Johann Hari

If so, I'd really like to interview you for an article I'm working on. Your details would be kept entirely confidential: I wouldn't use your name, and any identifying details would be altered so nobody could figure out it was you. If you are interested, please email me at johann [at] johannhari.com. (Yes, I know that is the most insanely narcissistic email address in the world. It was part of the websiter set-up, guv'nor...)

The death of Isabella Blow - the late fashionista icon - is already being spruced-up, slimmed-down and squeezed into a corset of mythology.

Her family are claiming "she had cancer. That's it. She's dead now." Her long-absent friends are wheeling out the stories of her life as The Hat, a style icon famous for headwear resembling an immense lobster, a silver castle, some veiled antlers, or an angry pheasant. They are collectively pitching a funny, light move - The Dead Wear Prada. But it isn't true.

Isabella Blow did not die of cancer. She died of depression. Two years ago - long before she was diagnosed with ovarian cancer - she threw herself off the Hammersmith Flyover, smashing her legs so badly she could never wear her beloved high heels again. Last year, she was admitted to hospital with a near-fatal overdose. And finally, last week, she succeeded with a bottle of weedkiller.

The violence of her will - demanding her head be cut off and sent to the father who rejected her, and her heart cut out and sent to the husband who left her - is a bleak hint at her mental state. I understand why her family want to remember her at her highest moments, discovering designers like Alexander McQueen and models like Sophie Dahl. But - to borrow a treacley Americanism - this can be "a teaching moment" about depression.

Too often, the one-in-six people who periodically succumb to clinical depression are barracked in Britain as lazy and selfish, and subject to a pull-yourself-together harrangue. Isabella Blow's life is a sad demonstration of why so many of them can't without serious, expensive help.

Izzy's first lesson is that - as a recent study by the Universities of Heidelberg and Bonn showed - some people have a propensity to depression written into their genetic code. Her grandfather was a depressive who ended up committing suicide, even after he was acquitted of committing murder in Kenya. (The movie 'White Mischief' is his story).

Her second lesson is that if you don't bond with your mother in childhood, it is far more likely this underlying depression will out. Isabella's mother was blizzard-cold, reacting to the drowning of her two-year old son by unweepingly heading upstairs to adjust her lipstick. When she abandoned the family a few years later, she said goodbye by shaking her daughter by the hand. Brain-scans now show that small children who are not shown love develop differently-shaped, damaged brains. So depression is not laziness, or weakness; it is unchosen and unwanted.

Her final lesson is that depression is not simply unhappiness, a low day in a low week. It is a ravaging, consuming disease. Not long before she died, she admitted she had been "quite literally consuming myself. I was eating myself - drinking my own urine and worse - because I felt I no longer deserved to exist."

Professor Richard Layard, an expert on depression, has been urging the government to roll out a huge programme of therapy to rescue depressives early in their lives, before they accumulate so many fears and anxieties and debts they cannot function at all. (Isabella was bankrupt and convinced she would end up a baglady).

It's not fail-proof, but the evidence suggests it keeps a lot of people alive and working. And Layard has calculated this programme will pay for itself, since there are currently more incapacitated depressives claiming benefits than all the people registered unemployed combined. Izzy admitted she could never have held down a 9-to-5 job; her depression made it impossible.

The best tribute to her is not to pretend she died of cancer, but to talk honestly and demand real, hard help for depressives - so more people can be rescued before they fling themselves from the Hammersmith Flyover.

I have always thought of Robbie Williams as a whiny flat-voiced narcissist, but when I watched him strolling out of rehab last week - hoping he has left behind his antidepressant addiction - I felt an involuntary shudder of sympathy. For the past six months, I have been in the slow process of draining Seroxat, the pushy little sister of Prozac, from my bloodstream, one milligram at a time. I have had judders and jolts. I have had moments when I think I can't quit, that I am twinned till the tomb with my little blue pills. So - I thought I'd never say this - Robbie, I know how you feel.

For the past month, a small batallion of sweet-faced therapists has been helping Robbie to trace The Origins of His Pain. But how do you trace a depression back to its birth-place? When I look back over my seemingly standard-issue suburban childhood, I realise the depression was always there, hanging in the air like black smoke. I don't mean unhappiness, the fleeting low moods that everyone endures. I mean long, hard, daily sobbing. I mean the inability to take pleasure in anything for weeks on end. I mean a pining for death. This is not what you mean when you say "I feel a bit depressed today"; it's a blank, flavourless life, laced only with rootless and inexplicable pain.

There was no obvious explanation, for me or for him. Robbie has said in interviews, mystified: "I was really loved by my mum, I was totally loved by my grandmas, I wasn't molested." It was only much later - as an adult - I discovered that both my parents have had depressive nervous breakdowns, in their own style and in their own time. Last year I found out my mother was taking anti-depressants and tranquillisers when she was pregnant with me, so maybe my depression was born with me in the womb, an invisible Siamese twin.

As a teenager, Robbie's main anti-depressant was, he has said, fantasy. "I would always imagine I was an actor or a rock star," he has said. Me too. My depression was buried beneath plush cushions of lies. I pretended I had a millionaire father - rather than a depressive bus-driving dad - and that I would one day be a film star. But as you get older and the world refuses to confirm your fantasies, that anti-depressant melts into air.

This dissolution of my dream-life coincided, when I was seventeen, with the end of my first intense teenage love affair - and so my four-hours-a-day depression morphed into a twenty-four-hours-a-day depression. I remember a long, blank summer inter-railing across Europe with my friends in almost ceaseless tears, weeping in Barcelona and Venice and Prague over nothing and everything, rousing myself only to read a few bleak pages of Albert Camus. (I was even less fun than I sound).

There were dabs of self-medication with ecstasy and other Class A modd-brighteners, but they were only followed by an even harder thud to the ground. On a beach in Madrid during an ecstasy come-down, anti-depressants suddenly appeared on my mental landscape like a blazing chariot across the sky. Was it possible that all the daily agonies I took forgranted were not an inevitable part of Being Me? After touch-down in Heathrow I hurried to my G.P., hungrily swallowed my pills and waited for change. And it came. Within a fortnight the tears ducts dried - they stayed dry for a decade - and my mind cleared. My life became a manic whirr of happy, happy, happy acts. I was constantly making friends and working hard and swirling through the world with a serene glee.

And so it continued for ten years. I glided through University, into journalism, into a great group of friends and through some sweet boyfriends. Then last year I began to realise that ever since I became anti-depressed, some strange characteristics had sunk into my personality. I would rack up huge amounts of debt and not feel any anxiety about it. I would take wild risks - like getting into fights in public - and not feel any sense of fear. On the rare occassions I felt bad, I would just pop an extra pill and it would
disappear. At times, I began to think I was locked in a new human state I called 'anti-depression': manic, resillient, impermeable. I realised I could spot other anti-depressed people at parties or in the office in a matter of minutes. But I had been taking Seroxat all my adult life, so it was hard to tell where the Seroxat ended and I began. Was this just my personality?

Once, about four years after I started taking the tablets, I made the mad impulsive decision to stop one day, just to see what would happen. Within a week I was sweating and shaking and crying all the time and pledging never to try it again. But last autumn I decided to discover what would happen now if I stopped slowly, under the supervision of a therapist, because I was forced to see that the boons of Seroxat were finally being outweighed by the banes. The debt was
becoming unmanagable, the fights were becoming more dangerous, the imperviousness was more striking. Freedom from anxiety and despair is not only a liberation, I learned, but also a hobbling limitation.

And I had also started to notice something odd: the years of my life immediately prior to anti-depressants seemed more vivid to me than anything that had happened since. University, journalism - it was all passing in an upbeat blur, while the life before - with all its painful details - still seemed real and immediate. I found myself still intensely daydreaming about a boy I had loved back then, as a teenager. Robbie did the same. He developed an obsession was the first girl he was ever in love with, back in Stoke, before fame and anti-depressants, when he was 17; he even tried to rekindle his relationship with her, shipping her out to Los Angeles and trying - futiley - to rediscover his lost self via her.

My life prior to anti-depressants had been razor-pain; my life since had been a soapy, speedy slide. Was it possible - now my life was going better than I could ever have imagined - to find a third way beyond these two impostors? I wanted at least to know, so I have been slowly cutting back my 30mg a day dosage, five milligrams at a time, every few months. I am on 10mg a day and falling.

Letting anti-depressants out of your system is a slow process of becoming permeable to the world once again. When you are anti-depressed, you have a thick suit of mental armour. People can attack you, insult you, leave you, and you feel little. It's exactly what you need when you have been so depressed you can't function. The trite cliche about becoming a zombie isn't true. You are very clear headed; you just don't let much in. So as I cut back I have been feeling subtle mental sensations I had almost forgotten: romantic longing, pique, irritation, anxiety about the small essential things in life like whether I'm
running over my overdraft or my fridge is full of
moudly crap.

I've been realising over the past six months how essential these niggling sensations are. Without them, I have been crashing through life chaotically. If you lost sensation in your arms, your hands would quickly get burned or broken because there would be no pain-signal to pull your hand off the cooker or out of the car door. In the same way, I realise that by losing some of my mental sensations, I had been allowing things that hurt me to drag on because I couldn't feel pain keenly enough. Since I cut back I have been sorting out my finances. I ended a close friendship with another Seroxat-addict, a woman who lived in a Seroxat-rut where she leeched off other people and refused to see any problems with this life, or this drug. In the same way alchoholics have to give up their drinking buddies when they put down the bottle, I had to leave behind a handful of Seroxat-buddies with whom I had shared a sweet holiday from real emotion. I was starting to put my life in order, for the first time.

Feeling pain and fear and anxiety is - however strange it might sound - a relief after years of mania. Most people think of mania as the opposite of depression, but actually they are twins, both states where you fend off the world with an impervious mental state that cannot be penetrated by reality. Robbie downing Red Bulls with his antidepressants is cruelly logical.

Is it easy to stop? Is it easy to be an undepressed adult? No. There are days when these unfamiliar new feelings jut too deeply into my gut, and I am tempted to swallow an extra tablet to jab them away. (I don't.) My greatest fear - that I will regress to the helpless depressed state of my seventeen year old self - hasn't come to pass, at least not yet. Perhaps I will collapse into a heap in a few months as I near the zero-option, and have to go back into Seroxat's frenemy embrace.

But for today, I am saying goodbye to Seroxat - the drug that saved me - with the first real tear I have shed in a decade.

I have spent this week in bed shivering, sweating and in withdrawal. No, I haven’t done a Pete Doherty – as my mother reassured me recently, “I know you’re not a junkie son, you’re far too fat”. My drug is legal, my dealer for the past decade has been my GP, and this withdrawal is Officially Sanctioned. It is called Seroxat, sister of Prozac, proud member of the SSRI family of anti-depressants. This is the first week of my adult life where I have had only a trace ten milligrams of Seroxat in my bloodstream – and it feels…

But wait. This story begins almost exactly a decade ago. I was trapped in the black sludge of depression, and I couldn’t see a route out. I was eighteen, and three holes had just been blown in my mind’s serotonin uptake. I come from the Chernobyl of nuclear families – a mixture of great warmth and warping radiation – and it had finally blown into pieces. My great adolescent love-affair, my first true love, my obsession, had ended its tender tango with a rejection. And, partly in search of an end to the wracking, sobbing low, I took some party-drugs guaranteed to blow your brain chemistry even further out of whack.

And, yes, it was depression, not unhappiness. The whole bleak package: crying all the time, flying into rages, seeing no point to my little life. In the years since, I have seen people disappear onto the far shore of depressions like this, and never really come back, living and dying in despair. But when somebody, a friend, told me this could be an illness, that there might be a cure, I had no doubt. Give me the pills. Give me fistfuls of them.

So I took the forty milligrams of bright blue salvation every morning, and my life turned around. I had a great time at university, I got a great job, and my life has never been better. Seroxat put a great warm blanket around my brain and nothing could break through and cause it pain. I became a nicer person than I had ever been: no more rage, no more self-absorption. Seroxat became a constant partner, an aid that made everything possible. The idea of stopping seemed like madness.

So why? Why now? After a decade of joy, after spending all my adult life chemically enhanced, why stop? I certainly don’t regret taking the drug, and I would urge any depressed person to do the same. I have friends who say Seroxat simply makes them whole, and they will no more stop than a diabetic will kick insulin. They gape at my decision. But over the past two years I have slowly begun to realise that, in addition to their great, glorious strengths, anti-depressants cause slow, subtle problems too.

You enter a new state that I think of as ‘anti-depression’. We are not depressed, but nor are we like the undepressed. We are different. Whatever we do, wherever we go, we will never be truly, madly, deeply unhappy. It’s like we have been inoculated from the miseries of life. And that changes you. People who cannot feel physical pain end up getting into terrible accidents. They burn their hands without realising it, crush their legs in doors, contract illnesses that eat away at them unawares.

There is a similar process when you cannot feel searing mental pain. Like all the anti-depressed people I know, I have racked up big debts, been crazily casual about my health, and allowed myself to continue in emotionally damaging relationships for years, all because none of it really hurts. The potential anxiety and grief are washed away by a blue pill each morning; who cares? That shrug – that who cares – is precisely what you need when you are depressed. But when it becomes a permenant part of your mental furniture, your life careers away from you. Your mental brakes are cut. You miss the anxiety and the anger.

So I want to know what it is like, to be an ordinary undepressed, undrugged adult. How much of this is me, and how much is the medication?

Of course I am anxious. Could the depression come back? Will the withdrawal be agony? Will my ugliest character traits re-emerge from below the Seroxat? But I also know there will never be a better time – when I have a job and a life I love – to try.

I’m taking it slowly. I’m cutting back by inches. I’m gently – very gently – acclimatising to the colder climate beyond Seroxat. And so far, from my sick-bed, it feels… yes, it feels okay. I am beginning to cry at films again – warm, healthy tears – and to feel flickers of rage at small irritations. It feels real. It feels human. It feels like me, after all these years.

POSTSCRIPT: You can send letters for publication on this article to letters@independent.co.uk or just to me by clicking on the 'contact' button above

I belong to the first generation of people who have been anti-depressed all our adult lives. I started taking the antidepressant Seroxat when I was seventeen. I come from the Chernobyl of a nuclear families, and it had finally imploded along with my neuroses. I couldn’t get out of bed in the morning except in a tearful, uncomprehending rage. A familiar story passed in the suburbs once I had my pills: the toxic black fog of depression parted; it was like wearing glasses for the first time and discovering you had been half-blind since birth. Life turned from being a muggy minefield to being a bouncy castle. Now – a decade later – I do not know what life would be like without it, and I am starting to wonder and to worry.

There are millions of people like this, scattered across the developed world, with their blue and yellow and white pills making their minds cleaner, or clearer, or more tolerable to live in. Most of them wonder too if, amidst the glories, there are drawbacks.

For the first few years, I was extremely defensive about any criticism of my beloved anti-depressants. I became fond of quoting the writer Andrew Solomon, who in his gargantuan study of depression ‘The Noonday Demon’ compares his need for anti-depressants to a diabetic’s need for insulin. “If you discover somebody is diabetic at a party, you don’t pat them on the shoulder and say, ‘I hope you’re off it soon’, so why should you do it to somebody on anti-depressants?” he asked. Depression, he said, was caused by malfunctioning neurotransmitters. It’s an engineering problem in the brain, and SSRIs – the family of anti-depressants created in the 1980s – are the crew sent in to fix it.

I was even tempted by the arguments of Dr Peter Kramer, whose book ‘Listening to Prozac’ argued that SSRIs are actually a way to enhance the human species. He interviewed hundreds of people who had seen their bad tempers or obsessive fears dissolved by the drugs, and concluded that SSRIs are like antiseptic steel knives that cleanly, painlessly slice off the ugly parts of your character, leaving a fresher, more efficient person behind. He called this “cosmetic neuropharmacology”, and recommended it even for the non-depressed.

But doubts began to poke through this Promethean optimism a few years ago. I have never regretted taking the anti-depressants to lift me out of the depression, and I never will, but I began to wonder if they were really a lifetime companion rather than a long fling. I sensed somewhere that they had drawbacks, but I could never really articulate what they were – until I recently read the book ‘Artificial Happiness – The Dark Side of the New Happy Class’ by Dr Ronald W Dworkin, which has been causing a chemical stir Stateside.

He doesn’t buy into the hysteria about Seroxat causing suicide, and nor do I: most metastudies show that suicide rates have fallen dramatically in countries after the introduction of SSRIs. No, he has a very different objection. He says that anti-depressants quite quickly create a state of Artificial Happiness, where your life and your mind slip out of synch. The ordinary signals that you receive from the world – I don’t like that, I like this – become blunted, because you feel pretty good no matter what happens. Just as people who lose physical sensation become extremely vulnerable to being burned or bruised without noticing it, people who lose the mental sensations of unhappiness become vulnerable to emotional damage they can feel happening.

Dworkin illustrates this by talking about a fortysomething friend called Kenny who became depressed because every night he would head to bars to chat up beautiful twenty year old girls, only to find they were no longer interested in him. He would slope home alone at the end of the night feeling rejected and dejected, and began to show the symptoms of mild depression – weepiness, listlessness, despair. Kenny went to his doctor, who explained that his neurotransmitters clearly weren’t functioning properly and gave him an SSRI prescription. As a result, Kenny kept going to the bars and he kept getting rejected – only now it didn’t really hurt. He’s still there, still objectively miserable, except with a sweet foam of Prozac to draw the sting.

Dworkin says people like Kenny “don’t feel the unhappiness they need to feel in order to move forward with their lives. Sometimes people need a critical mass of unhappiness to push them out of a bad life situation. Artifically Happy people lose this impulse to change. Their unhappiness is suddenly erased by medicine, so they ask themselves, ‘Why bother? Things aren’t so bad.’ With life artificially clean and comfortable, they stay in their old ruts, stagnate in a pool of sham happiness, and sacrifice any chance for the real thing.”

When I read this, I recognised handfuls of my SSRI-taking friends, like the smart twenty-seven year old guy I know still living with his parents, unemployed, in a miserable situation, but kept happy – and stuck – by Seroxat, because he never felt miserable enough to change.

And, I admitted after a few months of jabbing the thought away, it applied to me too. Dworkin believes anti-depressants are useful tools for lifting people out of chronic depression, and I suspect he would have supported my initial prescription. But after my depression was blotted up, I kept taking it. All sorts of things came along, as they do in every life, that would have made me miserable and forced me to change if I hadn’t been anti-depressed: a bad relationship, swollen debts, over-eating. All continued far longer than they needed to because they didn’t really make me feel really bad; nothing did.

Yes, I think Dworkin overstates his case. At points he presents the anti-depressed as almost alien people, disconnected from the world, conscienceless, “incapable of empathy”, people who “don’t know what kindness is” – not features I think apply to me or to the dozens of other anti-depressed people I know.

But his book – and my sweet decade-long romance with Seroxat that I know now must end – has taught me that although depression is a disease, unhappiness is not. On the contrary, it is an essential state, a signal we all need from time to time to show us when our lives are going wrong. Stripped of that signal, it is easy to lose your way – as many, many people who take antidepressants too long do. Don’t get me wrong: I’m not some Calvinist (or Sadist) who believes unhappiness is a good thing, a morally enriching experience. I’m not even a Stoic who believes unhappiness should be piously endured; I believe maximising happiness is and should be the most basic goal of human ethics.

But we can only steer ourselves towards real happiness if we know when we are going off the road – and an adult lifetime on anti-depressants clouds the windshield. That’s why I have decided, with one last synthetic tear, to bid antidepressants goodbye.

Squeezed inbetween the tedium of Geography and the sweaty senselessness of PE, students at Wellington College are poised to study a new subject: Happiness. Headmaster Anthony Seldon has recruited a top team of “positive psychologists” to tutor his young charges, declaring: “We have been focusing too much on academics and missing something far more important. To me, the most important job of any school is to turn out young men and women who are happy and secure.” It’s a strangely hippie message from as stern and starchy a figure as Seldon: enough with the neurotic studying and swotting, kids – don’t worry, be happy. Is Wellington College is morphing into the Bob Marley Academy?

At first glance, it’s hard to imagine what these classes will teach. Will the students be examined on my own shimmering symbols of happiness – Fred Astaire and Ginger Rogers dancing cheek-to-cheek, Frank Sinatra singing, “If I can make it there, I’ll make it anywhere”, and boozy Hyde Park picnics on a Sunday afternoon? But after puzzling over its contents, I realised that, in an odd way, I have spent the last decade slowly and steadily learning happiness myself.

When I was seventeen, I finally slid into the black cloud of depression that had been hanging over me – and the Chernobyl of nuclear families into which I was born – all my life. After a year of thrashing and smashing and weeping, my morose teenage self realised I just didn’t know how to be happy. I had never learned. Ever since then – helped by the sweet blue magic of Seroxat – I have been teaching myself how to enjoy life, in steadying, dizzying steps. In a country where three and a half million of us are taking anti-depressants and even more are turning to the competing delusions of self-harm, self-help and ‘alternative’ medicine, I know I am not alone. So is Seldon quietly pointing the way forward for Britain? Do we all need Happiness classes?

Until recently, it was left to the poets, song-writers and philosophers to dissect happiness, and to ask the most basic question: what is it? Aristotle believed it was the feeling that emerges from contemplation and from virtuous behaviour – but even he (and his smartest successors) found the search for a definition to be a willo’-the-wisp. Indeed, an obsessive search for an intellectual understanding of happiness seemed to push it further and further away. As the great nineteenth century novelist Nathaniel Hawthrone warned with a wagging finger, “Happiness is as a butterfly which, when pursued, is always beyond our grasp, but which if you will sit down quietly, may alight upon you.”

But after a century on the couch and a decade hooked up to brain-scans, human beings can scientifically understand happiness – and how it works – better than ever before. We know how to measure it, as surely as bags of sugar: through levels of seratoinin in the brain. The lessons from this new science for how we live our lives are a series of harsh slaps in the face (offered with a smile and some laughing gas, of course).

One of the first and most shattering findings is that we have been looking for happiness in the wrong place – through endless economic growth and consumption. Our societies are structured to maximise Gross National Product, not Gross National Happiness, and we all passively absorb this truth, however much we imagine we are above it. Asked in the abstract if you would choose economic productivity over happiness, the dilemma seems stupid - but how many times have you chosen to stay late at a dull headache-churning computer rather than head off for a pint with your friends or a night with your kids?

This wealth-obsession creates misery at the top and misery at the bottom. We now know that once you reach a certain level of wealth – around £25,000 – extra cash to play with has diminishing returns. The endless quest for riches and status symbols actually makes you more miserable, lowering your seratonin levels and inducing chronic insecurity. The kids at Wellington School are especially vulnerable to this “Oxbridge Syndrome”, as they are trained by their over-achieving parents to reflexively, ceaselessly build ladders to climb to prove their superiority.

But this obsession with wealth and status claims victims at the bottom too. Human beings are simply smart monkeys, and if you look at our hairy cousins (no, not George Michael) you can see the effect of these status games. When monkeys are made to feel that they are at the bottom of the pile and will never be able to rise to the top, they become withdrawn, depressed and suicidal. Over the past thirty years of Thatcherism, we have seen more and more people gathering at the bottom of the British ladder, unable to climb – so why are we surprised to see depression spiralling? It’s ironic that it is a private school costing a cool £23k a year – the epitome of inequality – that has relearned this old, old lesson. Is it really 150 years since Robert Louis Stevenson said, “There is no duty we so underrate as the duty of being happy. By being happy we sow anonymous benefits upon the world”?

Now, if you’ll excuse me, I am going to force myself to stop working, swallow some anti-depressants and listen to some old jazz records. You don’t have to go to Wellington College to experiment with some happiness lessons of your own.

Seven years ago, I wanted to die. Not consistently, not every moment of every day; but I was suffering from clinical depression and I knew I could not bear to feel like that any longer. The best description of how it feels to be trapped in a morbid, protracted depression can be found in a throw-away joke by the late manic depressive Spike Milligan. After hearing a woman scream in childbirth, he said: "She was howling in agony. Fortunately, it is a language I speak fluently."

I was lucky. I managed to find medication that stopped the agony. If I had not, I might have killed myself. It would have been a reasonable choice. Sylvia Plath and the late playwright Sarah Kane tried all the anti-depressants and treatments they could, and none of them worked. They made a rational decision to die. Individuals forced to choose between unbearable pain and death should not be condemned for choosing death; it can be the kindest thing to both themselves and to their families. To dismiss them as "selfish" is a failure of empathy.

Over the past week, I have noticed a small, insidious tremor of condemnation recurring in our public discourse on this subject. The British attitude towards suicide has been slowly, steadily moving in a softer, more sane direction for over a century. As recently as 1961, if you killed yourself on British soil, you were posthumously punished. Your estate was seized by the government and your relatives were stripped of their inheritance. Your family would not only be bankrupted but shunned; the churches would refuse to bury you on "consecrated ground". We were coming to a more subtle understanding of suicide, and beginning to accept that sometimes it is a decent choice.

Yet Brian Drysdale's death - the event that caused the Berkshire train crash last weekend - has given an opportunity to those who want to revive the stigma around suicide. A gaggle of bishops and Catholic pontificators like Mary Kenny have used the tragedy to expound their view that suicide is always, invariably wrong and must be condemned. I disagree. Drysdale was horribly, disgustingly wrong to take seven people with him, including two children - but if he wanted to kill himself, assuming he was not completely insane, we should respect his decision.

When it comes to allowing people to choose death, Western societies are in the middle of a painful ethical transition. We are moving from a Judaeo-Christian belief in the sanctity of life to a more nuanced understanding that quality of life can be more important. The debate about whether people should kill themselves might seem obtuse; who, after all, can stop people doing it? But it matters because any conclusions we reach about suicide inevitably affect our conclusions about assisted suicide.

The important question underlying both debates is: do you own your own life, and do you have a right to end it if you want to? If we believe you do, then it cannot reasonably be denied to people too infirm, physically incapacitated or just plain cowardly to perform the physical act. A willing doctor handing a patient the medical equivalent of hemlock - or delivering a lethal injection - is simply delivering suicide by other means. The ethical difference between me killing myself and a willing doctor helping me seems slight, and it is often exaggerated by the opponents of euthanasia.

These are particularly important questions at the moment because, as part of the Mental Capacity Bill currently before Parliament, the Government is proposing to introduce legally binding "living wills". Already in place in most European countries, this new law will give you the right to stipulate circumstances in which you would prefer death to life. The most common scenarios are if you are mentally incapacitated, or if you could only survive in extreme physical pain. This Bill is a little-noticed tipping point, a moment when we should be forced to look at our slowly evolving moralities and realise how far they have shifted. Iain Duncan Smith has condemned the Bill as "government-sanctioned suicide" and "euthanasia by the back door". These are pretty accurate descriptions. The Government should stop ducking the debate and denying the obvious euthanasia implications. They should argue back against IDS and defend your right to choose the time of your own death.

IDS, like most opponents of euthanasia, argues that all lives - no matter how unwilling or miserable - are worth preserving equally. This sounds attractive at first. Yet almost nobody, not even the Vatican, believes that the "sanctity of life" ethic (to use the philosophical label) can be consistently followed any more. Look at Anthony Bland, one of the victims of the Hillsborough disaster. He was left in a persistent vegetative state, and kept alive for four years by medical technology. He had no more self-awareness than a cabbage, and no cure was ever going to be possible. But he was undoubtedly alive; if you believe in souls, then he presumably still had one.

If you really believed in the sanctity of life at all costs - irrespective of quality of life - then you would have to argue against switching off the machines and killing him, which was finally done in 1993. Hardly anybody did. This was an admission that sometimes quality of life can be so poor that it overrides the sanctity of life and makes death preferable. Once you make this admission, we are simply haggling over how bad life can get before allowing (or helping) a person to die is justified.

This is slowly being understood by the British public, but many people feel understandably uncomfortable that the old ethic is dying away without a clear replacement. We need to craft an alternative - a legally protected right to choose the timing of your own death, if you wish to exercise it. This should not be restricted to the terminally ill, even though they are almost always the focus of this debate. While they are obviously the most sympathetic candidates for the cause - they have the most emotionally blackmailing case - the vast majority of people who want to die are suffering from no physical illnesses except life itself. If these are firmly resolved to do it and they have pursued reasonable medical treatments and found them ineffective, they should be given medical help to end their lives.

Dignitas, the voluntary euthanasia society, has helped four people with a history of severe depression travel to Switzerland to be helped to die over the past three years. This has attracted a great deal of condemnation. But, given that these patients had exhausted the medical options and were in unbearable psychological pain, I think it was a compassionate act to help them leave life in a dignified way of their own choosing.

If I had been born just a decade earlier - before the creation of SSRIs, anti-depressants that actually work - I might have chosen the same route for myself. The small minority of British people who find life too painful to endure should be given this option - and the Mental Capacity Bill is a very small, faltering step in that direction. It provides us with an opportunity to move away from the rotting carcass of Judaeo-Christian ethics and acknowledge that sometimes - just sometimes - death is the least bad option.

[On 13th March, the following story, culled from the BBC site, broke: Charity chief slams drug watchdog. The head of mental health charity Mind has resigned from a review of anti-depressants accusing a government drugs watchdog of negligence. Richard Brook acted after GPs were advised to limit doses of the anti-depressant Seroxat. He claims the Medicines and Healthcare products Regulatory Agency (MHRA) knew about the concerns for 10 years and he was pressured not to reveal them. Mr Brook has left the MHRA's working group. The MHRA denies any cover-up. Johann wrote a small piece accompanying the Independent on Sunday's report of this story.]

Seroxat saved my life. It’s as stark – and stupidly
melodramatic – as that. I was eighteen, lost and
suicidal. I couldn’t sleep; I couldn’t eat; I could
only think fitfully, in manic bursts in-between tears.
I was becoming unanchored from reality, alternating
between being shut morosely in my room and wild,
anarchic sociability.

And then came my small blue tablets – 30mg of sanity
once a day – and success. Seven years on, I have never once doubted or cursed my Seroxat. Like the vast majority of people who use it, I have found – for the first time in my life – a sense of coherence and
control. No more waking up crying without an
explanation. No more cluster bombs of despair strewn
throughout the day.

On this issue, I fear Richard Brook has made a rare
misjudgement. I have seen the effect of the new NHS
guidelines myself. Two months ago, my doctor refused
to give me a repeat prescription for the first time.
She called me in and said something so stupid I
thought for a second she was joking: “You know, I do
not know why you are even taking anti-depressants. You do not look depressed to me.”

I don’t look depressed, doctor, because I am taking
anti-depressants. Her response was to read me the new NHS guidelines for GPs. If after six months the
patient is not showing further symptoms of depression,
stop giving out the drug. If the patient is still
depressed, continue with the prescription.

If the drugs work, stop prescribing them. This is the
absurd reality of limiting Seroxat prescriptions. I
can afford to go to a more understanding private
psychiatrist. But for people dependent on the NHS,
these restrictions will be a road-map back to darkness.