Treating the hardships of life with an antidepressant medicine fails to acknowledge difficult and complex life circumstances, offering rather a simplistic, paternalistic, pharmacological sop, and can undermine the necessary and more constructive process of developing the resources to cope with adversity as best as possible.

In this state all is noise and chaos and devoid of meaning. It is difficult to imagine: our lives are so much more made up of light and sound and thoughts and feelings that form meaningful patterns and which help us to make sense of our lives and may grant us pleasure. The patient experiencing a psychotic episode is robbed of these harmonies. We cannot know the mind of another, and certainly not the mind of a psychotic other, but we can imagine that such noise, such a dissolution of meaning, would be intolerable. In this context it becomes understandable that a person in such a state should urgently seek to find or construct meanings and, in this process, to employ themes that are culturally or spiritually familiar - albeit often in deeply strange ways, given the disorder of mind.

As Jungian analyst James Hillman remarked, “Psychotherapy is only working on that ‘inside’ soul. By removing the soul from the world and not recognising that the soul is also in the world, psychotherapy can’t do its job anymore. The buildings are sick, the institutions are sick, the banking system’s sick, the schools, the streets - the sickness is out there.

The French psychoanalyst Julia Kristeva says, making a fine distinction, that we should find language and images that are “lucid counterdepressants rather than neutralizing antidepressants.” You want to find a way to counter your heaviness without denying it or even escaping it. You don’t want to neutralize your sadness, but you want to find ways not to succumb to it. This is a fine but crucial line to walk.

James Hillman has observed that depression may be a special problem in a society hell-bent on happiness. But let’s examine this connection more closely. It is possible to imagine that the situations life offers may not be happy ones and yet may be the most desirable of all.