‘B’ is for breakdown; a nervous breakdown to be precise. Although not a recognisable clinical term, this is still often used to describe a loss of mental stability. In medieval times it might have been called ‘melancholia’, in the early 1900’s it was known as neurasthenia and then in the 1930’s our present term was used. It describes the experience of ‘snapping’ under immense pressure, with consequent physical or mental collapse, or both. More commonly now we would call it depression.

Depressive episodes may be caused by genetic and biological factors but are often triggered by social and environmental circumstances. Moving home for an elderly person after many years in the same place can do it. A sudden and unexpected death of a dear friend can do the same. Similarly anxiety about failing powers and the fear of not being able to cope with what once would have been ordinary pressures can destroy a sense of wellbeing. Retirement for somebody whose work has been their life, can plunge her or him into a strange and unwelcoming world.

Bereavement is often a cause – losing someone you have loved may mean losing your own sense of who you are. Whatever the reason (and it may not be easy to find), depression saps your energy and motivation and can leave you feeling rootless, guilty and without hope.

I had such an experience in the mid 1990’s. I was on prosac for about five months (too long I now think, but I hadn’t then the energy to argue with my doctor). I also had some counselling, saw a homoeopathist, struggled back to work which became part of the therapy, had guidance from the Irritable Bowel Syndrome Support Network, and was supported by my wife and family.

The condition can make you a stranger to yourself and it’s therefore very difficult to manage your life -just existing is no fun: the worst thing about depression is being depressed! It is very difficult to move out of the trough in which you feel you have fallen.

But it is possible. So what is to be done? Drugs are one answer, perhaps too easily prescribed. Counselling is another, social support a third, a fourth someone who has had a similar experience around to tell you that there will be better times, and finally the conviction of people who love you, that you are still yourself and will recover your equanimity. Most of all you need patience.

Bryan