Depression and related disorders, such as dysthymia, are prevalent and costly both to the individual (in terms of interpersonal relationships and well-being in addition to money) and the health care system. One of the primary reasons for this is that depression is a chronic disorder such that sufferers are more likely to experience recurrence of symptoms following a symptom-free time period or relapse shortly after recovery. This is the underlying theme of Chronic Depression. The authors spend the majority of the book considering the reasons for the chronicity of depression and treat depression, in part, as a self-propagating process.

The initial chapters set the tone of the book by both stating the main themes and delineating the basic information a reader should be aware of regarding depression. The premise of the book is that depression is a disorder that includes interpersonal processes that help to sustain depressive symptoms and prolong depressive episodes. The authors spend much of the first two chapters defining terminology used in the rest of the book, as well as impressing upon the reader the importance of understanding the mechanisms that make depression a chronic disorder. This section serves to acquaint readers outside of psychology with knowledge needed to understand the content of the following chapters. They also explore current theories that attempt to explain the chronicity of depression, although these issues are dealt with in greater depth later in the book.

The next six chapters (chapter 3-chapter 8) delineate their view of a potential culprit for the chronicity of depression: interpersonal processes. They begin with a discussion of stress generation whereby individuals who are prone to depression (e.g., pessimistic outlook on life) place themselves in situations that either cause or aggravate depressive symptoms. The authors then describe a number of additional interpersonal behaviors depressed individuals engage in that appear to contribute to their depression. Each chapter includes a clear explanation of the process and how it contributes to depression relapse and recurrence. Where available, the authors include examples from their own clinical work adding a personal element to the reading.

After explicating each of the five specific processes, the authors turn their focus to individual difference factors that might predispose  a person to depression and the interpersonal problems that follow. They then discuss potential interactions between these individual difference factors and the interpersonal processes they believe to sustain depression. The final chapters are spent applying their model of interpersonal processes to assessment, treatment and prevention of depression.

In general, the book is well written and informative. The authors draw on a wide range of research to justify the interpersonal processes they propose. The arguments they make for how these processes sustain depressive episodes are compelling. The book is directed to anyone interested in depression and, for the most part, this is done well. There are points, such as in the chapter discussing assessment, where they may lose readers outside of psychology. The writing here becomes technical and assumes some knowledge of clinical assessment. Additionally, in light of the sparse evidence supporting some of their claims, the chapter on interactions between personality characteristics and the interpersonal processes they propose is quite short given the number of possible combinations they themselves note exist. As the book is mostly speculative, they could have spent more time discussing the interactions of individual differences and interpersonal processes.

Overall, Chronic Depression is an interesting and succinct synopsis of how interpersonal processes play a role in depressive episodes. The book is informative as well as interesting to read given that it reviews current research and builds on it with well formulated speculation. It provides some fascinating avenues of thought for clinicians and researchers alike.

© 2007 Jacqueline Mogle

Jacqueline Mogle, M.S., is a PhD student at Syracuse University where her primary focus of research is cognition-emotion relations and aging.

Categories: Depression, Psychotherapy