Review: Undoing Depression by Richard O'Connor

A couple of months ago I was sent Undoing Depression to review by the lovely people at Souvenir Press. Before reading it, I has a few reservations due to its bold title, and I hoped it wasn't going to be gimmicky. But once you're a few pages in, you realise it's the least self-help self-help book there is. Not because it's unhelpful, but because you don't feel like you're being fed positive-thinking crap that you will forget as soon as you put the book down. I read one review that described the book as 'sensible', and I agree - this book is exactly that.

This book is aimed at anyone suffering with depression, anyone in recovery wanting to avoid relapse, or anyone who might be close to someone with depression who wants a better understanding of the disease. And for the latter, O'Connor gives a vivid sense of what it's like to be depressed. He says, 'its not just that we believe life is dull and bleak; that is actually how we experience it'. 

O'Connor has personal experience with depression, which he refers to throughout the book. He has grown up learning, challenging and helping within the mental health community - turning his negative experience into a positive one, which definitely helps when reading the book.  

One thing this book doesn't shy away from is information.  It begins by explaining neuroplasticity, which is something that has fascinated me for a while. The point behind this is that we all have the potential to rewire our brains into new ways of thinking. 

O'Connor says that tackling depression is all about behaviour change, and that willpower needs to be tackled head-on. He gives some great practical advice on how to do this. The thing is - depression is difficult to write about. As with any other mental health problem, it has chemical reasons behind it. I'm sure a lot of sufferers fall into the trap of living with depression because they don't think they have a choice. O'Connor respects that way of thinking, and I don't think he necessarily shames it, he just gently coaxes people out of it as the book goes on. 

He says that there are unconscious forces at work, primarily fear, that oppose change. Sufferers develop defense mechanisms that go against reality in order to put up with depression, or sustain the unconscious belief that they  don't deserve to feel better. He says that depression becomes a set of habits and behaviours that become like a 'core self'. As I read this I found myself nodding along - because it's completely relatable to anxiety, too.

Since the last edition of Undoing Depression, scientists have confirmed that depression reshapes the brain. This, O'Connor argues, is why medication and therapy isn't enough, but doing (he uses the example of getting out of bed in the morning) will help. O'Connor often compares depression as alcoholism. I'm not sure how readers will feel about that, but it does put across his point - that both need a deliberate change in lifestyle to overcome it. He then talks about his own experience of depression, including his mother's suicide - although this was quite heavy reading and may be a bit much for some readers.

Amongst the usual, albeit shocking, statistics,  one that stood out to me more than any other in the book was this one: 'In the US, four men commit suicide for every one woman. But in Amish culture, where macho acting-out is frowned upon, the incidence of depression is the same for both sexes.'

One third into the book there is a practical exercise for readers to try. This is a mood journal, designed to help uncover underlying causes to mood changes. O'Connor says that no mood changes are out of the blue, but always have a cause. This is the first example of addressing the reader with a practical exercise - there are a few throughout the book, but not in every chapter. 

The book really delves into the thinking process of depressives. He looks at optimists' and pessimists' thinking patterns, and explains it really well. For instance, optimistic people see bad events as unique rather than pervasive, but if a pessimist is ill they might think 'I'm always ill'. 

The book then looks at mindfulness, mindfulness-based meditation and detachment, which is found in Buddhism. I've read better explanations of this, but it is applies to life with depression well.  

The section on medication is always going to be the difficult part. But O'Connor gives objective, honest and sensible advice, going in to detail about the different medications to treat depression. However, further in to the book, 
O'Connor has a section saying that the depressed person is a great employee because they are perfectionists and they would never take home office supplies. If there's one part of the book I find a bit iffy, it's this part. It's just a bit too generalising.

The book took me a while to get through, not because it was uninteresting, but reading about depression, no matter what the state of your mental health, can be a bit draining. Undoing Depression is not a self-help book that sugarcoats anything. It's a heavy read, but it's worth persevering. One thing I took away from it is O'Connor's understanding of depression and his honesty and, unlike other self-help books, you don't get a false sense of hope, but a realistic idea of what might help you. He admits that he has a therapist he can rely on when he needs to. This could be perceived as a bit disheartening, given the book's title. But it's honest, and it's reality.

Then there's a program for recovery at the end, summarising the book's key messages. He drills it in to the reader that you must practice new behaviour repeatedly in order to make a difference.Some parts can be a bit harsh. For instance, the very last page says that we either grow or we die - we can stay in our dressing gown and watch television, but if we continue to do so we'll eventually stick our head in the oven. Hmm...

Before I began reading, I had often wondered whether or not I've suffered with depression, as it's quite common for those with anxiety to be depressed. I'm sure I'm not the only person who's felt a bit down and wondered the same thing. But now I know I definitely haven't suffered with it. O'Connor gives the reader a good understanding of such a confusing, misunderstood disease. 

I will end my review on this - in the chapter looking at the argument of whether or not we can control our depression, O'Connor says we must behave as if we have the power to control ourselves, because if we don't, we have no hope. This perfectly sums up his writing - intelligent, insightful, realistic and relatable - but positive in the face of one of life's hardest challenges.

"Unwittingly we get good at depression. We learn how to hide it, how to work around it, how to survive. We may even achieve great things, but with constant struggle rather than satisfaction. Depression defines us, becomes a part of who we are."

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