Like heart disease or diabetes, depression can be highly debilitating, even fatal; but unlike heart disease or diabetes, depression is poorly understood and heavily stigmatized. Melancholic people are often seen as failures or losers, too feeble or lazy to pick themselves up or pull themselves together.

Neel BurtonNeel Burton, M.D., is a psychiatrist, philosopher, writer, and wine lover who lives and teaches in Oxford, England. He is a Fellow of Green-Templeton College, Oxford, and the recipient of the Society of Authors' Richard Asher Prize, the British Medical Association's Young Authors' Award, the Medical Journalists' Association Open Book Award, and a Best in the World Gourmand Award. His most recent books include Heaven and Hell, Hide and Seek, The Art of Failure, and The Meaning of Madness.

Editor: Arman Ahmed

Of course, nothing could be further from the truth. If you feel the way you do, it is most probably because you tried too hard or took on too much, so hard and so much that you have made yourself 'ill with depression'. In other words, if you feel the way you do, it is because your world was simply not good enough for you. You wanted more, you wanted better, and you wanted different, not just for yourself but for all those around you. So if you are a ‘failure’ or a ‘loser’, that is only because you set the bar far too high. You could have swept everything under the carpet and pretended, as most people do, that all is for the best in the best of worlds. But instead you had the strength and integrity to admit that something was amiss, that something was not quite right. Rather than being a failure or loser, you are all the opposite: You are ambitious, you are truthful, and you are courageous. And that is precisely why you got ill.


Although painful and incapacitating, depression can present a precious opportunity to identify and address deep and difficult life problems. Just as physical pain evolved to signal injury and prevent further injury, so depression evolved to remove us from distressing, damaging, or futile situations. The time and space and solitude afforded by depression enable us to reconnect with our bigger picture and encourage us to reassess our relationships, think about those who matter most to us, and relate to them more meaningfully and with greater compassion. Your depression could be your way of telling yourself that something is seriously wrong and needs working through and changing, or, at the very least, processing and understanding.

Sometimes, we can become so immersed in the humdrum of our everyday lives that we no longer have the outlook or opportunity to think and feel about ourselves. The adoption of the depressive position can force us to cast off the Pollyannaish optimism and rose-tinted spectacles that shield us from reality, stand back at a distance, re-evaluate and prioritize our needs, and formulate a modest but realistic plan for fulfilling them.

On another level, the adoption of the depressive position can lead us to a more refined perspective and deeper understanding of ourselves, our lives, and life in general. From an existential standpoint, the adoption of the depressive position obliges us to become aware of our mortality and freedom, and challenges us to exercise the latter within the framework of the former. By meeting this difficult challenge, we are able to break out of the mold that has been imposed upon us, discover who we truly are, and, in so doing, begin to give deep meaning to our lives.

The concept of depression as a biological disorder may be useful for the more severe and intractable cases treated by hospital psychiatrists, but not for the majority of cases, which, for the most part, are mild and short-lived and more readily interpreted in terms of life circumstances, human nature, or the human condition. Thinking of unhappiness in terms of a mental disorder or a chemical imbalance in the brain can be counterproductive in that it can prevent us from identifying and addressing the important psychological or life problems that are at the root of our distress.