A typical psychiatrist spends 20 to 30 minutes with patients during medication visits. Those rare birds who still do therapy can devote 40 to 50 minutes.

Either way, that’s not a lot of time in comparison to the rest of our patients’ lives, nor in comparison to the size of their problems. A key way for patients to continue their self-exploration outside of our offices is by reading self-help books, thousands of which are published each year in the United States.

With so many potential titles to choose from, which are we to recommend to our patients? In this issue, TCR takes a pass at creating a short list of highly recommended self-help books, organized by diagnosis.

Before diving in, a word on our methodology. We compiled a candidate list of books by quizzing colleagues, visiting bookstores (both the online and brick-and-mortar varieties), and requesting suggestions from clinicians on the excellent psychopharm listserv run by Ivan Goldberg, M.D. (www.psycom.net).

We acquired books via local libraries, bookstores, and often by purchasing used copies via Amazon.com, an incredible money saver. We opted not to accept free promotional copies in order to avoid the possibility of bias.

Armed with well over 100 books, we proceeded to evaluate them. Obviously, we couldn’t read all these books cover-to-cover, but we reviewed them thoroughly, making sure to at least scan each page to get a feel for what the book offered. Our criteria for judging included the following:

1. Accuracy and currency of content. Content had to be in line with generally accepted scientific understanding of psychiatric illness. This eliminated certain books – for example, those that advocated a strictly nutritional approach for dealing with psychiatric disorders. In addition, included books had to have been written or revised within the last 10 years.


2. Legitimacy of authors. All other things being equal, we gave higher marks to books written by prominent figures in the field.


3. Ease of reading. Since some of our patients are not well-educated or are not big readers (often due to effects of their psychiatric illness on cognition) we gave highest marks to shorter books written close to the high school level, with short sentences and paragraphs, minimal jargon, and an engaging, easy to follow style. This criterion alone excluded many otherwise excellent books from our self-help list.

The list is organized by diagnosis. There is one “Grand Prize Winner” for each diagnosis (which merits a brief review), followed by one or more “honorable mentions.”

Warning: This was obviously a very subjective enterprise, and we apologize for having omitted some of your favorite books. Your feedback will help us the next time we undertake to publish a similar list.

Major Depression

Grand Prize Winner

Feeling Good: The New Mood Therapy
David Burns; Avon Books, Revised Edition, 1999, 736 pages
Yes, this is a very thick book, but it is such a classic and so perennially helpful that we couldn’t resist awarding it our Grand Prize for books on depression. The first edition was published in 1980, but it somehow manages to stay fresh, because of a perfect balance between expert teaching and very user-friendly self-help style. The experience of reading this your favorite uncle. Burns talks directly to the reader and is ever the informed optimist. The book is based entirely on the cognitive behavioral approach to depression, so if you find this approach excessively simplistic, you may want to avoid the book. Chapters include charmers such as “Do-nothingism: How to Beat It,” “Your Work is Not Your Worth,” and the very helpful, “How I Practice What I Preach.”

Honorable Mentions

Creating Optimism
Bob Murray, Ph.D., and Alicia Fortinberry, M.S., McGraw-Hill, 2005, 224 pages
Focuses on improving interpersonal connections, a relief from the majority of depression books that focus purely on cognitive behavioral approaches.

The Depression Workbook
Mary Ellen Copelant, M.S., M.A., Second Edition, New Harbinger Press, 2001, 333 pages
Large format (8 x 11) workbook with practical and helpful exercises for patients struggling with depression.

Bipolar Disorder

Grand Prize Winner

The Bipolar Disorder Survival Guide: What You and Your Family Need to Know
David J. Miklowitz, Ph.D., Guilford, 2002, 322 pages
A thorough and well written guide that is extremely helpful for both patients and clinicians. It includes many riveting first person accounts. One of the most intriguing chapters is “How Can I Manage My Disorder?” with a series of “Maintaining Wellness” tips such as Keeping a Mood Chart, Maintaining Regular Daily and Nightly Routines, Avoiding Alcohol and Recreational Drugs, and Relying on Social Supports. There’s also a wonderful chapter outlining specific preventive strategies your patients can take to head a manic episode off at the pass, including advice on taking precautions regarding money. Another chapter, “Dealing with Suicidal Thoughts and Feelings,” provides several excellent strategies for getting out of the suicidal mindset.

Honorable Mentions

Several books by Kay Redfield Jamison, especially her memoir, An Unquiet Mind. The reading level is more sophisticated.

Anxiety and Panic

Grand Prize Winner

The Anxiety and Phobia Workbook
Edmund J. Bourne, Ph.D., New Harbinger Publications, 3rd Edition, 2000, 436 pages
This is a large format workbook that covers the spectrum of all anxiety disorders. Extremely user-friendly and helpful, with excellent chapters on relaxation exercises, desensitization techniques, and cognitive reframing.

Honorable Mention

10 Simple Solutions to Panic: How to Overcome Panic Attacks, Calm Physical Symptoms, & Reclaim Your Life
Martin Antony, Ph.D. and Randi McCabe, Ph.D., New Harbinger Publications, 2004, 142 pages
So slim and concise it’s irresistible.

Obsessive Compulsive Disorder

Grand Prize Winner

Stop Obsessing
Edna Foa, Ph.D. and Reid Wilson, Ph.D., Bantam, 2001, 247 pages
A user-friendly book written by luminaries in the field. Self-help suggestions are concrete and easy to implement and are often set aside in boxes in the text, making it easy to find what is most relevant. Examples of these boxes include “Supportive Statements to Help End Obsessions,” “Calming Breath,” and “Daily Worry Time.” There are also very helpful flow-charts delineating self-help options for specific aspects of OCD, such as rituals.

Insomnia

Grand Prize Winner

No More Sleepless Nights
Peter Hauri Ph.D. and Shirley Linde Ph.D., Revised Edition, John Wiley & Sons Inc., 1996, 284 pages
How much can you really say about sleep hygiene without boring yourself and your patients to sleep? Keep your speech short, and tell them to read this great book. From the former director of the Mayo Clinic Insomnia Program and a professional medical writer, this book combines immense readability with thoroughness. All of the basics of insomnia treatment are covered here, including help with keeping a sleep log, essentials of environmental manipulation (the right bed, the right temperature, the right place for the clock), cognitive restructuring, relaxation exercises, diet, and sound advice on gradually reducing reliance on sleeping pills. There’s also an unusually interesting chapter that surveys 29 specific sleep disorders, which is just as useful for clinicians as for patients.

Alcohol Abuse

Grand Prize Winner

Sober for Good
Anne M. Fletcher, Houghton Mifflin, 2001, 324 pages
Written by a medical journalist who overcame her own alcoholism after many years of trying, this is a fascinating description of how real people overcame their drinking problems. Fletcher recruited 222 sober alcoholics via flyers, advertisements, and websites, then gave them questionnaires and built the book around the responses. Fletcher shows that, contrary to popular clinical wisdom, many people do not have to hit “rock bottom” before sobering up, but rather become fed up with the constant struggle with drinking. For patients, this is a tremendously inspiring book, and includes many stories and quotes from those who have successfully stopped drinking. And while the book gives AA its due, it refreshingly profiles the many patients who achieve sobriety in other ways.

Honorable Mentions

Alcoholics Anonymous-The Big Book
Alcoholics Anonymous, Hazelden, 4th Edition, 2002, 575 pages
A surprisingly fun and engaging book to read, many patients swear by it. A thinner companion book, Twelve Steps and Twelve Traditions (Alcoholics Anonymous, Hazelden, 2002, 192 pages, hardcover only) is also almost required reading for AA participants.

Eating Disorders

Grand Prize Winner

Runaway Eating
Cynthia M. Bulik, Ph.D., and Nadine Taylor, M.S., R.D., Rodale, 2005, 288 pages
Although focused on subsyndromal eating disorders, this book will be invaluable to patients with full-symptom eating disorders as well. The book is centered around an “8-Point Plan to Conquer Runaway Eating,” and includes strategies such as “Eat on time and in time” (the authors strongly discourage any kind of formal dieting), “Identify your triggers,” “Reroute your thinking” (a CBT component), “Transform your moods,” and “Pare down perfectionism.” The genius of the book lies in its practical advice for achieving these aims and in its engaging style and high readability.

Honorable Mentions

Life Without Ed
Jenni Schaeffer with Thom Rutledge, McGraw-Hill, 2004, 188 pages Written as a memoir by a country music singer, this entertaining book chronicles her dysfunctional relationship with “Ed” (eating disorder).

The Overcoming Bulimia Workbook
McCabe, McFarlane, and Olmstead, New Harbinger, 2003, 225 pages
The definitive eating disorder workbook, chockfull of exercises, checklists, and great advice.

ADHD

Grand Prize Winner

Driven to Distraction and its more recent spin-offs, including Answers to Distraction and Delivered from Distraction
All three by Edward Hallowell, M.D. and John Ratey, M.D., various publishers and years
Driven to Distraction was the first one, a classic book that drove hoards of children and adults to our offices for an ADHD diagnosis. Rather than updating that 1994 book, the authors collaborated on a new book, Delivered from Distraction, which many feel is not as good as the original. We’d recommend Answers to Distraction instead, a follow-up to Driven that is fun to read because of a Q and A format based on common questions asked by people about ADHD.

Alzheimer’s Disease

Grand Prize Winner

What Your Doctor May Not Tell You About Alzheimer’s Disease
Gayatri Devi, M.D., and Deborah Mitchell, Warner Books, 2004, 281 pages
Ironically, given its title, this gem of a book is in fact co-written by a “doctor” who is double-boarded in psychiatry and neurology. It is extremely engaging and accessible in style. It devotes a few pages to the science of dementia but knows when to stop before boring most readers, and spends most of the book giving very practical non-pharmacological advice to both patients and their caregivers. There are a series of 28 “Brain Boosters,” advice on medications (both traditional and complementary), and common sense tips for caregivers.

Relationships

Grand Prize Winner

The Seven Principles for Making Marriages Work
John M. Gottman, Ph.D. and Nan Silver, Three Rivers Press, 1999, 271 pages
The research psychologist John Gottman has studied hundreds of couples in his famous “Love Lab” in Seattle. In this artificial apartment, he monitors the conversations, behavior, and even the pulse rate of couples over a two-day period. His research has yielded findings that allow him to predict the fate of marriages with 91% accuracy. He converted these findings into “seven principles” of a good marriage, each represented in a different chapter. Chapters include excellent exercises that help make his concepts relevant to each couple’s situation.

Honorable Mentions

Men Are from Mars, Women Are from Venus
John Gray, Ph.D., HarperCollins, 1992, 323 pages
See the interview with John Gray in this issue. This book is the Rosetta Stone for modern relationship talk.

The Dance of Anger and The Dance of Intimacy
Harriet Lerner, 1985 and 1989, respectively, various publishers
Although somewhat dated, these are classic books that have empowered women in creating relationships that work, and have something useful for men, too.