Sadness Revealed: Insights on Women's Depression

In the introduction to A Secret Sadness, author Valerie Whiffen states that the book is a self-help book. It is surely structured as a self-help book, with real-life case examples and “Questions to Ask Yourself” at the end of each chapter. However, unlike most self-help books, A Secret Sadness presents substantive, informed summaries of state-of-the-art empirical research to support the book's advice and claims. Some of the research cited is Whiffen's own work. Indeed, one of the greatest strengths of this book is Whiffen's expertise as a researcher and clinician. Throughout the book, her insights are informed by a thorough understanding of current evidence and practice regarding the etiology and treatment of women's depression. This informed stance gives the book a compelling and engaging quality rarely found in psychology books that are written for a nonacademic audience.

A Secret Sadness is organized in a manner that allows readers to examine specific depression-related factors that may be present in their lives. The introduction briefly explains that the book is intended for depressed women and the people close to them. The first main chapter of the book outlines the symptoms of depression and how these symptoms manifest themselves in three case examples of women from Whiffen's practice. These three women are presented throughout the book to illustrate the various risk factors, life experiences, and treatment approaches that form the book's content. The case examples are well chosen, and the three women are described in a manner that is sympathetic, yet straightforward in its analysis.

The second chapter, which focuses on the role of biological processes in women's depression, is also very direct; Whiffen states that “there is no evidence that reproductive hormones cause depression” (p. 20). That statement is just one example of how Whiffen dispels myths concerning what is known (and what is not yet known) about the causes of depression in women. She also explains the complex interaction that exists between genetic risk and life stress in bringing about a depressive episode. In such explanations, Whiffen exemplifies the writer's dictum “Know how complicated it is and then state it simply” (Hemingway, 1986, p. 37). She presents the current state of scientific evidence and knowledge around the issue of biological risk factors in a concise manner, while still accurately articulating the current challenges faced by researchers in accounting for women's elevated risk of depression during the reproductive years. The reader sees that biology alone is likely not the cause of depression, even during the postpartum, premenstrual, and menopausal phases of a woman's life.

Whiffen is able to use the research literature and her clinical expertise to encourage the depressed woman reading this book to examine her whole life in searching for possible causes of her depression. This examination includes careful consideration of current stressors, as well as past traumas. Three of the 10 chapters of the book are dedicated to a discussion of attachment styles and childhood abuse. Whiffen details the possible causal pathways of influence between childhood trauma and depression in adulthood. Because that discussion is a dominant theme in A Secret Sadness, this book may be most useful for women looking to better understand the roots of patterns of recurrent depression in their lives, rather than for women coping with one current singular stressor that is depressogenic. However, Whiffen does devote attention to the importance of gender-role expectations in accounting for women's experience of life stress and consequent depression. In Chapter Three, entitled “The Process of Living Is Stressful,” she cites current research in describing the types of stressors that are most likely to cause depression, as well as key protective factors, including the importance of having a confidante who provides guidance and support.

The book certainly succeeds at demonstrating how some current relationship behaviors that are problematic may have served an adaptive function for a woman earlier in her life, especially in the context of childhood abuse. Such information can be highly enlightening for depressed women who engage in self-blame concerning their self-destructive behaviors. Also helpful is Whiffen's reframing of potentially pathologizing terms that are often applied to depressed women. For instance, she favors the phrase “blind spots” over the label “cognitive distortions.” She details how certain types of blind spots, such as not recognizing one's need for independence within a damaging relationship, can make women vulnerable to recurrent depression. However, it is also evident in her descriptions that everyone, male and female, has blind spots. Such normalization in Whiffen's writing allows for a combined effect of nonblaming and clarity.

Another strength of this book is its practical guidance concerning different types of treatment approaches and how to seek a suitable therapist. In addition to describing the broad range of available treatment options for depression, Whiffen outlines the techniques and strategies that were instrumental in the course of treatment for each of the three case examples of women she has presented in the book. She also recounts the key roles played by the women's readiness for change, the presence of a supportive social network, and the therapeutic relationship in determining the effectiveness of treatment.

As a self-help book, A Secret Sadness is decidedly psychological and quite apolitical. There is not a great amount of content concerning the role of societal oppression in increasing women's risk of depression. However, Whiffen does address the role of the social context of women's lives (including their work lives, friendships, and lives at home) in demonstrating the complex interplay between various sources of risk. She also focuses on much more than just symptoms in describing the experience of depression and recovery from depression. Whiffen has accomplished something rare and crucial in writing this book; she has done justice to the women whose lives and relationships are so dramatically impacted by the devastation of depression. Moreover, she has shown the powerful synergy that can exist between empirical research and sound practice in helping women cope with depression and its consequences.