The voice on my answering machine says, T am calling to cancel my appointment for tomorrow. I am just too upset to come in and talk about it.’ This is the paradox of severe depression. It is a downward spiral. You feel so bad you have no wish to seek assistance nor any hope that it will help. You become more isolated and depressed. Work and relationships suffer, compounding the problem, and so it goes. You can be helped but you have to get to the doctor if this is to happen. And sometimes, if you can’t manage to do so yourself, a loved one or friend must take you there. Often this takes relatively little work on the friend’s part, but what a difference it can make!

Someone rings me to ask me to ask to see his friend, who is very depressed and needs help immediately. I am closed to new referrals, I say, but something in the friend’s voice changes my mind. If someone has a friend who cares so much for him, somehow that makes me care more too. I become involved, recruited to be a member of the team and help the friend out of his depression. Two months later the friend is completely well (on Lustral, incidentally, not St John’s Wort. It was too acute and serious to warrant my trying the herbal anti-depressant, though, in future, as we learn more about the herb it may become a first-line treatment even for more serious depression). Serious depression can cost a person his or her life. It can wreak havoc with relationships and jobs. It is a medical emergency – and it is treatable. So it is clearly a reason to seek out medical help without delay. And if you have a friend or loved one who is severely depressed, do go the extra mile or two to connect him or her with a good doctor. It is really worth the trouble and effort to do so.

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