MMM...I'll say it again. The only way to understand depression is to have it yourself. How can you put into words the feeling when you wake up in the morning. How can you describe the need to stay in bed all day and cry. How can you explain to someone the thought of getting out of bed and making a cup of tea terrifies you. How can you explain that disastrous black feeling that is with you all the time. If you could give someone these feelings who is currently healthy, after an hour they would be begging you to take them back.

Steve Price, Llanelli,

If only a dog, a walk in the country and a decent therapist were the way to beat depression. If only a short term spell on prozac would be enough. I think a few people who have had short term or low grade depression believe these were their cures and so they should work for everybody. But as we must all be aware, everyone is different, and those for whom these cures do not work, and who rely on prozac or similar to stay well, are further stigmatised for doing so.

liz, london, UK

Dear Libby Purves
Your clearly never had a true depression. They don't just go away after only 6 months.
Very little is yet known about the real causes of depression - though prolonged severe stress with high adrenalin levels are one proven cause.
Scans have recently documented brain change and damage linked to true depression caused by severe stress. So much for long walks with Rufus as a cure.

Gerald B, Aarhus, Denmark

Yes, a dog and exercising it can certainly help, however, even physical exercise can be near impossible at times in some depressions. At times like this, I'd recommend serious changes to the diet - lots of salmon making sure to eat the oil, and other similar fish, bananas and other foods known to boost the 'happy' chemicals in the brain. Keep this up for as long as it takes and longer, when your outlook is brighter and physical energy is returning increase your exercise to build up stamina and increase confidence. After that you can try reducing the anti-depressants gradually with your doctor's help. It works.

Christine, London, UK

Claire is quite right to emphasise the seriousness of clinical depression. A nice walk with a canine friend won't end it. And while we are on this grim subject would Libby Purves like to write a piece on the fact that French people are prescribed more anti-depessants than any other EU nation?
Simon of Windermere: an old friend of mine had two years of profound depression and as he belonged to the 'Anti-psychiatry' generation he refused all medication .His GP pointed out that decades of therapy had done him no good at all. To his absolute astonishment SSRIs saved him and he is now someone who has a very fulfilling life as a writer---so still capable of 'thinking outside reality'. It seems to me that your own depression is a mode of self-validation. 'I am depressed, therefore I am superior'.

Diotima, London, UK

Heroin is not a chemical. it is the name given to a patients perscective experience of satifaction, euphoria, and in the case of my addiction; codiene. Consider Mitrazepam. This chemical metabolized in the liver to a potent intermediate, a sulphate which can cause a kind of euphoria and flushing which many patients describe as being their "heroin". Since the dawn of mankind the human race has being picking which plants to smoke, which seeds to eat, which brews to brew. Even the dinosaurs were eating hallucinogenic plants. There role in the evolution of the human mind is unquestionable. If you find drug taking unethical; surely consider that the genocide and slaughter which which have taken place on our planet are far worse by comparison.
Here's a question. Do psychiatric drugsand thearapy offer a solution to our personal, local, national and global problems which i have just touched on. Possibly.

Robert A Rubin, Campbeltown,

This is a ridiculous oversimplification of the worst illness in whole universe.I have beaten the illness with ssris which i continue to take for protection against a possible reccurrence.A person can forget how devastating this illness is,when all the things are under control and the symptoms have stopped.The disease is SO strange,SO unfair,SO utterly painful that people just they have not the guts to see it as an illness.And all of us who have diagnosed with depression,prior to our diagnosis we were harsh stigmatisers of 'mental' issues.We just now understand that these views really kill.The infinite shame which is a symptom of the illness combined with these ignorant views make people commit suicide.And YES they are not 'crazy' those who commit suicide for this reason.Expressly they don't commit suicide but they die by suicide.For examble if you continue to hold these views and you(or a family member) diagnose with depression there will be an other tragedy.

Chris, Xanthi, Greece

So deeply offensive and irresponsible is gordon ramsey's promtion of the horse meat trade that I would sincerely ask you to discontinue your association with him.

louise whayman, leicester, uk

For many years I have had the greatest respect for Libby Purves both as a writer and broadcaster and also as someone who has who has done much to reduce the stigma of depression. So why, WHY has she suddenly backtracked?

Has she forgotten what a distressing and debilitating illness this is. Has she also forgotten that a walk in the country will not help one bit? Equally, does she not have any understanding of ADHD and how it can ruin people's lives - and how many GPs poo poo it as a personality trait simply becauswe they don't know any better?

There may be many incompetent doctors who write prescriptions at the drop of a hat. So what? Isn't it more more worrying that there are people who do not seek the medical help they desperately need purely because of articles like this? And indeed, when they do, they are not given the help they need because of the ignorance of their GP?

Catherine, London, England

Thanks CP! I don't need sympathy at the moment, thankfully and sorry for overheated response - wasn't actually meant as a demand for sympathy. A few years ago, from my experience, depression wasn't seen as something serious - it was a weakness rather than an illness. My grandmother thought I was playacting and the doctors at university and when I was 25 just told me to get used to the fact that life isn't always a bed of roses. Although they're now sometimes too quick to push meds, at least doctors now treat you as if you've got something genuinely and medically wrong with you - it's a huge relief, especially if you're like me and you've got no "real reason", such as bereavement, to feel depressed.
I really don't want us to go back to the time when you actually had to have scars before someone took you seriously and I am worried that comments telling us that it's the fault of watching too much television/ desire for excessive numbers of handbags will drive us that way.

Claire, London,

Jason, London

I'm not happy with the impression your post gives. My reading on this subject, although as a layman, is that there is far from a consensus within the medical profession about this at all. There does seem to be a POLITICAL consensus that mental illness is a form of aberration and that the only appropriate treatment is that which quickly and cheaply causes the aberrants' behaviour to realign with what is the Establishment expectation. Within the confines of this political directive, the medical profession have decided that drugs and CBT are the most effective form of treatment, but I stress that this consensus is how to make the best of a bad job, not in the slightest how best to deal with the problem of mental illness.

Simon Stephenson, Windermere, UK

Libby I would have expected you to have a better understanding of this issue. The medical consensus is, as you should know, that a large proportion of depression is biological and is effectively treated by drugs that increase levels of serotonin in the brain. Apart from that your article is a series of false choices: antidepressants are significantly more effective when combined with (cognitive behavioural) therapy and the programme of exercise you recommend. As for 'CP' from Aberdeen, people suffering from depression rarely find anything 'cool' about their situation.

Jason, London,

When in rehab, i met two extremely nice people. One lad was just 16. He was schizophrenic and had been on medication for 6 months. He had a solicitor so was probably under a section. He had no therapy, no idea of when he would be allowed ho home, and got more and more depressed every day. When will therapy MEAN therapy, rather than dishing out meds as if to pretend that the NHS is solving any problems. People deserve and pay for, much better surely?

HR, hgte, n.yorks

A classic response Claire, from someone keen to let us all know you have suffered. As you have demanded it, have my sympathy.

But allow me to contribute in return: I found Libby's explanation of a potential stimulus, or catalyst, for depression helpful. The root of that evil cannot be a melange of television and materialism, but they could certainly provide one answer to some cases. If only depression lost its "cool" and regained some of the stigma it had. If only to persuade some that the answer to their problems does not lie with a prescription or a label, but within themselves. This would also allow more effective treatment to be allocated to those who really are suffering in a darkness most of us are fortunate enough not to comprehend.

CP, Aberdeen,

One argument is that virtually everyone has something wrong with them physically, like a cold or a bad back, so why doesn't virtually everyone also have some minor mental illness? The other is that, if people are depressed, that might be the body's way of protecting itself against wasting time and energy on losing projects, so by masking the symptoms you will make things worse. There are limits to our knowledge.

Malcolm McLean, Bradford, UK

Dr Roddy Campbell

I'd agree with you that there are many different causes of depression, and that different treatments may be called for in different circumstances. What I'd also like to say is that the susceptibility to depression is by no means uniform, and there are certainly some people who would be prey to depression no matter what were the underlying conditions of their existence. However, it is my firm belief that much of the old-style endogenous depression is down to an incompatibility between the demands of self and society. Also, that there are social arrangements where most of the currently depressed would no longer be so, but that a number of the currently "well" would develop depression through being incompatible with the new order. So perhaps it would pay dividends if we were to seek to discover the set of social arrangements with which the maximum number of people are able to feel compatible, and the fewest number became depressed. Good idea?

Simon Stephenson, Windermere, UK

Thee is no doubt that SSRIs are excellent - when correctly presribed. They are not, however, a catch-all for every depressed person. Depression used to be classified as either 'endogenous' (spontaneously arising) or 'reactive' (where there was a perfectly good reason for the person being depressed). For various reasons this classification is no longer used, but it is helpful to appreciate that not all depression is the same. Some responds very well to change of circumstances, a bracing walk or even a bracing talk. Other depression (which we used to call 'endogenous') probably needs other treatment, including SSRIs. Of course there is a huge spectrum. Nevertheless, treating all depression as the same disease is foolish and probably gives rise to far too many people being put on pills when something else would be more appropriate; and a few like, Claire from London being told to 'pull yourself together' when what they really needed was proper medical treatment.

Dr Roddy Campbell, Christchurch, New Zealand

There's no doubt in my mind that depression, for me, has been my body's natural defence to the mental devastation of being unable to find a life script acceptable to the demands of both self and society. It is the switching off of the mind's determination to deal in reality, as one sees it; it opens up the welcome idea that, temporarily at least, one can find some peace in fantasy and/or nothingness.

What SSRI's did for me, on both occasions that they were prescribed, was very quickly to make it impossible to think outside reality, so that I was forced to exist in a mental world that terrified me, from which I had no escape and which provided nothing that was comforting or supportive. Extremely dangerous, I'd suggest, and unhelpful too.

Simon Stephenson, Windermere, UK

Get a dog then you have to get off your tottie and do walks, it's the best depression buster ever. Having had a difficult and unpleasant divorce, getting a large dog that needs plenty of excercise keeps me and my young son sane and forces us out and about into some lovely local countryside that we might otherwise have missed. And a dog is always there with doting love and attention. TV viewing in our house is so minimal now I'm consiseraing getting rid of it altogether.

Roslyn, Huddersfield, England

Hooray! The stigma is gone! Well, you seem to be doing your best to put it back, don't you? If depression is caused by too much television and an obsession with materialism, perhaps you could explain why I experienced my first episode as a 12 year old in 1987, living in the country? Bill's comment angered me enough yesterday to provoke me to respond and your reiteration of his idiocy angers me again today. Please stop trivialising a serious, potentially fatal illness: do you really want to return to the days when doctors simply told you to pull yourself together? That attitude nearly killed me.

Claire, London,

Given that the NHS waiting list for NICE's preferred treatment, cognitive behavioural therapy, can be as long a 4 years it should be no surprise that antidepressant prescriptions are soaring.

Ian Westmore, Andorra la Vella, Andorra

"Too many children are put on Ritalin merely because they have too much energy and originality to fit the narrow mould of school or the confined space of home."

Ok, I have to take issue with this, as the statement just demonstrates that you have no idea what ADHD is, and are just perpetuating an overused myth.
Please show the evidence that Ritalin is overprescribed, as it's widely acknowledged that ADHD in both children and adults is underdiagnosed, and that only a small percentage of those diagnosed are actually treated with medication.

ADHD is not just about "boisterous" behaviour, but consists of a set of symptoms derived from real, measurable neuropsychological deficits, that tend to cause chronic underachievement and social isolation.

When used appropriately, medication does not "dumb down" the child but activates regions of the brain that enable them to interact more effectively with their environment.

PJ, UK,

Libby, I fully endorse and agree with the views put forth in this informative write up. Now a days, taking anti-depressant drugs like Prozac or Alprax , don't carry any stigma. On the contrary it is a fad, a vogue thing. Whom should we blame....perhaps both the pharma companies as well as Medical practitioners. Such drugs are known to the gereral public like OTC (Over the Counter) drugs, and a mere prescription can fetch them up for popping in. Equally so is our medical fraternity, who start the treatment with a shot...of such anti-depressants. Research shows that more than half of such cases can be cured by proper counselling by clinical psychologists, where as we load them with such drug dependences. Mild depression or borderline case of neurosis can be termed as "life style" diseases..,. due to stress factors, state of loneliness and at times pushing the bar too "high".We live in a pressure cooker state, and don't vent out or expel our frustrations, and look for a panacea in drugs

Sanjeev Dheer, New Delhi, India

But wait a minute, do we even understand how the problem comes to be? In this instrumental society - let's just apply this raft of strategies here and deploy these machineries there - it seems common sense has gone out the door. Wait a minute here... let's stick it out in whatever exploitative position of labour possible, and spent the better parts of our lives slogging it out, and then we get depressed, upset, frustrated, and wait, lets take some drugs or go talk to someone to help us cope with this, so that we can continue to live the same way. Is it a prison or is it an asylum?

Leon Tan, London, London