"Even though depression has periodically made me feel that my life was not worth living, has created havoc in my family, and sometimes made the work of teaching and writing seem impossible," writes David Karp, "by some standards, I have been fortunate." Indeed, depression can be devastating, leading to family breakups, loss of employment, even suicide. And it is a national problem, with some ten to fifteen million Americans suffering from it, and the number is growing. In Speaking of Sadness, Karp captures the human face of this widespread affliction, as he illuminates his experience and that of others in a candid, searching work.
Combining a scholar's care and thoroughness with searing personal insight, Karp brings the private experience of depression into sharp relief, drawing on a remarkable series of intimate interviews with fifty depressed men and women. By turns poignant, disturbing, mordantly funny, and wise, Karp's interviews cause us to marvel at the courage of depressed people in dealing with extraordinary and debilitating pain. We hear what depression feels like, what it means to receive an "official" clinical diagnosis, and what depressed persons think of the battalion of mental health expertsdoctors, nurses, social workers, sociologists, psychologists, and therapistsemployed to help them. We learn the personal significance that patients attach to beginning a prescribed daily drug regimen, and their ongoing struggle to make sense of biochemical explanations and metaphors of depression as a disease. Ranging in age from their early twenties to their mid-sixties, the people Karp profiles reflect on their working lives and career aspirations, and confide strategies for overcoming paralyzing episodes of hopelessness. They reveal how depression affects their intimate relationships, and, in a separate chapter, spouses, children, parents, and friends provide their own often-overlooked point of view. Throughout, Karp probes the myriad ways society contributes to widespread alienation and emotional exhaustion.
Speaking of Sadness is an important book that pierces through the terrifying isolation of depression to uncover the connections linking the depressed as they undertake their personal journeys through this very private hell. It will bring new understanding to professionals seeking to see the world as their clients do, and provide vivid insights and renewed empathy to anyone who cares for someone living with the cruel unpredictability of depression.
This sociological consideration of illness and disease in contemporary America comes from a professor (Boston Coll.) who uses his own suffering, treatment, and theory along with reports of 50 others who volunteered to talk with him about their major depressive episodes. Karp writes well, addressing psychological, chemical, and cultural perspectives, with much credit to C. Wright Mills, Erving Goffman, and Arthur Kleinman. Many psychiatrists would agree that too little attention is paid to the nature of the pain and the impact of social context on our definitions of normality and treatment. "Self-help" comes under fire, too, as shallow ideology in a time of advancing anomie. A careful, honest writer, Karp has produced a classic equal to William Styron's Darkness Visible (LJ 8/90) and Clifford Beers's A Mind That Found Itself (1908). Highly recommended for sufferers, would-be healers, and anyone interested in the effects of depression.-E. James Lieberman, George Washington Univ. Sch. of Medicine, Washington, D.C.