The story of depression and how we treat it

A new book weaves science, history, philosophy and personal narrative in a refreshing and more globally inclusive look at depression.

Woman sick with malaria sitting outside a small hospital in Zimbabwe. Image credit Ulrika via Flickr CC BY-ND 2.0.

Dixon Chibanda is a Zimbabwean psychiatrist who developed The Friendship Bench, a program started in Harare, that country’s capital, that utilizes the power of trusted community elders as informal psychotherapists and liaisons between patients and medical professionals. The program has been shown to reliably improve the symptoms of patients diagnosed with common mental disorders within six months. It represents a new frontier in the field and has been a source of inspiration for many other community-based programs for mental health around the world.

Chibanda is one of a featured subjects in science writer Alex Riley’s new book, A Cure for Darkness: The Story of Depression and How We Treat It, which takes a more global and socioeconomically inclusive approach to studying depression, the most common mental illness there is.

Mental health has grown from being a subject discussed within the psychiatric and scientific community to a topic commanding growing coverage in the mainstream. In 2019, the World Health Organization launched the WHO Special Initiative for Mental Health, an effort to improve access to mental health services in some of the world’s most vulnerable nations. This summer, in my home country, a bipartisan gun-safety law was signed into US federal law. It includes some unprecedented commitments to addressing mental health, including a 13 billion dollar commitment to expanding mental health programs in schools. Even in pop-culture, from Simone Biles to Giannis Antetokounmpo and beyond, famous figures are making an effort to remove the stigma around discussing mental health. At the same time, crises and generational challenges—including a global pandemic and the effects of social media—are some of the latest and most powerful antagonists in this field. While the desperate calls for better mental health services are beginning to be answered, Riley has written A Cure for Darkness to help get us up to speed on depression.

In 366 pages, Riley takes on the ambitious and vulnerable task of telling the story of depression through a historical and scientific lens, while simultaneously weaving in personal experience. The book is bound by a prevailing scientific and philosophical debate about the inner workings of the mind, particularly the debate between nature and nurture. A theme throughout A Cure for Darkness is how scientists have gone back and forth between the biological and psychological explanations of depression, and how many of the modern tools and strategies to address mental health come from a collaboration between the two schools of thought. Laced in the fabric of each chapter is a memoir of Riley’s journey with depression, turning what could have been a very impersonal book of science history into a compelling piece of self-reflective literature on depression.

The chapter on Chibanda in Zimbabwe is followed by one on Helen Skipper, a peer resource trained in mental health, substance abuse, and criminal justice from New York, who has also been through mental health issues, incarceration, and drug addiction. As a peer resource for the New York City Department of Health and Mental Hygiene, Skipper helped addicts by drawing from her lived experience, further strengthening the idea that affected communities can and must be a part of mental health solutions. The work of Chibanda and Skipper reminds readers of how culture and socioeconomics are important factors to consider in order to truly democratize treatment for depression.

Early on, Riley also mentions the work of Abu Zayd al-Balkhi, a first-century scientist from what is now Afghanistan. Abu Zayd was ahead of his time in the way that he categorized depression in his book, Sustenance of the Soul, a framework that the West began to popularize 19 centuries later in diagnosing and treating depression. Additionally, Riley digs into Brazilian scientist Draulio Barros de Araujo’s work studying ayahuasca, a psychedelic drug used by indigenous people in religious ceremonies in Brazil for centuries. In providing such examples, Riley shows how globally sourcing scientific expertise is integral to true scientific progress.

While A Cure or Darkness has pockets of refreshing perspectives and strands of powerful themes, at times Riley can make them hard to track. Although the transitions between chapters tend to be smooth and follow a chronological arc, Riley jumps between writing styles in a way that produces some uneven pacing. Some sections move from dense and analytical explanations of biological or psychological phenomena, to a more novel-type mode that places greater emphasis on storytelling. This balance between exposition and narration is a difficult feat of literary gymnastics, and at times the book falters under the weight of its great ambitions. However, considering the ground Riley covers, he delivers on driving home the relevant takeaways and unique perspectives.

In this monumental effort to fit history, science and memoir into one book, Riley delivers a unique profile on depression. The way in which A Cure for Darkness is written is coincidentally symbolic of a larger conclusion: solutions to the most important problems require a holistic and collaborative approach. In the same way that Riley combines memoir and science, narrative and exposition, large problems such as mental illness require a combination of psychological and biological knowledge, in addition to cultural and socioeconomic understanding. This anthropological angle turns the study of depression into a look at the human condition. So, as a 22 year-old student studying computer science and philosophy, I finished A Cure for Darkness thinking, “where can Artificial Intelligence (AI) fit into mental health?” While it’s fair to treat it as out of the historical or contemporary scope of depression, AI is poised to play a huge part in every aspect of human life, including mental healthcare. I’m left wondering how AI can be a part of the expanding toolkit against depression, or even bring those tools together in ways that we can’t imagine.

Further Reading