Some time ago, struggling to cope with the realities of life as an inner-city general practitioner, I came across a paper by the author of this book that changed the way I practised (Reference DowrickDowrick, 1992). Thirteen years later Professor Chris Dowrick, now a highly respected academic general practitioner, has once again shown that there are many different ways of thinking about the doctor–patient relationship, this time in the context of depression. Depression is, of course, a serious business, contributing 12% of the total burden of non-fatal global disease, and generating over 23 million prescriptions for antidepressants in England in 2002. This is therefore a timely book. In the wake of the evidence-based but doctor-centred National Institute for Clinical Excellence guidance on depression, it is also an important and necessary one.
Beyond Depression starts with a robust defence of depression as a medical entity, followed by the case for the prosecution that the concept of depression contains some important theoretical and functional problems. The heart of the book, however, lies in the chapters that reflect on alternative ways of understanding the thoughts and feelings within the concept of depression. Professor Dowrick proposes a new conceptual framework based on purpose and meaning, where practitioners are encouraged to be enablers who listen and understand rather than diagnose and prescribe. Patients’ stories vividly illustrate how this new approach makes sense in practice. The book also suggests that when we help our patients to find better stories to tell about themselves, we also find opportunities to reflect on our own lives.
This is a beautifully written and erudite book. The reference list is an Aladdin's cave of literary, religious and political sources, with juxtapositions that should not work, yet somehow only add to the pleasure of reading this thoughtful and distinctive book. It deserves to become a classic.
eLetters
No eLetters have been published for this article.