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Depression: Depression & Related Conditions
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by Kelly Lambert
Basic Books, 2008
Review by A.Ch.F. Weizmann, Ph.D. on May 5th 2009

Lifting Depression

Kelly Lambert is Chair of Psychology at Randolph-Macon College and published several papers in Nature, Scientific American and other important scientific journals. She also is the author of the text Clinical Neuroscience (together with Craig Howard Kinsley).  In his new book Lambert developed theoretical and realistic overviews concerning depression and its social-cultural context. Lifting Depression is a book not only for the scientific researcher in mental health but also for the people suffering from depression and other related mood disorders.

Depression is difficult to understand and to cure or even alleviate.  Lambert, with a scientific and clear style, helps us to be familiar with the biological, personal and social roots of depression.  Particularly her analysis about the "driven rewards brain circuit" (chapters 3 and 9) are very important from the neuroscientist point of view. The "effort driven rewards" are related closely with the "resilience" (chapter 7).

"Resilience" is one of the keys of this excellent and very useful research. The flexibility of the brain and the hormones in the brain are connected to the moods disorders and, in this sense, the research emphasizes accurately the bearing of physical-therapeutically activities building a very practical hand-to brain link The approach of Lambert stresses not only the need of self-awareness but of a true change that ought to be dynamic, self-motivated and active; i.e., achievable and directly comprehensible and skilled by the people suffering or coping with depression.

Lambert is convinced that if the drive-reward lessens (concretely through the dwindling of physical work) we, our personality as such, is exposed to depression. Why? Firstly because "an innate resistance to depression" (p.7) is relatively, more or less, worsened within our emotional and natural web.

The research of Lambert set up, in some way, after the painful experience of her mother's death. She experienced the debilitating affliction of depression and pointed the method in order to expand new theoretical-practical treatment of depression. The effort-driven rewards (also well-known more commonly as "vacuuming theory) is indeed a very meaningful way in the actual psychoteraphy.Lambert did some important investigational research about: the so called "The trust fund rats" was an experiment Lambert did with the help of some of her students of Psychology and also with the collaboration of her colleague Craig Kinsley of Richmond University. In few words this experiment offers the practical verification concerning the adaptive value of "effort-based rewards». Lambert called it "learned persistence".

Chapter 3 is central in the approach of Lambert: "Building the effort-driven rewards brain circuit: use it or lose it."  With a very comprehensible style, Lambert broadens and gives explanation of the complicated neurological background of our brain, its circuits and drives in relation to mental health. Some lifestyles in Western Culture and its narrowed dynamism have deteriorated our psychological health, opening the way to mood disorders.

To work with the hands seems to have a healing effect in people suffering with depression, etc. Also group contact fortifies the brain resilience against mood disorder. One important remark is the potential healthier and therapeutically force of effort-driven rewards and supportive social contact in as much they existed together in the personal experience. The so called "touch" therapy strengthens social communication and contact: so it dapper up into the effort-driven rewards of the brain and helps to improve the anxiety and depression moods.

In chapter seven Lambert studies the concept of resilience that is central in her neuropsychological study and her experience in laboratory about such concept or central key is truly innovative and it is also very important to situate such researches in the widest context of contemporary neurosciences and treatments of depression and other mood disorders. Lambert gives special importance to the "social brain" (if we are allowed to use such turn of phrase). Effectively in this important book, so distant from the more classical psychoanalytical or psychiatric approach of depression; Lambert explained, with a very dynamic and clear style that nothing diminish its soundness and scientific value; the importance of the social "touch" not only with another human beings but also with animals to strengthen the rewards brain and our resilience to the emotional frailness.

In fact Lambert offers a project of non-pharmacological treatments for depression and it is not little merit to recognize her approach as one and indeed very effective therapy but certainly not as the unique one.  The "effort driven rewards" work therapeutically very well with some physical effort to get better our emotional well-being and health. The context must be evolutionary because our brain goes forward through interaction and contact.

Scientific and ordinary experience teach us, according to Lambert, that our mood will certainly improve  if the brain get farther away from a sedentary and static way of life and itself engages in a more dynamical lifestyle.

Lifting Depression is an excellent book and offers an important help to understand the modern trends in the neurosciences to cope with depression.

© 2009 A.Ch.F. Weizmann

A.Ch.F. Weizmann, Ph.D., Haifa University