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As both an academic and professional psychologist, my background is somewhat unique. Most psychologists either opt for the research route, where they study human behavior in the hope of generating insightful theories, or they choose to work clinically with clients and patients. The problems with these distinct pathways should seem appar­ ent. In their academic role, research psychologists study and gener­ ate numerous theories about people, both as individualsandas social beings. However, while their conclusions may provide the basis for therapeutic work, research psychologists are not clinicians. Con­ versely, clinical psychologists and other therapists are trained princi­ pally to work with clients and patients. While many clinicians carry out research projects, their time is mostly spent offering professional help to people. Although both roles serve to advance the science and practice of psychology, researchers in their ivory towers may find their abstract theories and conclusions are inapplicable in the "real world," whereas therapists might discover they work within pre­ scribed treatment frameworks without questioning the limits of these approaches. Because of my two professional roles, I have aimed to bridge this gap. Here, I have combined my experiences of researching and treat­ ing depression with the intentions of improving treatments and of encouraging better communication between the two psychologies. Kristina Downing-Orr Oxford, England V Acknowledgments Many people provided the inspiration for this book, and I will be etemally grateful for all their assistance.

As both an academic and professional psychologist, my background is somewhat unique. Most psychologists either opt for the research route, where they study human behavior in the hope of generating insightful theories, or they choose to work clinically with clients and patients. The problems with these distinct pathways should seem appar­ ent. In their academic role, research psychologists study and gener­ ate numerous theories about people, both as individualsandas social beings. However, while their conclusions may provide the basis for therapeutic work, research psychologists are not clinicians. Con­ versely, clinical psychologists and other therapists are trained princi­ pally to work with clients and patients. While many clinicians carry out research projects, their time is mostly spent offering professional help to people. Although both roles serve to advance the science and practice of psychology, researchers in their ivory towers may find their abstract theories and conclusions are inapplicable in the "real world," whereas therapists might discover they work within pre­ scribed treatment frameworks without questioning the limits of these approaches. Because of my two professional roles, I have aimed to bridge this gap. Here, I have combined my experiences of researching and treat­ ing depression with the intentions of improving treatments and of encouraging better communication between the two psychologies. Kristina Downing-Orr Oxford, England V Acknowledgments Many people provided the inspiration for this book, and I will be etemally grateful for all their assistance.

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CONTENTS

Part Ⅰ Current Problems in Understanding Depression

 Chapter 1 Introduction = 3

 Chapter 2 Shelly : A Case Study = 15

 Chapter 3 Toward a More Definitive Understanding of Depression = 23

 Chapter 4 Biological Theories about the Causes of Depression = 33

 Chapter 5 Psychological Theories about the Causes of Depression = 47

 Chapter 6 Alternative Theories about the Causes of Depression = 61

Part Ⅱ Current Problems in Diagnosing Depression

 Chapter 7 Diagnosis : A Problem of Stereotyping = 81

 Chapter 8 The Subjectivity of Symptoms = 91

 Chapter 9 Problems in Classifying Depression = 99

Part Ⅲ Evaluating Treatments for Depression

 Chapter 10 Problems Related to Physiological Treatments = 117

 Chapter 11 Problems Related to Psychological Treatments = 131

Part Ⅳ Recommendations for Improving Diagnosis and Treatment

 Chapter 12 Toward an Improvement in Treatment = 149

References = 157

Bibliography = 159

Index = 161