Peter Kramer, Against Depression (New York: Viking, 2005), 353pp.

           As I finished Peter Kramer's new book on depression, I read an article about a recent scientific study led by epidemiologist Ronald Kessler of Harvard that concluded that about half of all Americans report at least one symptom of mental illness at some point in their lifetimes. But I suspect that very few people needed Kessler's study to appreciate the ubiquity of depression in particular; we all know people who have suffered from depression. Peter Kramer, a psychiatrist at Brown University and author of the best-seller Listening to Prozac (1993), has written a sort of cultural history of depression that raises an interesting question: if depression is such an insidious disease, as Kramer believes it is, why does our society ennoble it rather than do everything it can to eradicate it?

           Advances in science the last decade have confirmed the horrible symptoms and devastating consequences of depression, including abnormal brain anatomy, cellular pathology, chemical imbalances, and clear correlations between depression and coronary disease, early death, and other ailments. Depression destroys families and careers, causes massive economic losses in public health and employment through poor job performance, and robs people of joy. But in both overt and covert ways society can distort, glamorize and romanticize depression. Unlike cancer, malaria, or most any other disease, we suggest depression is a source of "heightened awareness, (justified) social-disaffection, moral insight, and creative genius." In an entire chapter Kramer examines the "charm" that attaches to depression. Depressives can be desperate to please, attractively and even erotically vulnerable, compulsively generous, attuned to life's absurdities, and full of ironic-self-awareness. Kramer considers the role of the tortured artist who is so productive, the melancholic hero, the depressed writer, and so on. After all, he asks rhetorically, what would have become of Kierkegaard or van Gogh if they had been "cured" with Prozac? Would we have lost the legacy of their genius? Their deep insights into our human condition?

           Kramer admits he has written a "polemic, an insistent argument for the proposition that depression is a disease, one we would do well to oppose wholeheartedly." He draws on a broad variety of sources, including art, literature, philosophy, recent scientific studies, interactions with readers from his book tours, case studies from his clinical practice, and his own family history ("most psychological theory is veiled autobiography," he admits). I found it hard to argue with the final sentence of his book: "How glorious it will be to free ourselves from depression."