In this short book, Depression
in Later Life, Manthorpe and Iliffe examine the ways in which older people
exhibit depression and the ways that they can be helped.  They write clearly
and have done thorough research, with twelve pages of references at the end. 
Unsurprisingly, depression is a serious problem in old age, and often occurs in
conjunction with other health problems.  Furthermore, people at the end of
their lives tend to face their own mortality, and suffer significant losses as
other close friends and family members pass away.  The physical and
psychological difficulties faced the elderly put them at increased risk for
depression. 

Manthorpe and Iliffe are careful to
spell out not just the personal costs of depression and the medical treatments
available for it, but also the effects on family and other caregivers of
depression, and they discuss non-medical ways of both preventing and treating
depression.    They use short case vignettes throughout the book to illustrate
their points, and this makes the text especially approachable.  The authors are
British, and their discussion is almost entirely based on the health care
system in the UK.  This will reduce the interest of the book to readers outside
of the UK, but most of the authors’ main points will transpose to other Western
countries. 

After the introductory chapters,
the authors discuss the relation between depression and dementia, the relation
between depression, anxiety and psychosis, suicide and self-harm, support for
those who care for old people with depression, and ways to prevent depression. 
All through, they survey the existing knowledge base, and emphasize the social
elements.  For example, for an immigrant woman from Eastern Europe who is
socially isolated, they stress the need to find someone who can talk with her
in her native language.  For a woman with some psychosis, they discuss the need
for social services to be involved in her care so she is able to continue
living in her own home.  In their conclusion, the authors stress the importance
of a social model in thinking about depression. 

It is not entirely clear what
readership Depression in Later Life is aimed at.  It is not designed for
patients or their families, since it is slightly too academic for that, and it
does not focus on the steps that families can take to solve the problems caused
by depression.  It does not seem to be aimed at clinicians either, since it
says little that would be new for them, although it could be a helpful summary
of existing knowledge.  It seems to be best suited to policy-makers and
academics: the authors are themselves academics as well as clinicians, and they
seem to be writing for their peers.  The book could certainly be used in an
undergraduate course in gerontology and social work, especially for UK students.  Other readers may also be able to find some useful ideas of perspectives
here, and since the list of references is so thorough, the book can be used as
a guide to the other literature in this area. 

© 2006 Christian
Perring. All rights reserved.

Christian
Perring, Ph.D., is Academic Chair of the Arts & Humanities
Division and Chair of the Philosophy Department at Dowling College, Long Island. He is also editor of Metapsychology Online Reviews.  His main
research is on philosophical issues in medicine, psychiatry and psychology.

Categories: General, MentalHealth