Do not read this book if you are severely depressed. This book has helped a lot of people -- people who are mildly or moderately depressed. For people who are severely or chronically depressed, not as much.
I bought the book after three years of clinical depression and then had the book for four more years of depression, and I only got a few chapters into it. In fact, it really stressed me out. I took it to my therapist's office several times with me feeling upset, brokenhearted, like a failure, desperate, and hopeless.
"This guy, Dr. Burns, says that if you just think differently, you can change how you're feeling," I said, shaking the book in the air. "He tells about all these people that are really depressed and that come to his office and then they aren't depressed anymore. He even says that in his opinion people who take medication for depression don't need to be taking medication, and that if depressed people would just follow Dr Burns' program here in this book, then their depression would go away.
"What am I doing wrong? I've tried for years to change my thinking! Why can't I get better? He and my other CBT therapists say this is supposed to work, supposed to fix everything! But I've tried so hard!!! Is it just not hard enough? I would have killed myself years ago without medication, but he says I shouldn't have needed medication. I would have been dead many times over already without meds. But he says that essentially no one truly needs meds." I was very upset, in agony, near tears.
"Perhaps," my therapist said in his usual calm, reassuring manner, "he is right -- about a certain group of people. Dr Burns is rather famous, especially in certain circles. Many of his clients may have gone to see him because a) of his reputation and b) they can afford his exorbitant prices. For instance, many may be rich wives who are feeling a little down because their cat died or struggling to communicate with their business-obsessed husbands or having relationship issues with their rich but insincere friends. They feel a little down, and if they've gone to their family practice doctor and gotten a prescription for prozac, they may not actually need the medication. They may benefit more from examining their relationships or thinking. Therefore, his clientelle may be self-selecting and not an accurate sample of the population in general."
"Oh," I said, feeling less shame and more relief. "I guess that could be right. Maybe his claims are true -- for some people? They just may not be true for me? I'm not failing? I'm not just not thinking hard enough. I'm doing okay and I'm trying hard, and I need to set his claims aside as applying to someone else but not something I have to impose on my own life."
"Right," my therapist said. "Your situation is VERY different. Years of depression, medications not working consistently, years of therapy and working on your negative thoughts and managing emotions, very severe and sometimes suicidal depression.... We've already seen that your depression is beyond just changing your thoughts, and your depression needs chemical regulation. So let's set this book aside. Dr Burns may not be seeing an accurate sample of the population, so we don't have to feel that this applies to you. You're doing a good job."
A couple years later, I read that CBT and self-help books are wonderful -- for people with mild to moderate depression. For people with severe depression, CBT and self-help books can CAUSE MORE HARM. I found that to be true for myself. In severe depression, the chemicals and mood are so beyond one's control that medication is usually needed to reduce the symptoms and severity, and THEN the person can start to make progress in therapy. (Anyone who has been severely depressed knows what I'm talking about regarding inability to change thoughts or feelings at that point.) AFTER the symptoms are not so disabling, most people can indeed benefit from examining their thinking, as I did when my depression finally started getting better.
My depression ended up being part of bipolar disorder. Bipolar depression DOES NOT get better by changing one's thinking! Medication is essential. Once I got on mood stabilizers, for the first time in 7 years I was not clinically depressed. At that point, I could actually make progress in therapy. Examining my thinking *actually caused changes* where before it was basically pointless discussion that my brain couldn't truly fix.
My overall review is:
Don't read this book if you are severely depressed. It may actually cause more damage. Instead, get a good therapist and a good psychiatrist, and after your depression isn't so totally disabling, then you may be able to benefit from the book.