Self-help books & depression: can they really help?

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E ach night, my six-year-old and I dip into Penguin’s ‘Pocket Jokes’ book to go to sleep on a laugh (it’s life-affirming – try it). Current favourite: What did the 0 say to the 8? ‘Nice belt!’ The other book I’ve got on the go right now is about depression, the antithesis of a book of gags (though I have to say there are bits of it that resonate so deeply that they’ve made me laugh out loud – ‘Hurrah! I’m not the only one who duvet dives!’). I’ve read it before but it was so good I decided to read it again.

As it happens, a study was published this week in the journal Plos One saying that self-help books can help with depression. Technically, the book I’m reading isn’t a self-help book, but as anyone who has suffered from depression will tell you, help can come from curious and unexpected places.

More than 200 patients diagnosed with depression by their GP took part in this recent University of Glasgow study. Half of the patients were also on antidepressants. The research found that patients who were offered books dealing with various aspects of depression (such as how to be assertive), plus sessions guiding them in how to use them, had lower levels of depression a year later than those who were offered simply the usual GP care.

Not only that but the study led to Professor Christopher Williams found that a year later, the patients in the self-help group were more likely to be keeping on top of their depression. In other words, the benefits seemed to endure.

Of course, most studies have an antagonist, research that posits the opposite, and therefore you may not be surprised to hear that other research has suggested that self-help books can make depressed people feel worse. Canadian researchers found that people with low self-esteem (which people with depression will tell you can be a constant companion) found they felt worse about themselves after repeating positive self-statements found in self-help books.

The study in Psychological Science, a journal of the Association for Psychological Science, found that positive self-statements like “I am a loveable person” or “I will succeed” may have been designed to lift self-esteem and prompt positive action but actually did the opposite.

The authors found that, paradoxically, mood fared better in people with low self-esteem when they were allowed to have negative thoughts than when they were asked to focus exclusively on positive ones. And they concluded that whilst repeating positive self-statements may benefit people with already high self-esteem, it may ‘backfire for the very people who need them the most.’

What to do? Do self-help books for depression offer any true benefits of not? The Canadian study resonates for me – the number of times, over the years, that people said to me, in the depths of my depression, ‘But you’ve got so much to live for!’ They were effectively reflecting what these positive self-statements in books are saying – ‘Think positive and you’ll get better!’

Actually, in the depths of my illness, urging me to think positively (albeit by dear friends often not knowing how to best help me – thank you for your persistence) made me feel even more bleak and lonely. Sorry lovely people – it’s the nature of the beast.

I didn’t realise why until I analysed it, when I was feeling much better and had more clarity. I then realised that – like the Canadian authors suggested – positive statements, those ‘giddy-ups’, just served to widen the chasm between how I felt and how I believed I OUGHT to feel. (Remember, depression is an illness, not a state of mind or a choice. My pet topic. I shall return to this. With bells on. Repeatedly).

To this extent, the self-help book market, hoping to instil real change in people with depression and other mental health issues, may offer a lifeline but may also add to the already heavy heart of a person with true depression. Opening one of those books and ploughing through its worthy chapters is a bit like joining a gym in January and being told by your personal trainer that you can go from an inert life to signing up for a half-marathon within weeks. It can be too much, it’s not necessary appropriate for you and may even set you up for a fall.

But there are self-help books and self-help books. They are not all the same (it’s worth noting, too, that whilst the economic downturn has seen UK books sales down by 1 per cent overall in 2012, sales of self-help books during that same period rose by 25 per cent, creating a £60m industry. These people WANT you to buy in to what they are evangelising). Fostering a healthy scepticism is, I feel, no bad thing.

I’ve read some that have compounded my feelings of depression and hopelessness, and I’ve read some tripe that has burned nicely on an open fire. I’ve also found some – like the one I mentioned at the start of this blog entry – that have made me say, ‘Yes!! This is it!! Someone gets it – at last!!’

Even the experts acknowledge there’s good, bad and indifferent out there by way of self-help books. The Royal College of Psychiatrists (RCPsych), as part of the Resilience and Recovery campaign and working in partnership with the Reading Agency, has compiled a Books on Prescription list of helpful books in the mental illness arena.

Depending on where you live, you may be offered one of these by your Primary Care Trust in conjunction with local library services. If not, it may be worth taking a look at the list anyway as a starting point, whether you’ve got depression or another mental health condition, or you’re someone trying to help someone who has.

Personally, I’ve found some of the books on the list to be of the kind that the Canadian researchers talked about – they only served to increase my feelings of inadequacy. But it’s important to acknowledge that there are different levels of depression, from mild to severe, as well as different types (unipolar or bipolar, for example) – maybe mine was too bad to be helped by the kinds of self-help books I sought out during my most desolate times. One size doesn’t fit all. The books that made me feel worse may be the very ones to put the spring back in your step.

The list also contains two of my very favourites – ‘I Had a Black Dog’ and ‘Living with a Black Dog’ by Matthew and Ainsley Johnstone. These cleverly illustrated books talk about depression as it is (and in the case of ‘Living with a Black Dog’, offer advice on how to ‘take care of someone with depression while looking after yourself’). ‘I Had a Black Dog’ was described by Stephen Fry as saying ‘with wit, insight, economy and complete understanding what other books take 300 pages to say.’ There. And he should know.

What of the book I’m reading at the moment? It’s ‘Shoot The Damn Dog: A Memoir of Depression’ by Sally Brampton. I absolutely love it. When I first read it, I felt relieved and vindicated (“Telling somebody who is in the grip of severe depression that they are being selfish and self-pitying is like telling somebody with asthma that they have breathing difficulties.” Exactly!!!). It’s the book I would love to have written. To my knowledge it’s not on the RCPsych list but in my view it is a mental health masterpiece and I would urge you to read it.

So here you go – here’s the Books on Prescription list (am seeking a more universal link, but this shall suffice for now, I hope). In my experience, I suggest using it as a good starting point. But I’d also say, again in my experience, that helpful books can often be the ones you discover by chance, the ones that aren’t touted as ‘self-help’ books, the ones whose helpfulness you didn’t see coming, like ‘Shoot The Damn Dog.’

I’d also LOVE to hear your suggestions as to what has worked for you, self-help book or other. Oh, and if you know of a good joke book, I’m up for recommendations. I think ours has almost run its course…

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Freelance journalist and mental health blogger, based in London UK

3 Responses to “Self-help books & depression: can they really help?” Subscribe

  1. Steve Ferber February 6, 2013 at 11:15 pm #

    I thought that your readers might find my new book “21 Rules to Live By” of service. It pulls together the expert advice from self-help gurus worldwide.

    Said one reviewer:

    “I want to pass this book onto my son and daughter who are in their early thirties, because the advice within it takes a lifetime to accumulate, but this book provides a short-cut to living an examined life.”

    Said another:

    “Steve Ferber’s ‘21 Rules to Live By’ should be one of those books you want to keep upon your bookshelf for life – one you will find yourself going back to and reading passages or the entire book many times throughout your life . . . .”

    The book is available on Amazon (along with full book reviews). If you decide to take a look, I’d love your feedback. Thank you kindly. – Steve

    • martharoberts69 February 7, 2013 at 8:23 am #

      Thanks so much for this, Steve. I shall take a look. Best wishes, Martha

  2. tony frais June 22, 2015 at 1:57 pm #

    Some of your readers may be interested in a new book for carers who are looking after a depressed partner.
    The book is designed to bridge the gap between the basic short leaflets that give the carer advice and the longer self-help books.

    The title is; An Introduction to Coping with Depression for Carers. Author: Tony Frais Published by Littlebrown London, Released July 2nd 2015

    From the back cover

    An indispensable guide offering insight and support to carers of people with depression

    Looking after a person with depression can often leave carers emotionally and physically exhausted. This short, straightforward and easily understandable guide offers valuable advice on how carers can:

    – better understand the nature of depression and how it affects both patient and carer

    – have a clearer understanding of the treatment options for the patient, including medication and therapy

    – lessen the impact of the illness on the carer’s life

    – find the help and support they need

    – maintain their own well-being whilst supporting the patient through to recovery and beyond

    Although aimed at the carer, this is a guide that is equally valuable to the patient themselves and to their wider family and friends in promoting a better understanding of the experience of depression

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