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Melanie Klein claimed that children became depressed at the time of weaning and that this resulted in rage and sadness at the apparent loss of the mother.

She thought that depression in later life was related to the inability to deal with this early loss. Yet another view emphasises the role of fears about castration, and it is even claimed that this could account for the greater prevalence of depression in women.

Psychoanalysts live in a hermetically sealed world in which ideas and findings from other disciplines cannot get in - biology is totally excluded. Not only are their ideas difficult to understand - terms like "ego" and "superego" are rather arbitrary abstractions - but their sessions with patients often only reinforce the feelings of negativity that led to depression.

I am more impressed by Aaron Beck's cognitive theory of depression. He has shown how patterns of negative thinking maintain a patient's self-defeating beliefs. An essential feature of this theory is that such negative thoughts are automatic. It may be that a malignant sadness, partly biological in origin, maintains this pattern and thoughts and emotions reinforce each other in a vicious, depressive loop.

What structure or activity in the brain could be the biological basis of the loop? The amygdala, a small structure near the base of the brain, is intimately involved in emotion. It is the only structure in the brain that consistently shows increased activity with depression. Antidepressant drugs can successfully treat this: with the remission of depressive symptoms, the amygdala's activity becomes more normal.

Treatment can be even more successful if combined with cognitive therapy, which aims to alter patients' negative thought processes. Their automatic thoughts are believed to be sustained by distorted thinking, such as a tendency to recall negative experiences and to see things as wholly bad or good. Cognitive therapy limits the ease with which these adverse memories are activated: in essence, patients learn to alter their beliefs and assumptions.

Unlike pychoanalysis, which can take many years and innumerable sessions without any evidence whatsoever that it is helpful, cognitive therapy typically involves about 20 sessions, or even fewer, over the course of three to four months. If, for example, a patient feels low and without hope, the therapist will ask what thoughts are associated with these feelings, helping to illustrate the relationship between negative thoughts and feelings. A detailed plan of action might be scheduled, beginning with relatively easy tasks such as going for a walk or reading a magazine. One should not underestimate the difficulty some patients have with such apparently simple tasks.

Appleyard was right to say that I believe the future lies in biology, for it is extremely unlikely that there will be significant advances in psychotherapy.

If we understood how genes predispose us to depression, it might be possible to design much more effective drugs. Instead of criticising the drug companies for trying to make money, we should be grateful for their antidepressants. We should not deny our biology when it comes to mental processes, whether normal or abnormal, for every thought and feeling is the result of the activities of nerve cells in our brain.

Professor Lewis Wolpert is the author of Malignant Sadness, published by Faber on March 1 (Pounds 9.99). His television series, A Living Hell, begins on BBC2 on March 3