder, it will lead to a suicide
can be dangerous and counterproductive for a person who already feels hopeless;
this may reaffirm their belief of hopelessness and the inevitability of the
Once the first paragraph is passed the author indicates that there is
hope in curing depression, giving the reader an encouragement to continue with
the book.
According to the Diagnostic and Statistical Manual of Mental
Disorders(DSM-IV), mood disorders are classified into two broad categories,
bipolar and unipolar depressive disorders. The book Feeling Good only talks
about the unipolar depressive disorders, thus, I will only concentrate on that
one category. Unipolar mood disorders are classified under axis I of the DSM-IV.
Unipolar depressive disorders are further classified into two categories:
dysthymic, and major depressive disorder. Even though both of the disorders are
mood disorders they have some fundamental differences and similarities.
According to DSM-IV people experiencing major depression must have depressed
moods and/or diminished interest for at least two weeks, for most of the day,
and for most days than not. They must also experience four additional symptoms,
such as: weigh loss or gain, insomnia or hypersomnia, psychomotor retardation or
agitation, feelings of worthlessness, feelings of hopelessness, low self-esteem,
difficulty concentrating, or suicidal thoughts. This is an acute , and usually
recurrent disorder. Around 50 percent of people who experience one major
depressive episode will experience another in the course of their life.
Dysthymic disorder is similar to major depressive disorder in that
people experiencing the disorder go through periods of depressed moods. However,
intensity, and duration of such moods are one among many differences between the
two disorders. Dysthymic disorder is a chronic disorder lasting, on average,
five years. In order to be diagnosed with the disorder one has to feel
depressed for most of the day, most days than not for at least two years. The
person experiencing this disorder also has to have two of the symptoms mentioned
in the section that described major depressive disorder. Due to its chronic
nature, dysthymic disorder is sometimes difficult to distinguish from a
personality disorder.
Feeling Good does not clearly identify the categories of unipolar
disorders; it groups them together into one category called "depression". The
danger of this is in the reader\'s perception of what condition they may have.
For example, a person who is expressing a major depressive episode and is
incapacitated may not have the energy or concentration to employ some of the
cognitive techniques outlined in this book. This person may however benefit
more from of an Electroconvulsive treatment (ECT) which is not outlined in this
book. The readers are not informed of all the options they have to treat the
disorder they are experiencing. Rush and Weissemburger (1994), suggest that ECT
is very effective in treatment of the major depressive disorders. Research
indicates that in 80 to 90 percent of patients experiencing a major depressive
episode, ECT is effective. However this treatment is shown not to be effective
in treatment of milder forms of depressive disorders such as dysthymia. David