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Down and Out

Down Is Not Out
Teenagers and Depression
Lee and Wortman
1986

This book has personal stories and treatment scenarios and uses terms like “moodiness” when talking about suicide.   Although anti-depressants are mentioned,  other treatments for depression include ECT (or as I remember,  Electro-Shock) and lithium.  I also have to mention the entire bibliography and resource list is completely out of date.  This remains one of the best examples of why we weed.  Can you imagine a teen checking this out for current information on depression? By the way there isn’t much in way of graphics or any illustrations.

I included just a brief excerpt about suicide and by the way,  that is where the chapter ends.  Next page starts the chapter on “how to make it go away”.    I guess we will never know if it is “for real”.

I am now going to write in my diary and then read some Sylvia Plath.

Mary

0 Responses to Down and Out

  • Actually Mary, lithium can be lifesaver, even today. I have a bi-p0lar teenage daughter and her meds were not working well until a new doctor added lithium to her daily routine. While I have no doubt the book is too dated to be of much use, unless Mary is a doctor, she shouldn’t add comments on prescription medication.

  • Ideation? Is that a real word? Time to break out the dictionary!

  • OMG, I’m totally suicidal. I hate my job and always forget my lunch at home. Good thing I’m not a teen otherwise it’d totally be ‘for real’. I also love how the title reduces ‘moodiness’ to what I would have assumed is a second grader’s grammatical text book with a heavy focus on prepositions.

    • Depression and ‘moodiness’ are not the same thing. Practically all teenagers are ‘moody,’ due to being caught between childhood and and adulthood. Depression is a psychological disorder characterized by a chemical imbalance (ie, too little serotonin). Do try not to dismiss it as ‘moodiness.’

    • Jason, you know what prepositions are! That gets my endorphins flowing!

  • Um, lithium and ECT are still used as treatments, especially for bipolar disorder (manic depression, as was) – so maybe this book isn’t quite as obsolete as you’d like to think.

  • Nobody’s taking this blog as medical advice. No reason to get so offended that she was mistaken about a medicine. She’s hardly prescribing or recommending any medical treatment. Chill.

  • Lithium is quite often used for depressive illness which is not responding to other medications. When added, at an effective dose, up to 50% of people find it causes a 50% reduction in symptoms. Electroconvulsive therapy (or as you remember – Electroshock) is a third-line treatment for depression and is less often used to treat treatment-resistant mania or catatonia. For depressed patients receiving medication, up to 30% will not respond (i.e. have a 50% reduction in symptoms) even after multiple medications have been tried both together and one after another. ECT gives 60-70% of these people complete remission (i.e. no symptoms) after 6-8 treatments administered over 3-4 weeks. The average use of ECT in the ’00s was between 8 and 11 per 100,000 of country population – data from Munich, Oslo, Edinburgh, London, Dublin.

    By all means comment on the form and style of medical / pop-medical literature, just maybe not the content.

  • Sure, there are definitely more up to date materials available about depression and teens, but the term “suicidal ideation” is absolutely used today in the mental health field, and clinical depression is still defined as lasting two or more weeks and involving changes in sleep and appetite. Interesting also that in ’86, before goths and before “emo” kids, it was still sometimes hard to tell if a kid was seriously thinking of suicide or just being a “moody” teenager. I for one have a stack of really bad “dark” poetry from those years stashed somewhere…

  • I take it this book isn’t directed at teen readers.

  • Yes, lithium is fantastic. I have an older family member for whom it made all the difference after half a century of bipolar syndrome (manic depression as it used, less subtley, to be called) including frequent breakdowns and admissions to mental hospitals. And I’ve witnessed the scary effects of EST too – how could they do THAT? The recent past was unbelievably cruel and stupid.

    The book looks like it was aimed more at concerned parents, rather than the depressed teens themselves. Ironically, if parents are good enough to refer to such things (however misguided the old book may seem), then their children probably won’t go getting depressed.

  • ECT was moderately helpful to my wife, though it turned out to not “stick” with her (she’d gone through almost every AD drug prior to this), and while there was some memory loss, it wasn’t “scary”, unless you’ve watched a lot of old movies. She was completely sedated during the procedure.

    What has finally worked (knock wood, cross fingers) is Nardil, one of the MAOI family. These are not prescribed often due to severe dietary restrictions, but giving up cheese and soy sauce is worth it to not be hospitalized 3 or 4 times a year while doctors play medication roulette. She’s been stable for a full year now, which is bordering on a record since her depression first manifested.