Mental healthcare has long held great importance and interest to me, and while it has now become clear that I will not be entering psychiatry as a career (many reasons), mental health will continue to be a very important part of my interests.

Fighting Chance is the work of Sarah Zabel, a science-writer who was in the US Air Force in her previous career. Her research into depression, and its novel cures, stems from personal experience with a friend who has treatment resistant depression, and multiple suicide attempts.

In order to describe cures - past, present, and hopeful futures - Zabel has cemented the very foundations of physiology and pathology of depression, and done so in depth. She is able to convey this fairly simply to the reader, without minimising the complexity.

For myself, as a physician, it is important to note that my undergraduate training still taught a fairly simplified cause/effect model of depression (and other mental illnesses) - and I know that patients are still mostly educated about the monoamine hypothesis; that is, that depression is caused by a deficit of serotonin and other hormones of the CNS, and is thus treated by replenishing these.

Zabel elaborates on the truly multifactorial aetiology of depression, from genes and environment, dating right back to early human history. This knowledge aides the reader in understanding why depression can be such a difficult thing to manage, and why so many treatments exist.

Told by a good author, the history of pharmaceuticals is fascinating, and here Zabel delves into treatment of depression, and how many were originally designed for different conditions entirely.

While Fighting Chance does investigate depression in general, it also zooms in on a very difficult subset of patients: those who are known as “treatment resistant”. Herein lies the fascinating new treatments which Zabel has set out to investigate. Why does it work, and when does it not? What makes it good, and what are the pitfalls?

Fighting Chance is an excellent example of medical non-fiction that understands its resources: Zabel is clear about the strengths and weaknesses of studies quoted. She is mindful of the biases of her sources, and does not (appear to) cherry-pick studies based on good or bad outcomes. In this way, she side-steps the risk of writing a histrionic, dissenting work, and instead writes something that supports and encourages growth in the field.

This is a work of scientific literature, but with a very clear heart for the patients and doctors it addresses. The very title drew me in: how many patients have wished for just that - a fighting chance at a typical life? Zabel distinguishes herself here for her ability to learn and understand, and thereafter convey what she has learned in a critical fashion.

By its nature, Fighting Chance requires the reader to have some knowledge of basic biology. Reading it can be of benefit for laypersons with an interest in mental health (be it purely out of interest, or because of a personal connection), and can serve to ignite further interest in students of medicine and the sciences. Generalists and hospitalists may be inspired by it, and I daresay even qualified psychiatrists and psychologists will find something new, or reaffirming, in these pages.

From a readability perspective, I will say that much of the book is compulsively readable, but there are parts that are a bit of a slog. I would encourage readers not to give up when they get to such parts.

Fighting Chance is a scientific journey inside depression, from its underpinnings in cellular neuroscience to the most modern treatments. Incorporating the voices of researchers making fundamental discoveries about depression, physicians fighting to bring advanced treatment options to their patients, and ordinary people struggling for relief from their illness, Fighting Chance is a compelling tale of ingenuity, resilience, and hope. Absolutely brilliant book. As a sufferer of clinical depression I found this book immensely important ⭐️⭐️⭐️⭐️⭐️

As a med student I’m always looking for books that tell a story with some real science.
It was definitely one of the most interesting reads (for me) this year.
If you want to know more about depression from a medical point of view, this is definitely the book for you!

Fighting chance is a perfect blend of Science and the art of story telling. I like this book and will probably read it over a few more times.

The book describes mental health issues through experiences shared by people and their journey through the illness. We also find detailed study containing the history of mental illness and it's development.

Dealing with mental health issues is a complicated process for the patient as well as their families, this fact has been explained in a good way throughout the book.

Fighting Chance is a must read book for everyone. Life is complicated and at times demanding, we ourselves or people around us may require attention that we're not even aware of. Fighting Chance is a good source of mental health awareness information and data.

The book can be received in different forms by the readers, it offers something for everyone. If you're looking for stories of people dealing with depression, stress, bipolar disorder and other issues or if you're looking for scientific research and references along with examples - this is a great read!

Thank you netgalley, Sarah Zabel and publishers for the ARC.

Thank you netgalley for the arc.

I totally loved this book because of so many reasons. It is an inherently fascinating and impressively informative medical history of treating chronic depression, schizophrenia, bipolar disorder, and related psychological ailments, it helps to gain knowledge in such fields that I think it can help me.