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Depression: The Mood Disease
Mondimore, Francis Mark, M.D. Baltimore: The Johns Hopkins University Press, 1990; revised 1993. Hardback, 256 pages; also in paperback.
Although Dr. Mondimore, who received his psychiatric training at Johns Hopkins and is now on the faculty of the University of North Carolina School of Medicine, focuses his book on the scientific knowledge about mood disorders, he makes the technical information easily understood by the reader. For example, to illustrate the action and malfunctions of the brain’s neurotransmitter system, Dr. Mondimore draws analogies to automatic teller machines (ATMs) and ATM cards. He uses the analogy of malfunctioning thermostats to illustrate the mechanics of mood disorders.
Because Dr. Mondimore keeps away from “typical” cases, the case-study vignettes he uses are more interesting than most. In many of these composite case studies, he portrays himself as making errors in the initial diagnosis and treatments. With this device he not only illustrates the difficulty and importance of accurate diagnosis and treatment, but also provides a refreshing bit of realism.
This comprehensive book covers not just depression, as its name may imply, but also manic-depressive disorder and other variations of mood disorders. In the discussion of each, Dr. Mondimore summarizes the current state of knowledge for the lay reader who does not want to pursue the details of individual studies. For example, in discussing the use of light to treat seasonal affective disorder, he reports that every pertinent research study has affirmed the effectiveness of this treatment. In contrast, he reports that studies have not substantiated some popular theories about the relationship between alcoholism and depression.
Dr. Mondimore’s advice to patients is candid. When asked, “How many drinks can I have?” he answers, “How many chocolate cupcakes should a diabetic eat?—the fewer, the better!” Although his advice to families is sympathetic, DRADA readers found it to be less substantive than other sections of the book; his description of involuntary commitment, for example, is more a textbook recital of procedures than the realistic discussion that characterizes his treatment of medical issues.
New in this revised (1993) edition is a section on new medications. Defending the value and safety of the antidepressant Prozac, Dr. Mondimore laments that many patients have stopped taking much-needed medication because of unfounded attacks on Prozac and other psychiatric drugs as well as irresponsible talk-how hosts who are uninterested in providing accurate information. Dr. Mondimore also comes on strong against stigma. He says it is time to toss the stigmatizing phrase “mental illness” into the trash bin, along with the terms “madness” and “insanity.”
The book ends on an upbeat note. Dr. Mondimore describes research as proceeding at a “dizzying pace.” Thus, he says, the answer to the question “Will I have to take this medication for the rest of my life?” is “Probably not.”
By Delphine Peck
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