04 Mar Self-Help Books to Combat Depression
It’s no secret that down time now and then is good for health. In the unrelenting rat race of deadlines, traffic, and constant connectivity, curling up on a comfy couch with a good book and a cup of one’s favorite coffee or tea once in a while can do almost as much for physical and mental health as a good diet and appropriate activity level. As more healthcare practitioners recognize the power of words, sometimes a bit of reading is just what the doctor ordered.
For relaxation purposes, any type of book patients enjoy would fit the bill, but when it comes to addressing specific health concerns, a surprising body of literature suggests that “bibliotherapy” can be beneficial. Bibliotherapy is a form of cognitive and behavioral therapy, usually involving self-help books that can further educate patients about their conditions, in order to offer supplemental information beyond what practitioners might have time to provide during a typical appointment. It can also be empowering for the patients, as they may feel they are a more active participant and have a greater hands-on role in their own treatment.
One of the most well-researched conditions regarding the efficacy of bibliotherapy is depression. According to Australia’s National Health Medical Research Council (NHMRC), bibliotherapy is supported by Level 1 evidence (systematic review of randomized controlled trials) for patients twelve years old and above who experience mild to moderate depression.
Bibliotherapy, in the form of self-help books that included actionable strategies and real-world exercises, showed statistical and clinical significance for improving depressive symptoms in young people (early to mid-twenties) with mild, sub-threshold depression. This study even had a placebo group, as best as one could be constructed for such a study: the placebo group was assigned reading material similar in length and structure, but whose content included practical advice about unrelated matters, such as becoming more organized at home or in the workplace. Compared to the placebo and a non-intervention control group, the group assigned to bibliotherapy showed improvement in depressive symptoms throughout the month-long intervention, as well as upon follow-up three months later. The authors speculated that results might have been even more promising if subjects had applied themselves to completing 100% of the exercises presented in the intervention book, rather than the reported average of 65%. Much like physical exercise, the benefits of cognitive and behavioral therapy via bibliotherapy are more likely to last if the recommended exercises are continued on a regular basis, over the long-term.
Similar results were seen in a small study involving mild depression in adolescents (ages 14-18). This study showed impressive statistically and clinically significant improvements in depressive scores in this subject population. Further improvements were seen at follow-up testing one month after completion of the therapy. The most notable decrease was seen in what the authors called “dysfunctional thoughts,” while no significant changes were noted in negative automatic thoughts. Bibliotherapy may be a helpful first approach for these younger patients, whose parents might be reluctant to introduce pharmaceutical drugs. It is crucial to note, however, that bibliotherapy and self-help exercises are not intended to take the place of more intensive therapies, when indicated.
Older adults have also experienced benefit from bibliotherapy. In a small study involving subjects over age sixty with mild to moderate depression, books that taught either cognitive or behavioral therapy were superior to no intervention at reducing depressive symptoms. The authors emphasized that the content of books intended as bibliotherapy needs to be “relevant and reasonable” to the condition it’s intended for. They also made it clear that bibliotherapy is likely not sufficient as a standalone therapy, and it should not be considered a substitute for more intensive treatment strategies, when necessary, but it may be a useful adjunct to other treatments, especially in cases where patients experience financial, physical, or geographic barriers to getting help—all of which may be more likely in an older population.
While self-help books specifically designed to address depression may be warranted at times, don’t underestimate the potential beneficial impact upon any patients carving out a little quiet time to unplug and read whatever they enjoy. Beyond reading books with the specific intent to help understand and ameliorate a particular condition, taking time for occasional self-care via reading and recharging may rank right up there with so many other healthy lifestyle choices. Think of it as vitamin R – relaxation – as long as it’s looked as an adjunct and not a replacement for professional guidance, of course.