We dont have here in Sao Paulo, Brazil, the threat of terrorist attacks but, on the other hand, we are in the middle of a very unbalanced society wich means theft, robbery, kidnaping, etc besides the huge pressure for professional and personal success due to an obsessive mimetism of the 'american way of life' as a capitalist paradigm. This factory of depression has produced weird neologisms as the word 'looser' that finds no equivalent on the russian language, for example, and sounds quite awkward in latin languages as portuguese, spanish, french and italian.
To deal only with the consequences of such imposed way of living is a benefit given to the chemical industry and the western medicine as a whole.
Since I 've decided for chinese medicine, within 3 years from now, more specificaly acupunture combined with herbs tea, depression and panic syndrome just disappeared from my life and the colateral effects on digestion caused by previous medical poisonings nearly vanished. Give a try!

L. A. Pitanga do Amparo, sao paulo, Brazil

Patients should have a choice of treatments. The British Association for Counselling and Psychotherapy (BACP) deal with thousands of people each month who are calling about depression related issues. Many have to wait months, even years, to see a counsellor and so it is no wonder that people use what ever method is available to lessen the symptoms of debilatating depression.
A BACP survey into depression in 2006 showed that 60% of respondents thought counselling should be more widely available on the NHS. Often depression is lifestyle related and many people would prefer to learn coping strategies, so they are able to deal with their problems themselves, rather than take pills. However, at present counselling is not an option for the majority despite being regularly cited as the most popular choice of treatment for depression.

Gilly, Lutterworth, Leicestershire

This is a resubmitted e mail as the email I sent yesterday has not been posted. This article is incorrect. The NICE guidelines are in the public domain and can be found at www.nice.org. They were revised on 25th April 2007 and reccommend that antidepressants are not used first line for MILD depression. They reccommend treatment with antidepressants and psycological treatments for moderate and severe depression. I work as a G.P and would like to remind readers that depression is not the same as sadness. Suicide is the leading cause of maternal mortality in this country and depression is
a leading cause of disability world wide.Mental illness is stigmatising in our society and many patients have been very ill for some time before they consult to ask for help. MIND seem to be at odds with NICE guidelines and against patient choice which is disappointing. The journalist has obviously
not read the NICE guidelines and this is irresponsible.

helen teare, Swindon, Wiltshire

I have been on and off anti depressants for 7 years now, since I was 18 years old. I've been on different types, not just SSRI's. At different times in my life different drugs have worked. I have now been on Sertraline for 18 months (SSRI) and it's been brilliant for me. Anti depressants are not something I've ever expected to be given by my GP but it's not always your choice. Some GP's have prescribed them after talking to me for 5 minutes and others have taken the time to sit down and discuss my options with me.
I am well aware of the alternative options such as talking therapies, exercise, diet etc but for someone in the midst of a depressive episode it can be nearly impossibel to even get out of bed. Sertraline hasn't done everything for me but it gave me the push I needed to make changes allowing me to move forwards.
I do think ad's are prescribed to often but until there are more resources available what other choice to GP's have?

sonia, maidenhead, UK

Well as a patient in the mental health system at the moment, I feel that pyschs and gps push tablets on people to go away and just increase increase the dose until you are so foggy you can not think let alone feel, trying to get therapy on the NHS is a joke 2 year waiting list here. I have been unwell for over 8 years now and have they helped apart from drugs no, do I think they care no, what I need iis support not drugs.

The mental health system in this country is a mess and needs some money spent on it to help people 1 in 4 get depression yet its still not widely reackonised and it lacks in what the patient needs

Sam , West Yorkshire, UK

I have struggled with depression for years, and have just given in and am taking anti depressants, the change in my life is radical, I now believe they would have saved my marrage.

I really think I do not manufacture enough seratonin, this is a genetic disorder and there is no shame in taking a drug to redress the balance....the long term effects of depression would have been suicide, surely the long term effect of the drugs is no worse!

Geraldine Hampshire

G Wilson, Hampshire, England

Yet again the GP is slapped on the wrist because NICE are miserly penny pinching skin flints who are not on the front line of treatment.
CBT is great if you can get it, but if someone is depressed, this can be due to a life event, the wait can range from 9 months as it does at my surgery to years for the psychiatric services. As services continue to be over stretched and under funded.
What do the so called experts suggest depressed patients do in the meantime while they are waiting to be seen by a counsellor or them?
Oh yes thats right! Exercise, go for walks in the great outdoors but for goodness sake dont cost the NHS any money by taking drugs that might make you feel better while you wait to be seen by a counsellor in 9 months minimum.

Dodie, Brighton,

Who needs drugs when ignorance is bliss?

Rod Munch, Northampton, UK

It might be sad but with the work ethic in this country at present as a woman amongst many trying to run house, children a miserable husband and hold down a challenging job I havent time for counselling and without these drugs i am not a nice person and all around me suffer! Easy to say make life changes but the children suffer most so many of us just plough on with the new 'mothers little helper' . It is still socially less acceptable for a man to be depressed!

Amanda , suffolk, uk

I'd like to ask a doctor which are the damages that Prozac can cause. I haven't found in any article a reliable information about the risks caused by using Prozac.

Paulo Klein, Sao Paulo - SP, Brazil

It's certainly worrying that, in a world where we have more organisations, government initiatives, gadgets etc. than ever before, supposedly to help us, there is apparently so much depression. I've been fortunate to reach retirement age without being affected. I believe I've been helped by the ability to get pleasure from the small things in life, and so avoid the "pressure to have it all" rightly mentioned by Sharon in Oxford. So I'd endorse the suggestion in your report that exercise in green space is helpful. I get pleasure and feel relaxed whenever I walk in my local park, despite having done it so many times.

Barry, Wallington, UK

Depression is a terrible affliction and only a person who has had or someone that is close to you can fully understand the effects it has. Mental health is still an area of medicine with many unknowns. Prozac is not the solution it just delays the problem. More money and research is needed to tackle the root of the problem to ensure we are working together for a brighter future.

C, London, UK

Aspartame is a major cause of depression.

Check it out at http://www.relfe.com/Aspartame_92.html

Consider this: Since it was introduced there has been a sharp increase in violent crimes, depression, truancy, obesity, unexplained deaths of otherwise healthy individuals (Esp. runners), Birth defects, Arthritis, did I mention depression?

It is about time the Government banned it!

Alex, Scarborough, UK

Im on fluxodine, the generic form of prozac, i'm 17. yes i agree that its often prescribed first but my doctors only prescrived it 2nd time i went. first time: do more exercise its a teenage thing your grow out of it. The diagnosis and prescription is helping me to get help. I don't know where i'd be without it probably dead to be honest. Im mixing my meds with exercise (swimming,gym,walking ect) , a healthier diet and counselling. The meds have helped me make this step into getting better so i can live my life and my future. Don't put us all in the same boat and to be honest its a bit more of a larger issue than reduce the number of prescriptions given. we are getting more and more unhappy with our lives as a nation prehaps something needs to be done to show how lucky and well of we really are alongside a massive stress reduction in teenagers/children from school. Home should be home not homework time or atleast not the amount. exams are to heavily put in children need to be children.

Hannah, Dudley,

I think talk of how gps overprescribe anti-depressants (which i have no doubt they do) makes people forget what a serious and debilitating disease depression can be, and something that 'turning the television off' isnt going to help. These drugs are not for everyone but for some people it means they can actually function in society rather than being in hospital. Any drug prescribed for the wrong reasons is bad, but this just adds stigma to people with serious mental health problems. I have been on SSRIs and other psychotropic drugs for a number of years now (not an immediate prescription - it was years before i was put on meds) and i do believe they have saved my life.

Shellie, Reading, UK

Appauling peice of journalism. Figures quoted selectively. "Research" cited with no information on its source. Soundbites from only one side of the arguement.

A prozac nation? Hardly! How many millions smoke? Whats the risks of an SSRI properly prescribed compared with tobacco (or even paracetamol come to that)?

Depression needs fast diagnosis, and effective treatment that is timely.

It does not need another peice of shoddy journalism sniping at an easy target.

Jason Knowles, Guildford,

Aha! Now I understand how and why Great Britain tolerated Tony Blair and his regime for ten years!

Garh Strong, Sherman Oaks, USA

In my case the anti depressants did not work well but thankfully my doctor advised me to get more light and recommended a daylight lamp. This did work ,cost peanuts and had no side effects at all. I also managed to change my lifestyle and quit the rat race, retiring (early) to France where tha pace of life is a little more humane.
I worked in the Pharmaceutical industry for over 30 years and have to say that SSRI's are legalised heroin which for some are highly addictive and once hooked are almost impossible to get off. They are not an answer. I am sure some would say they are not technically addictive but I have personal experience of a rationale young person who has been hooked on Seroxat for 3 yrs and just cannot get of them despite all sorts of attempts to quit.

Bob, castelnau, France

Please tell me, depressed people, how I can best help a friend who suffers from depression? Before he started taking prozac he would write to me and confide in me. Now, he has withdrawn completely and to some place where I cannot reach him and he doesn't seem to care, although he still holds down his work, interacts with other people etc. I know that it's simplistic to think that love can make a difference, but what else can I do?

HS, Brighton, England

I was prescribed Seroxat because my doctor assessed me as severely depressed (based on my answers to ten questions). He was being helpful and was cross with my reluctance to take them. I argued that I was justifiably depressed and that in life we experience feelings of happiness and contentment when life goes well and sadness and fear when things go badly. Our problems were financial, caused by someone else. It seemed right to me that I should deal with all this without drugs and that we would eventually come through. Doctor asked why I wanted to do it the hard way. My answer is that the brain is a precious, complex thing and as long as I could still 'cope' I didn't want to unbalance it. Feeling chemically better about our situation would not solve it. Life has highs and lows and the highs are high because of the contrast with the lows. However, if I had been depressed without a recognisable reason, I would probably have taken the tablets, or if I fell beneath a coping level.

Barbara, Bonn, Germany

Yet again doctors are to blame for the ills of society. As a GP I see increasing numbers of depressed patients, I think because people are more aware of the disease and its potential treatments, as well as the reduction of associated stigma. Also, people are realising they no longer have to accept the life of misery their parents suffered. I have had to become adept at assessing psychological distress and making shared decisions in a 10 minute appointment - this is no mean feat considering the patient is often sobbing and pouring out years of heartache. I try to avoid medical treaments unless absolutely necessary, and discuss all treatment options, but often despite our excellent prctice counsellor who is overworked and v skilled in CBT approaches we often have to resort to SSRIs. Usually there is a promp positive response. I feel that if the patient makes an informed choice of antidepressant treatment, and this choice is effective, why should I have to limit it?

sarah, york, york

Rachel..has got to be kidding me. I was prescribed Seroxat for serotonin deficiency and anxiety , the side effects were horrible and 10 weeks into this poison I had a severe adverse reaction to this horrible drug. I have been in protracted withdrawal ever since and my health has suffered terribly because of it. Personally I believe these drugs should be banned and made illegal. The long term damage far outweighs the short term gain. There are most certainly healthier and better ways to treating anxiety and depression.
The so called "science" behind the use of these drugs is very questionable as well as the so called "testing period" which wouldn't even pass for some pet food supplements.
If the real facts about the damage these drugs causes came out and the public was fully informed, people would come to understand the crime it is to have millions of people exposed to this horrendous poison. There would be an outrage. The fact that this isn't happening should give pause

Johnny, Ventnor, UK

As a person who has suffered with depression on and off for many years one can only laugh at the sweeping generalisations - both in terms of describing depression and its solution. The anti-depressant drug is essential for many people and to assume that the depression can be cured by a frolic in a green field is laughable. People who can be cured in this way just aren't depressed at all.

If medicine had been denied to me then I would have killed myself long ago (therapy and counselling were useless). Whilst that would have eased the NHS burden, it would not be very constructive for the country since I and many other depressed people cured by medication alone contribute a large wedge of tax every year for the government to waste .

The whole exercise is one of cutting costs and so the details don't matter - just cure depression with an attention grabbing story sums up the current state of the NHS.

Mark B, Hull, UK

As a GP, I find Paul Farmers (Cheif Exec of Mind) comments insulting and poorly judged. The decision to prescribe antidepressants is made following a long and often difficult consultation with the patient, where management decisions are agreed together. Patients with depression often need to time to accept and understand the diagnosis of depression, consider their own situation and how best to tackle it. At this stage it is important for GPs to discuss the many management options, of which medication if one. However, counselling, time off work, psychotherapy, psychiatry referral, alternative treatments, exercise, situation adjustment and other options are all discussed and the pros and cons of all these treatments considered. As part of our new contract we are encouraged (and paid!) to screen for depression amongst patients with chronic diseases such as diabetes also.
This is a complicated area of health care, and to tar all GP's with the same brush further reduces public trust in us

Paul, Macclesfield, Cheshire

Divorce can be benificial in treatment.

Philip Telling, Ipswich, uk

Many people don't want therapy because they don't have time to physically visit a psychologist. Contrary to the ridiculous remarks made by Bob, many depressed people actually have professional jobs to attend to. Drugs are a quick fix which suit sufferers as well as the cost concerned government. Invasive therapy- discussing personal issues with a stranger would only exacerbate anxiety in many patients.

Mandy, Manchester, England

I have suffered from depression cumulatively for several years, my GP after having me fill out the Depression Quiz Form diagnozed me with Clinical Depression...I've been prescribed Paxil, Prozac, Wellbutin and two or three other anti-depressants, all of which I gave up after first one to two days due to the intensity of the side effects (which they say go away after several days to two weeks...try feeling like your head is about to explode for two weeks or walking under a bus while in a complete daze). It's taken me 5 months to get an appointment with a phsychiatrist, upcoming, where I shall ask to join a therapy group. For the anxiety which often accompanies depression..including paralyzing and terrifyinf panic attacks I have been prescribed a zepam drug (Valium related) to which after ten years I have become addicted...my aim is not to replace one drug with another...and my sister whom was put on Zoloft and Prozac sufferred complete and irreversible spersonality disorders;she died.

will oliver, winnipeg, canada

I too was prescribed Seroxat for reactive depression and remained on them for years. I have now weaned myself off this drug - and also been enlightened by a 'new' doctor to think in terms of neurosthenia, a weakness of the nervous system, which makes a lot of sense in explaining recurring bouts of anxiety, which have been with me periodically since childhood. This is also genetic and I believe my Mother will have been similarly affected. My best defence is spiritual - using prayer/meditation - and pointing myself towards the love of God - and the needs of others.
Regarding doctors today, it seems they simply turn to the computer screen to get an individual's profile and then write out yet another drug prescription! For very many years doctors would examine heartbeat, pulse, tongue, hands, nails, eyes, skin etc. - and if need be spine and limb alignment - and with acquired experience and fine intuition, be able to diagnose accurately. Drug treatment would be a last resort.

Christine Cornelius, Llangammarch Wells, Powys, Wales

I want to my GP on 8th March to ask to be referred to a counsellor for depression. In spite of having resisted anti-depressants for almost 10 years, was prescribed prozac. I was also referred to the mental health team for assessment, which took until 12th April to get an appointment. The outcome of the assessment was to double the medication and refer for counselling (which is what I had asked for 4 weeks earlier). I then had a form sent to me to return to the practice, and then another assessment form recevied last week. I am now on the waiting list for counselling - more than 2 months after I originally went to the GP and ASKED to be referred. I didn't want medication, I knew what I needed, but now I am 2 months 'behind' on the waiting list for counselling because they decided I needed assessing!

Glynis, Middlesbrough,

I think we need to consider that for anyone suffering from depression the thought of exercising can be daunting. In fact any activity can be intimidating when you are at your worst point and certainly the work it takes to change your mindset through the likes of cognitive therapy can seem impossible. The benefits of anti depressants are that they can give you a lift from which you can begin regaining your life but they are only the beginning. If we saw an increase in the prescribing of therapy akin to that of the rise in SSRI's the figures might not be so concerning. In my experience a combination of the two is the most effective way of overcoming depression and gives the sufferer the best chance of recovery.

J, Melbourne, Australia

Animals live a life of bliss compared to man and even they seek out intoxicating plants. Man's situation is best summed up by Schopenhauer, 'this world is the battleground of tormented, agonized beings who devour each other for survival.' Twain says that a man who sees what's going on would stay drunk 24 hours a day. Sad, but true, is that life depends on us not knowing it too well.

Michael Whitehead, Rome,

Without anti-depressants I wouldn't be here. Life is too much of a struggle otherwise, constantly exhausted, several panic attacks a day, why suffer?

It seems to be a weakness I was born with, I was 30, very fit, did not take drugs, was only a moderate drinker, and with lots of friends, when it first struck. I then spent the next 8 years trying to get better until I was forced to pay for private treatment with an experienced psychiatric consultant. He finally got me onto the drug regime that sorted me out and gave me back my life after years of hell.

I got off the pills and had two years of normal life before it struck again, probably due to constant work and family pressure, and my father's death after a long illness, where my mother was constantly leaning on me too. I'm currently back on them again, if I had to suffer the panic and anxiety I went through previously, I think my decision would be made, life at that price just isn't worth it.

Anne, Romford, England

I can only say that this article reflects much of my own experience. It is bottom-up demand from the patient (and society at large) which puts pressure on GPs to prescribe SSRIs. I tried them once and they did not help me at all. I believe that the chemical imbalance in the brain is more likely the result of depression than the cause of it. I have ever since resisted "happy pills", despite family and others telling me that they are just what I need. I have now feel supported by everyone in the NHS. Exercise and therapy (music too) are far more help to me. Most depression results from people's very real problems and therapy helps us to handle them better. Pills do not. How lucky I have been to find therapy on the NHS! There is still much to be done to improve the mental health of our country, but we now have a lead from government which we must all follow.

Bill, Reading, UK,

Having suffering from reactive anxiety depression for the last two years, i was very hesitant to take anti-depressants as i am a neuroscientist. I took time off work, relaxed, saw a councilling for 3 months - and although helped to a certain extent - i finally started taking prozac two months ago. Although the side effects at the start(which is normal) wasn't nice, its basically made such a difference. I think in the given circumstances, if people need them, thats what they should get. Period!

Rachel, Glasgow, Scotland

Antidepressants have enabled me to turn my life around, without them I don't know where I would be today. However I receive no support from my doctor, every month I am asked the same questions, about what I do for a job, what did I study at University and other such irrelevant questions. I see this doctor every 4 weeks and he doesn't remember me! I think there needs to be a system in place for sufferers, maybe specialist clinics so that people are treated accordingly.

Lucy, London,

An estimated 93 per cent of GPs continued to prescribe people with antidepressants because a 'lack of alternatives'.
As a reflexologist these figures published today are rather upsetting. Doctors must certainly despair at these figures - what do they do - where do they turn? People who are depressed do need antidepressants in order to get their lives back on track. As a complementary therapist I do not need to give statistics on how much people are spending in Britain every year on therapies such as reflexology, aromatherapy, homeopathy etc, figures are available for all to see. Cost is a factor for those that need it the most. Complementary therapy works alongside conventional medicine - together they can benefit the healing process providing the patient with the best healthcare service available. However, doctors need a better understanding on the benefits of such therapies in order to make these referrals. Patient referrals - providing evidence-base practice necessary for reseach.

Liz, Edinburgh,

We over medicalise normal life. From what I have seen there are not that many depressed people. Not as I understand depression. The term is flung around too freely.

Perhaps we expect too much from the world. I've learnt to live with depression with little help from anywhere, and without drugs. I took Prozac for about 6 months, but I have got myself through the worst times on my own.

It's just how it is.

IK, Midlands,

There is no comment or apparent root cause analysis - surely before prescribing these drugs Doctors should be able to understand and report the individuals general circumstances?

When you align this issue with rising debt; people who have a social ambition that is not matched by their earnings potential, living in houses (and running mortgages) they can barely afford, with kids who are driven by peer group pressure for brands and material goods, internet, with it's instant access to all the above , low cost travel etc etc..................depression (by it's current definition) has become the new flu - 60% probably have no more than the common cold.

Being diagnosed as depressed is just great to hide behind, blame for all your bad decisions, justify the misery and grief that will undoubtably fall on someone else. Taking a drug that literally cheers you up.

Are so many really suffering from depression or a set of circumstances that have made life just plain miserable?

David Fox, Southampton,

I am someone who takes Prozac (fluoxetine). I took it from 2000-2002 with little/no side effects and got reasonable benefit from it. I then spent 2002-2004 on a catalogue of various different anti-depressants which either had an adverse affect on my mental health and behaviour or carried unbearable side effects. I have been back on Prozac since late 2004 and find it to be a God send.

I have tried CBT and psychotherapy and neither suit me or the way I work. I do have professional support from a CPN who works in a person centred manner that suits me and my abilities.

I ask you not to rubbish Prozac as some of us find it to be an effective and useful drug. Just because I take medication daily it doesn't mean I am not trying to help myself, it's just that one size doesn't fit all and we need care flexible to people, their needs, abilities, intelligence, family circumstances etc.

Jen, Arbroath, Scotland

A worrying reflection of our times indeed. As human beings, we react to our environment and the experiences which have shaped us thus far. We learn that material gain is important to our position in society and affects how we are viewed as individuals. We work longer hours and/or have higher stress levels than ever.
The cause of depression and anxiety is a very grey area and there is much we still do not know however it IS known that anti-depressants help to increase the level of serotonin in the brain, which is a chemical inbalance where low levels have been associated with many disorders such as aggressive behaviour, OCD, anxiety and depression to name but a few.
Anti-Depressants and therapy do help and I find it sad that sufferers are unable access the latter more easily. I fear the answer lies in how we are "developing" as a nation. If this continues, as it probably will, then we are all at risk of suffering from this illness. The statistics speak for themselves.

Hilary, Livingston, Scotland

If only life was as simple as 'therapy sessions' and your cured, i work for PNI-UK we work with mothers suffering terrible antenatal & post natal depression, first and formost is accepting meds, to engage on a course of 'therapy' no matter what form a client needs to be strong enough mentally. Mothers (and fathers) can miss out on years of their childrens liffe battling this debilitating illness.

What isnt mentioned is the waiting list for therapies such as EMDR they can be as long as 2 years what is a client ment to do in the mean time?

sherry , Tywyn, Gwynedd

In response to Bill in China, not all dpressed people sit on the sofa all day watching tv. Some of us even though we take medication do voluntary work or pursue academic studies.

In response to Abdul in Coventry, not everyone can benefit from CBT as it is a very prescriptive approach that doesn't suit everyone. Computerised CBT may suit some, but even 1 to 1 CBT is often delivered in such short courses that its benefit is reduced.

I don't like to take meds but why should it be acceptable to take meds for other conditions and not for depression. I take meds daily for asthma to keep me alive, and Prozac daily for my recurrent depression to keep me alive (and yes it has kept me alive at times when I would rather have died) - what's the difference?

I don't solely rely on meds. I talk to my CPN, I see my psychiatrist, I've returned to study, my lifestyle has changed, I take time for me, I use my immense artistic ability to express myself. Meds can be an effective part of treatment.

Jen, Arbroath, Scotland

A worrying reflection of our times indeed. As human beings, we react to our environment and the experiences which have shaped us thus far. We learn that material gain is important to our position in society and affects how we are viewed as individuals. We work longer hours and/or have higher stress levels than ever.
The cause of depression and anxiety is a very grey area and there is much we still do not know however it IS known that anti-depressants help to increase the level of serotonin in the brain, which is a chemical inbalance where low levels have been associated with many disorders such as aggressive behaviour, OCD, anxiety and depression to name but a few.
Anti-Depressants and therapy do help and I find it sad that sufferers are unable access the latter more easily. I fear the answer lies in how we are "developing" as a nation. If this continues, as it probably will, then we are all at risk of suffering from this illness. The statistics speak for themselves.

Hilary, Livingston, Scotland

Bill - what incredible ignorance you have shown. Perhaps you should find out a little more about the illness you're ridiculing before posting such damaging comments. There are, in fact, two general 'types' of depression - that brought on by work pressures or the death of a loved one, and that which is an inherent and usually genetic disorder. Both are equally damaging and dangerous, though clinical depression is severe in its longevity. As an active and hard-working 19 year-old who has suffered severe (clinical) depressive episodes since the age of 13, I can tell you that, having tried lifestyle changes, talking therapies and counselling to no avail, it is NOT merely laziness. And yes, I am now having to consider drug therapy to get me through my university degree, having already messed up first time around thanks to my illness. Thank God attitudes like yours are no longer as prevalent as they once were.

Eleanor Potten, York,

Stop trivialising what is an important issue: if you are feeling so bad that you go to your GP, you want treatment to start immediately. But counselling can come with a 6 month waiting list! That's why the pills are on the increase because people have no other choice.

Christian, London,

It is difficult to suggest strategies to people who are already in the state of 'depression'. For some, to come out of that black hole, is harder than one might imagine and at that stage, running in green fields is not an option. This is an epidemic with deep, deep roots and although medication helps the chronically affected cases, it is important to address the causes - loneliness, anxiety, stress, alcohol, poor food habits, broken families, abuse, need I go on? Doctors, governments, they can only provide quick-fix solutions. Ultimately, the responsibility rests with us as individuals, as communities to support one another.
indrani, st albans

Indrani, St Albans, Herts, U.K>

I agree with Fenella , above. As someone who has suffered clinical depression for a number of years, SSRIs have been a lifeline not only for me, but also for those close to me who deal with the effects of my illness. It is not only me who suffers when I am sick!
I have often looked for alternatives to stop my reliance on these drugs, and have sought help from doctors with no joy. 6 therapy sessions is not enough to counter serious mental issues! This is like saying one shot of insulin will cure a diabetic. I have trouble getting to work each day, so despite previously being a gym-junkie, the idea of self-help by exercise now brings on inexplicable tears of despair.
If the NHS is serious about mental health, they need to spend more time correctly diagnosing/treating it, and not prescribing the easy option for anyone feeling blue. Many factors cause depression which are quick/easy to treat, but not every depressive has reasons. This is harder to support and needs investment.

Alex, London,

"Little is known of Beating the Blues which is a computerised CBT endorsed by NICE which should be widely available for use by people with mild to moderate depression"

This programme is useless as all it does is churn out the same old ideas - join a class, go for a walk, make friends.
Well making friends is so hard in this society, One goes to church and they are not friendly especially in Southampton.
One goes to a fitness class and one cannot hear the tutor because of loud music - I doubt whether the tutor is even qualified. I wear two hearing aids so life is so much harder and stupid computer programmes do not help. Just another waste of government money.

Sue , Southampton, Uk

People demanding such drugs from their doctors should be made aware that there are alternative herbal remedies to addictive antidepressants.
It's all very well and good saying that counselling and CBT are the way forward, but I've been told by my own doctor to expect at least 12 months wait before I can see a counsellor. Ridiculous. In the mean time I take herbal remedies, go to the gym, quit smoking and cut down drinking and I don't see why anyone else cant do the same.
Maybe I just had a good doctor.

Katie, Manchester,

One of the major difficulties facing GPs is to try to distinguish between genuine depressive illness and simple unhappiness - not always easy in the time available for NHS consultations in a 'pill for every ill' climate of opinion.

Dr.Nicholas Lee, Windsor, UK

Oh, for goodness sake! Depression can be an extremely serious illness - can we please stop assuming it's because we watch too much television/ work too much/ suffer from acquisitiveness? That's insulting, ill-informed and only supports those whose funding decisions put effective treatment of this complex disease at a low priority.

Claire, London,

I went to my doctor with insomnia and he prescribed antidepressants despite my protestations that I wasn't depressed - these tablets then made me fall asleep during the day so after several months I went back to say I wanted to come off them due to this effect, the doctor (a different one) ignored this and said that tiredness is often a sign of depression and how was I feeling etc etc and wanted to treat me for depression. I didn't go back and I stopped taking the anti-depressants. I saw a nutritional therapist who recommended I give up caffeine and now my insomnia has gone - and I spent 6 months taking anti-depressants unecesessarily, and against my wishes. Doctors just don't have good nutritional understanding and definately dish out antidepressants at the drop of a hat. It's terrible.

Claudine, London,

Exercise is extremely beneficial but I found St Johns Wort to be the best, safest of all medication.

Philip Telling, Ipswich, uk

Lisa from London - I'm not sure whether you have a personal grievance against counsellors as such, but I can assure you that those with significant training behind them, did not obtain their qualifications with as much ease as you claim. Whilst I admit there are always bad apples, who tarnish the reputation of others in the same profession, there are a good number of counsellors who provide a valuable service with more credibility for dealing with depression than either astrology or tarot reading can lay claim to.

Gareth Evans, London, UK

I was prescribed SSRI's a year ago for depression and they had an enormous positive impact. I personally feel that I have a genetic disposition towards low serotonin and the counsellor I (eventually) saw confirmed that there was very little wrong with my cognitive abilities or outlook and therefore 'therapy' would not help. The environmental factors that contributed towards my increased stress and depression were the break down of a relationship, pressure of meeting endless targets in an under staffed education system that tries to measure 'results' as though children were employees or stocks and shares, and being forced to live in sudent standard shared accomodation with no prospect of being able to afford a home in the city I was born in, despite having a post graduate degree and being a teacher for 12 years. The experience of many of my friends is similar.

Dan, Oxford, England

The Prozac research and the evidence about the wonderful benefits of daylight and natural surroundings suggest we could cut medication costs and improve city life with greenery, PARKS - now there's a novel idea!

Sunny Aylesberrow, COVENTRY,

As somone considering medicating myself up to the eyeballs on prozac to get through writing my thesis, i realise that exercise would be far better for motivational gains, but finding the energy to contemplate such activities is strenuous in itself. Inactivity leads to a depressive attitude but it is a self-perpetuating vicious cycle whereby feeling trapped in a depressive mindset should motivate one to lift themselves out, although it is easier to slip in to being lazy, inactive and subsequently miserable. I'm off to exercise vigorously! :-)

lee, norwich, UK

Bill, your views on the causes of depression are facile. The disease is a chemical imbalance which can be prompted by any number of factors, and mistaking it with pure laziness is both inaccurate and ill-advised. Did you not reflect on why depression is linked to 70% of recorded suicides in Britain? Put bluntly, attitudes like yours create an environment of guilt which actively hinders those in need from seeking help. Before posting potentially damaging views again, please consider their potential impact.

Sarah, Paris, France

Exercise and religion work wonders for depression. Think of others and stop focussing on possessions are ways to a happier life.

Mark, Preston,

their is clear firm evidence that antidepressants alleviate depression
what is the evidence in random controlled trials that CBT is effective?

alan middleton, fowey, uk

I have to agree with Lisa in London that counselling is not always the most effective form of treatment- the point being that depressive individuals have a tendancy to become self obsessive and dwell on certain thoughts and issues.

Having taken SSRIs during and after my finals, 2 years on I have weaned myself off and feel drastically better. Obviously different cures/remedies are more effective with certain people than others.

Philippa, London, England

I see this as a testament that we live in a sick, fragmented society, where we are all like hamsters on a wheel, under pressure for space to live and think, but bombarded with messages that "life has only got better", alwas forced to compare ourselves negatively with the rich and successful (who often depend on drugs themselves). Don't blame the doctors. They must despair.

Bob, Thames Ditton, UK

I would be very reluctant to start by critisising the SSRIs. By all mean extend the range of therapy on offer on the NHS, but don't start by trying to cut what is the only and vital lifeline for many people...myself included. I spent a fortune on talking therapies while working, with rather mixed results. I must have been in therapy for about 15 years in total. My experience is that it is very difficult to find an effective therapist. And it is difficult whilst in therapy to know whether it is doing good or not. The discovery of the SSRIs (after I retired) was a godsend to me. Since I have been taking Prozac I feel I know what normality is. I do not have to spend an enormous amount of energy managing my inner state. Talk of replacing SSRI treatment by exercising in a green space is facile; no-one who has experienced depression could make such a comment.

Patrick, London, UK

Agree with Bill from Suzhou. However there are wider issues here:
1 - I think if some one counted the number of aspirin/paracetamols this nation/US consumes, that will be a more alarming figure than prozac - to show chemical dependancy.
2 - NICE and its predecessors have been too quick to categorise small matters as everyday state of mind (like depression, anxiety) and social mores as medical issues. Where a simpler solution in the form of life-style change could have sufficed, a dependancy on chemicals has taken precedence. They even tried to call a repetitive choice to gamble a medical issue of "gambling addition" at par with drug addiction.
3 - There is this innate reluctance of public at large to look at their lifestyle and for every problem to blame someone/something else. Availability of easier option of "not me guv but I am suffering a medical ailment" provides an easy way out of being responsible about one's own body.

Prabhat, UK,

For some it might sound as a commonplace, but depression is one of the symptoms in a nation departing from their God. Jesus Christ said in simple terms to come to Him and He will give us peace, a real peace. This is not some fantasy or silly prejudice. This is something that works perfectly today. There are millions of examples worldwide and the number increases.

Alex Spak, Aberystwyth, UK

Making people aware of the alternatives should be a priority, such as talking therapies and even computer aided therapies which have been approved by NICE. Little is known of Beating the Blues which is a computerised CBT endorsed by NICE which should be widely available for use by people with mild to moderate depression, Unfortunately no one seems to be aware of it.

Abdul, Coventry, UK

Doesn't this reflect the state our world is in? So many depressed people? As do the overcrowded pubs and bars and the rise in 'street' drug addiction. Instead of the Government 'tut-tutting' about it , why don't they take some drastic action to improve the state of affairs- start fighting carbon emissions, reduce the numbers of cars and toxic factories, save the NHS and the Education system. And yes, instead of greasing the palms of the multi-national drug companies- why not invest in more cognitive therapists?

Amelia, London, Uk

There is a clear role for all antidepressants-it is a lifeline for those with severe clinical depression who would otherwise end up in a more costly underresourced hospital bed. For those with mild to moderate depression there is a clear need for more highly skilled behavioural therapy ad psychotherapy. Not some quick fix 6 sessions by someone trained overnight in CBT which is what is now the first choice for many in primary care. One legacy of Blair's government is treat them as quickly as possible and discharge them. Previously patients were treated over the long term and successfully too. This now is a luxury in many mental health trusts who are strapped for resources and only the very few get the high skilled specialist service they need. the rest are medicated. We have a national shortage of skiled consultant clinical psychologists in the NHS -yet those needing their skills has grown by a phenomenal amount. Lets stop writing policy and start making it hapen.

Fenella, Whetstone, UK

Years ago, when Prozac and the like were new to the market, I had five ridiculous episodes where I ended up in hospital having taken an overdose. I also experienced black outs and increasingly erratic behaviour. The minute I flushed the various SSRI's down the toilet it all stopped. The feelings of emptiness and depression remain to this day, but at least I'm not out of control. The unusual part of my story is that I wasn't a child but a woman in her mid to late 20's. Have to say that the only drug to help me at all, and in any way, is Valium.

Lisa, London,

Blair's legacy is Prozac Britain. How depressing!

Roger, Sevenoaks, Kent

Also like to add that counselling isn't necessarily the answer as it tends to encourage everything to swirl around in the same pot until self obsession overtakes the depression it was meant to cure. I do think that some treatments, such as CBT can be successful, but in a country where the qualifications to become a *counsellor* are virtually non existant and easy to come by, you mmight as well go and see a tarot reader or an astrologer. Buddhist meditation was the latest that my doctor recommended, and I think he has a point, but the depressed are notoriously unmotivated. Unsurprising really, given the difficulty in achieving the basics of life that came so relatively easily to our forefathers; a nice house, a good job (for life) and a respect for marriage and the community.

Lisa, London,

Over prescription of often unneeded drugs is yet another problem with the NHS. A huge swathe of people in Britain perceive the NHS to be a 'free' service that can be used and abused at the first sign of a (metaphorical) sneeze.

Pat Thornton, Veliko Tarnovo, Bulgaria

I agree - I did not know the figures but have instinctively felt that there is a growing reliance upon drugs to treat depression. My understanding (I am no expert) is that the drugs mask and don't deal with the deeper issues which can be dealt with through 'talking therapies'.

The causes of depression are wide - work pressures, home life, extensive pressure to 'have it all' to name but a few..... the impact on self-esteem and self-confidence can be huge. Treat the root cause not the symptoms.

Perhaps when 'therapy' becomes more mainstream and acceptable in the UK people will ask to be prescribed it rather than Prozac.

Sharon, Oxford,

Drasticaly reducing the hours that televison is broadcast would be a good place to start. Without that addiction keeping them glued to thier sofas watching the so-called success stories of the tribe of celebrities that infest modern life they might find time to get off their totties and DO something.

Bill, Suzhou, China

This is interesting. According to the politicians we are all living longer, healthier and richer lives. Clearly long life, low-fat/low-taste foods and wealth from outrageous house prices haven't made the "Have it All, Have it Now" generation happier. Perhaps instant gratification is not the silver bullet it is advertised and sold to be.

Alternatively, perhaps everyone is so knackered by having to work outrageous hours, (to pay the outrageous martgage needed to buy a simple home), that chemical-induced paliatives are the only means to remain sane.

NickT, Hampshire,

Having experienced a lot of stress over the past years, I agree that it is possible to get by without 'pills'. I have instead, been cycling on a regular basis, walked through woodland areas, used meditation and dance to counteract the stress. In fact, I feel that I have become more resilient , psychologically as a result. I find that a good and patient ear from a motivating friend/relative can be a very big help too.

Kim Domnick, Torquay, UK