The Devil You Knew: The myths around depression, and why your best days are ahead of you

by Ian Hickie

‘Cuts straight to what you need to know about depression ­– no punches pulled.’ DR NORMAN SWAN

We are living amid a mental health epidemic. Clinical depression has devastated the lives of countless people, sending families into crisis and weakening the ties that hold communities together. It’s a disorder that doesn’t discriminate. At the outset it can be confused with grief and ordinary sadness; at its extreme it can end in tragedy. Within its labyrinth, the corridors and dead ends are many – unabating hopelessness, withdrawal from loved ones, fatigue of body and mind, panic attacks and addiction – and the ladder out difficult to find. But there is hope.

Informed by internationally renowned psychiatrist Ian Hickie’s 35 years of clinical experience and extensive case studies, The Devil You Knew explores the inner workings of the depressed mind and the myriad influences – environmental, physiological, social – to guide us towards the right diagnosis and offer pathways to healing. Useful tips on what to do and how to get better health care abound. Along the way he dispels some of those common fears and myths that keep people in need away from the best possible care.

Hickie includes stories and lessons learned from many people who have travelled these paths, reinforcing that, while we are all on our own journey, we’re never alone. He also looks into the latest cutting-edge treatments that are pushing our knowledge of the brain and consciousness, and their influence over the body, into the future.

Every mental labyrinth might be different, but The Devil You Knew offers a dynamic, expert look into the architecture of those labyrinths, passing along a blueprint so we – as individuals and as a society – can climb out into the open air.

Genres: Nonfiction

428 pages, Kindle Edition

Published October 3, 2023

Reviews

[Danya Button · Rating 3 out of 5]

it was interesting but then it got repetitive and kept going and going and going and going.....

[Chloe · Rating 3 out of 5]

Repetitive. Best read as a reference, to be dipped in and out of. Counters common myths and makes a clear (and valuable) distinction between clinical depression and depressed mood. Academic in tone, grounded in fact but written more like an opinion piece.

[Merridy]

I found this quite fascinating personally. I realised that most of what I knew about clinical depression was in fact false. I learnt a lot. The more I learn about health the more evident it becomes that we need to treat each patient in a highly individualised way.

“The pain of severe depression is unimaginable to those who’ve never experienced it”

“Many cases of clinical depression happen without any clear event or chronic stressor”

I found the chapter on ‘positivity movement’ extremely validating - where the underlying message is: just get on with it, it’s all about mental strength, I pushed through and now I’m okay, just get up and go for a walk. This is not how it works.

Anyway, very interesting read.

[Caitlin]

Ill be so honest, I feel as if this could have been much shorter. I fell asleep listening to a lot of this so not sure if I can give a fair rating

[Catherine McMahon · Rating 4 out of 5]

4.5 🌟

Anyone who has Depression, as I do, has had it, or loves someone who has, should read this book. Written by an expert, but in everyday language. Explains the Why’s and How’s so clearly. Highly recommend.

[Tiana Nairn · Rating 4 out of 5]

Professor Hickie presents a clear account of what depression is, its causes, its biology and its treatment, within a context of busting many myths about depression. The book is easy to read and helpfully explains the biological evidence of depression and the bodily damage it can drive, current understanding of its causes (it doesn’t need to be trauma) and the strong value of multi-disciplinary intervention for personalised treatment. He highlights the value of both medications and psychological supports in various circumstances.

I personally found the defensive style on medications a bit intrusive yet understand his tone given common media/public approaches. The book is also a bit repetitive when read as a whole and some diagrams would strongly benefit from being presented in a larger format (size 3-4 font on several I’d say). Aside from these views, overall it is a valuable myth buster and informative resource on how depression is an individual illness dependent on each person’s own genetic traits, life experiences and subsequent gene expression while also explaining there are some broad categorisations that can assist with its consideration. It provides a compelling case for early treatment of all sufferers due to its adverse life impacts, physical health impacts and increased risks of recurrence. Glad to have read it.

[Sebastian Calderon · Rating 3 out of 5]

It’s really 2.5 stars but this book’s score is low enough already.

I’m not the target audience of this book. Someone like my mum is, and she’s the one that bought it for me. There is some very useful information in here and this book is very much geared towards an older person / someone who doesn’t have any knowledge about mental health issues - clinical depression specifically - outside of the typical myths and assumptions.

So for me, who’s spent far too long researching and reading about these things, this book started off fine and then turned into an annoying tirade of repeated ‘truths’ that I’m already aware of.

I definitely wouldn’t read this cover-to-cover and instead focus on reading relevant sections; but also, the first ~80 pages and last ~80 are probably the most relevant for anybody to read. There’s a bit of an irony that he focuses so much on how knowing the cause ISN’T important, but then goes on to discuss the different causes for several chapters.

Ah well. Depression is fucked. This would definitely help someone who doesn’t know a lot about depression, but that is unfortunately not me.

[Ariel · Rating 2 out of 5]

I stopped reading about 50% of the way through. Hickie was very repetitive, arguing against assumptions about depression that I already considered debunked, e.g. that clinical depression does not always equal trauma/a bad childhood and that developing mental illnesses are based on a combination of genetic and environmental factors. I found the tone occasionally smug or self-aggrandising at times as well. Weirdly, I think one of HIckie's arguments was that PTSD doesn't exist? As in, because not everyone involved in a traumatic event develops PTSD, that is proof that a single traumatic event can't trigger depression? In any case, if you already have a basic understanding of how depression works, I don't think you'd get much out of this book.

[Maz · Rating 4 out of 5]

Interesting one. Don't know if I agree with all the interpretations of data as this book presents them, but definitely some valuable research about the physical aspects of mental illness.
Keen to see what my psych thinks of this one

[Rose Russell · Rating 5 out of 5]

Life changing.

[Mery · Rating 2 out of 5]

This was pretty boring. I feel like he didn’t approach the subject well. Made it seem like depression is only real if it’s severe and diagnosed by a doctor when that’s not the case

[Chrissie · Rating 1 out of 5]

would give 0 stars if was an option

[Kym Jackson · Rating 2 out of 5]

An interesting, if baffling, book. This is not a self-help book (except insofar as it tells you to seek professional help if you have depression). Hickie does a good job dispelling many myths about depression. His descriptions of the science are well written and easy to read and understand for a lay reader. He lays out the facts very well.

His arguments though are less clear. One thing I found unreconciled by the book is his assertion that unless you have debilitating physical symptoms you are not depressed (fair enough) but how does that square with the millions of people who have been (self or professionally) diagnosed with depression and who maybe take antidepressants but are otherwise functioning people (answer: those people have an adjustment disorder not true clinical depression)—ie how much of a problem really is this and are we contributing to massive over diagnosis or over medicalisation of normal mood issues? Hickie doesn’t think so (quite the opposite) but I’m scratching my head a bit at that one because it sure sounds like it. I’m sure he has a point but I couldn’t quite reconcile these things based on what he says. It’s somewhat understandable though because his thesis really is: depression is a medical issue which should be treated by medical doctors not self-treated or self-diagnosed.

The book could easily be half the length without sacrificing any real content. The actual section on how to treat depression (presumably what most lay readers are here for) is about 20 pages out of 400 (and amounts to: “see a professional“).

Also he really doesn’t like Donald Trump and he really likes Stephen Colbert. He mentions this many times.

Overall: not recommended unless you have a real interest in the science behind depression or you are involved in some sort of social studies looking at how depression is perceived and treated by society.