Depression is a Choice: Winning the Battle Without Drugs
by A. B. CurtissHyperion, New York. 2001.
Reviewed by Christopher Dowrick, Professor of Primary Medical Care, Universityof Liverpool, Liverpool L69 3GB, United Kingdom.

Curtiss is a family therapist and cognitive behavioural therapist. She also has long personal experience of the condition now known by psychiatrists as bipolar affective disorder - formerly called manic-depression - in which periods of intense despair and misery are interspersed with episodes of highly charged energy and excitement. This book is a detailed, honest and at times alarming account of her ongoing struggle with depression, which makes good use of historical, philosophical, professional and some very personal perspectives.

The book's central message concerns the importance of what Curtiss calls 'Directed Thinking'. She has found that it is not necessary to become a victim of depressed mood. She argues that although we cannot get rid of it directly, we do have some element of choice in the matter. It is possible for us to think our way out of the depths of despair. She explains the technique of 'conscious neutral thinking', whereby we can learn to use simple repetitive thoughts - such as nursery rhymes - to counter and replace depressive thinking that can so easily hampers and cripple us. She also explains some of the cognitive-behavioural techniques used to challenge negative thinking, which are aimed to help us to see ourselves as not as failures but as 'works in progress'. In place of the complex biochemical formulae developed by pharmaceutical companies to derive antidepressant medication such as Prozac, she presents us with her own much simpler formula for the cure of depression:
Full texthttp://human-nature.com/nibbs/02/curtiss.html.

Depression Is a Choice: Winning the Fight Without Drugs
by A. B. Curtiss
Hardcover: 480 pages; Dimensions (in inches): 1.37 x 8.57 x 5.93
Publisher: Hyperion; ISBN: 0786866292; (October 2001)
AMAZON - US
http://www.amazon.com/exec/obidos/ASIN/0786866292/darwinanddarwini/
AMAZON - UK
http://www.amazon.co.uk/exec/obidos/ASIN/0786866292/humannaturecom/

From Publishers Weekly:
In overwritten, overlong text, Curtiss (Time of the Wild), a cognitive behavioral therapist, author of children's books and contributing writer to the New York Times, etc., explains how to overcome depression without drugs. The suggestions herein stem chiefly from her personal experience: her periods of deep depression, followed by manic incidents that led her, for example, to launch poorly conceived business ventures that lost money. She also, somewhat capriciously, left her husband and children for a year to live in an ashram. She explains how she freed herself from years of ups and downs by following her own program of "directed thinking." According to Curtiss, as soon as one becomes aware of depressed or manic feelings, one must "as an act of will, replace the accidental, unchosen thoughts that have caused the problem with new, positive, neutral or common sense thoughts or actions." Even in cases resulting from chemical imbalances in the brain, contends Curtiss, it's simply a question of learning how to employ the mind. She feels strongly that prescription drugs coupled with "psychologized thinking" (i.e. the Freudianpremise that "the mind and the self... are one and the same") will only mask,not help with depression. Curtiss also emphasizes the importance of traditional family values versus the current pursuit of individual happiness. However one feels about Curtiss's ideas, "directed thought" comes off as a murky off shoot of standard therapy; wading through the author's convoluted thought processesmay cause rather than cure depression.

From Booklist:
Although never diagnosed with depression, since childhood Curtiss has suffered depression-like problems, which she describes in detail. She also explains why she refused drugs. The most engaging aspects of her long book are her accounts of her experiences and of the growth in awareness that led her to "Directed Thinking," the major goal of which is to control not depression but one 'sreaction to depression; not to find fault (a culpable condition) but to find aremedy consisting of mental processes to employ as soon as the first twinges of depression appear. Developing such processes is a choice, hence the title of Curtiss' hortatory book, which probably will rouse discussion among caregivers,patients, and drug companies.

From Library Journal
With an estimated 17 million Americans suffering from depression, interest in this disorder is intense. Much of the controversy involves the best method of treatment. Advocates of Prozac and related new antidepressants cite their efficacy and lack of side effects, while detractors argue that these drugs arecreating a nation of drug-dependent zombies. Curtiss clearly is one of thedetractors. She describes herself as a manic-depressive who has cured herself through the use of some age-old mental "tricks" keeping busy, distracting herself through the use of repetitive thoughts, and, most of all, taking responsibility for her own life. There is some truth in this position studies have shown that cognitive behavioral therapy, which relies on learning to identify depressing thoughts and then counteracting them, is as effective intreating mild to moderate depression as medication. Moreover, there arelegitimate arguments about the "medicalizing" of social ills. Yet Curtiss's book, which consists primarily of anecdotes about her own mental battles and those of her therapeutic clients, does not present that position well. The author's implication that even the most severe manic-depression is better treated without drugs is irresponsible, since such patients are often suicidal. Definitely not recommended; Wendy Kaminer's I'm Dysfunctional, You're Dysfunctional: The Recovery Movement and Other Self-Help Fashions (Addison Wesley, 1992) is still the best sociopolitical argument against themedicalization of emotional difficulties.

Booklist
"Will rouse discussion among caregivers, patients, and drug companies".

Kirkus
"For quick help, though, in those moments when depression strikes, she recommends having some simple mind tricks on hand".

Publisher's Weekly
"... children's books author and contributing writer to the New York Times, etc., explains how to overcome depression without drugs"

Booklist, September 2001
"Will rouse discussion among caregivers, patients, and drug companies".

Publisher's Weekly, September 2001
"contributing writer to the New York Times, etc., explains how to overcome depression without drugs"

Book Description
In our culture, it is taken as an unquestionable fact that depression is a disease, that it is quite common, and that it is the explanation for everything from lethargy to conditions and actions that are much more serious. In her thoughtful and at times explosive new book, A. B. Curtiss takes a look at these assumptions, exploring them from a philosophical, psychological, and often adeeply personal point of view. She tells us that for many, depression is a choice. Using a technique the author labels "directed thinking," Curtiss creates a road map for converting the energy we put into being depressed into a strength that can ultimately lead us out of depression.

As someone who has suffered from depression herself, and who is also a practicing psychotherapist, Curtiss is uniquely qualified to pose these questions. For example, she asks whether, in the name of depression, we excuse ourselves of responsibility in certain areas of our lives. While acknowledging the seriousness of depression, she asks whether at times we falsely classify what we are feeling as depression, the disease, when in fact we are simply experiencing the difficulties that are part and parcel of the human condition,part of the process of living.

Curtiss suggests that we are living in a culture that is deeply "psychologized", and that psychological terms and perspectives have become so imbedded in who we are and how we categorize people and things that at times we may rest on those categories, and therefore give up the chance to overcome them, on our own.

Curtiss takes the available research on depression and the brain, and makes a convincing case that just as individuals who are depressed reside in their depression -- to the point where it becomes their focus -- that focus can be turned on its head and into a determination to find our way out.

From the Publisher
In this revolutionary and provocative work, a psychotherapist with a family history of depression takes a hard look at the syndrome and how to overcome it naturally -- without medication.What if Prozac was not the best answer to depression? What if you could learn to think your depression away? What if you could "pull the plug" on depression any time you wanted? What if depression is a choice?

Of the more than 19 million Americans who suffer from depression, many will turn to Prozac or other psychotropic drugs for relief. Now psychotherapist A.B. Curtiss raises powerful questions about this trend -- pointing out that formost of us depression is not a disease to be cured by antidepressant drugs, which only offer temporary relief, but a necessary defense mechanism. She advocates a process called "directed thinking" to permanently manage depression.

While recognizing that in its most extreme forms depression is best treated through pharmaceutical and psychoanalytical intervention, Curtiss argues convincingly that most people can control their depressive tendencies without the use of drugs and without the burden of endless therapy. To illustrate this, she draws from her own experiences with depression, anecdotes from her practice, and a wealth of fascinating information about the history of the treatment of depression. This immensely readable, eye-opening, and extremely helpful book encourages those people to take responsibility for their symptoms,and gives them the steps they need to fight and win the battle againstdepression.

From the Author
Depression is a trick of the mind. You can learn how to free yourself from the trick. As far as depression is concerned, when our mind crashes it is not as much mechanical failure it is driver error. We have a language program hot wired. We have a depression program hot wired. The reason we can get stuck in one and not the other is because the depression program is a defense mechanism that is triggered by the fight-or-flight response that ends up in a closed feed-back loop as a result of our reaction to the stress of the reaction to the stress of the reaction to the stress ad infinitum. We can get out of this syndrome by using some simple mind tricks and I wrote this book to show how to do it.

My father and my brother were both diagnosed manic-depressives, as I was myself diagnosed with manic depression as a young woman in my thirties. My father diedin a state of catatonic depression and my brother, who hasn't been able to workin almost twenty years. I was frightened by outcome of the drug treatment my father and my brother underwent so I stopped going to psychotherapists, went back to graduate school and became one. And I found the answer in the research of neuroscience and medical hypnosis.

About the Author
A. B. Curtiss is a licensed family therapist and board-certified cognitive behavioral therapist whose writing on depression and other topics has appearedin The San Diego Union-Tribune, The New York Times, and The Boston Globe. She has published numerous books, including the critically acclaimed Time of theWild. She lives in Escondido, California.

Excerpted from Depression Is a Choice : Winning the Fight Without Drugs by A.B. Curtiss. Copyright © 2001. Reprinted by permission. All rights reserved.

JOURNEY TO A CHOICE
The moment I felt depressed, it never occurred to me to do anything else but be depressed. The progression from a feeling of depression to being a depressed person was a foregone conclusion that I never questioned.

Depression always ends. Not because of Prozac. Not because of psychotherapy. Not because of psycho analysis or shock treatments. Depression always ends because it is in the very nature of depression to end. The only question is, how can we get it to end sooner, the way we want it to, instead of later, which we hate?

The answer is that we have to learn to think about depression in a different way. But it is not going to be enough to simply consider new ideas from a safe distance. We have to get down on our hands and knees with a magnifying glassand crawl around inside of the beliefs we have for so long relied on. It is not going to be enough to consider what we think. We have to consider how we think because the problem of depression lies in the very gears of our thinking process.

To do this we must entertain some rather esoteric ideas that we cannot so easily dismiss with our ready-made answers. There are wonderful clues in ancient paradoxes, like koans: What is the sound of one hand clapping? These clues can reach beyond our normal considerations to some uninvented part of us that we are not normally in touch with. They help us learn to think sideways, intuitively, restructuredly -- all the better to match wits with our depression.

Depression makes us fear that we will never be truly happy because we see how our happiness can be blown away in an instant, like straws in a hurricane, and absolutely nothing remains to comfort us in our anguish.

We need not be afraid. We do not need comfort. It is not true that all our happiness has fled and what we are suffering is the pain of its loss. Our essential capacity for happiness is not something we can get back or acquire, no matter how hard we try, because it is our natural state. What happens is that depression covers over our natural state and tricks us into thinking that we don't have it anymore. When we properly address our depression, it relinquishes its hold upon us, and we find ourselves once again in the bedrock of our infinite okayness. Practically speaking, happiness is unlearned depression.

Our essential happiness is not conditional. Conditional happiness cannot pass for essential happiness any more than being serially grateful for disparate things can pass for a state of infinite and abiding gratitude. Conditional gratitude, where we see something that causes us to be grateful, is not the same as essential gratitude, where being grateful causes us to see something. Conditional happiness, the temporary excitement of having what we want, is not the same thing as essential happiness, the transcendent awareness that we can want what we have. Conditional happiness is a feeling that comes and goes. Essential happiness is our original state of well-being that is always available to us. It is not quantitative despite the fact that we think it depends upon some quantity of things or feelings we must have.

Depression is not quantitative, either, despite the fact that psychiatrists have labeled it a disease and divided it up into various classifications and diagnoses. Depression, like essential happiness, is qualitative. But depressionis not our natural state, it is a state of alarm. When I began my career as a psychotherapist in 1987, I was as deeply afflicted with depression as anybody else who walked through my door looking for help. But no more. I have come tosee depression in a revolutionary way, which has totally eliminated the whole idea of it as a disease in my life. After suffering with it for decades; after watching my brother struggle with the same ravages of manic depression that killed my father, I know, now, that it doesn't have to be that way.

There are 17 million people suffering with depression who are all seeking an answer to their hurt and pain. Ten years ago, as a result of my work as a cognitive behavioral therapist, my struggles with my own severe mood swings and my experiences with patients who came in for therapy, I discovered the realcause of depression. I haven't "been depressed" since that time.