Can Physical Symptoms In Depression Be A Consequence Of Low Energy Production Rates?

A report in the March issue of Psychotherapy and Psychosomatics introduces a new hypothesis on the mechanisms of physical symptoms in depression: energy production rates toward the lower end of the spectrum may predispose the individuals to develop depression and physical symptoms.

This hypothesis derives from a study performed in the Karolinska Institute. The Authors hypothesized that decreased ATP production rates in mitochondria underlie depressive disorder with very high levels of somatization. They assessed muscle mitochondria in depressed patients as well as somatic symptomatology with 3 self reported scales (Somatic Anxiety, Muscular and Psychasthenia) from the Karolinska Scales of Personality. At the end of the study, on each of the 3 Karolinska Scales of Personality, virtually every patient with very high levels of somatic symptomatology demonstrated muscle ATP production rates below the control range.

These results demonstrate that mitochondrial function correlates very strongly with self-reported data related to somatic symptoms in depressed patients.

This introduces the possibility that substances such as Alpha Lipoic Acid and Idebenone (next generation coenzyme Q10), may be of help in depression.

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Cruise Apologizes To Shields Over Post-Partum Depression Rant

(AHN) – From bizarre to congenial, Tom Cruise takes a step back from his accusatory and inflammatory statements regarding Brooke Shields use of anti-depressant drugs and apologized to the actress. Shields told Jay Leno’s Tonight Show, “He came over to my house and gave me a heartfelt apology.”

Cruise publicly accused Shields of failing to understand psychiatry in 2005 after she disclosed taking medication to treat post-partum depression. A spokesman for Cruise said, in a BBC report, “he has not changed his position about anti-depressants,” and he still deems them “unhealthy.” Of the apology, Shields adds, “I was so impressed with how heartfelt he was…I did not feel that he was trying to convince me of anything other than the fact that he was deeply sorry. And I accepted it.”

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Physical activity may protect against the development of depression

Many dedicated exercisers say they work out not just for their body, but also for their mind. In our high-stress society, slamming tennis balls, shooting hoops or stepping out for a walk are all socially acceptable ways to relieve tension and adjust attitude–just as Grandma knew when she advised taking out your anger on the woodpile.

Now a growing body of research suggests that telling someone under stress to “take a hike” or “go soak their head” in the swimming pool may be a dose of good medicine.

 “Exercise has a very positive effect on mental health from a number of perspectives,” says Dr. John Docherty, a psychiatrist and director of the Center for Innovation in Behavioral Health at New York Hospital / Cornell Medical Center. “We know exercise helps regulate biorhythms, which improves sleep, and it enhances energy level and vigor. Exercise is also very important in maintaining physical health and controlling weight, which impacts on self-esteem.”

There is no definitive research that proves the effects of physical activity on psychological health the way studies evaluate the impact of a drug on heart disease. But a significant body of evidence links regular exercise with components of improved mental health, such as brighter mood, reduced anxiety and enhanced self-efficacy.

And in some physicians’ offices as well as in health clubs and on biking trails, people are turning to exercise as a way to relieve symptoms of depression and anxiety.

Docherty, for example, prescribes exercise to all his patients, but cautions that “the science needs to be stronger” in helping physicians determine how much and what kind of exercise works best for varied psychological conditions. “With a pill, I know specifics such as what dose to prescribe and what percentage of patients will respond. We don’t have that level of data with exercise yet.”

A consensus is growing that “physical activity may protect against the development of depression,” as the U.S. Surgeon General’s Report on Physical Activity and Health noted in 1996.

“In general, persons who are inactive are twice as likely to have symptoms of depression than are more active persons,” according to the report. In addition, regular exercisers are less likely to report symptoms of depression and anxiety than are people who do little or no physical activity. On the other hand, “persons who have good mental health may simply be more likely to be active,” the report pointed out.

Yet the exercise-mood connection is strong enough to bring psychiatrists and psychologists together with exercise specialists to explore the ways in which regular activity might be used as therapy. In a society where depression affects an estimated 10% of the population, many experts are embracing the idea of “sweat therapy” as a powerful
adjunct to standard treatment, which is typically antidepressant medication and / or psychotherapy.

 A few small studies even suggest that, in cases of mild to moderate depression, exercise may be as effective as standard therapies. A major study funded by the National Institutes of Mental Health is examining whether aerobic exercise alone can be an effective treatment for depression.

“Not everyone responds to medications or the other treatments we have available for depression,” says psychiatrist Dr. Madhukar Trivedi of the University of Texas Southwestern Medical Center.

Not a Cure By Itself

Doctors caution that exercise is not a substitute for medical care. People suffering from depression, they say, should be evaluated by a mental health specialist to determine an appropriate treatment regimen. ‘Exercise is not a panacea,” says Norwegian psychiatrist Dr. Egil Martinsen, an authority on the link between exercise and depression. “You can’t replace psychotherapy with exercise.”

But it can be an important adjunct therapy, he says, noting that “it doesn’t seem to be necessary to have the fitness gains to experience mental health gains.”

Good for Others Too

Easy to administer, readily available, inexpensive and low risk, exercise holds great promise for helping nondepressed people too, as they fight the daily battle of the bummers–such as ordinary life stresses, frustrations and bad moods.

“With every aerobic exercise bout, there is at least a temporary period of calmness lasting from two to four hours,” says Jack Raglin, associate professor of kinesiology at Indiana University.

Although the connection between exercise and psychological well-being is firmly established, further studies also are needed to identify the mechanisms by which exercise appears to exert these effects. Popular theories point to exercise’s effect on brain chemicals, on body temperature and on “psychosocial” factors, such as being with other people or getting away from problems.

 “It seems so simple that people feel better after exercise,” says Brad Hatfield, associate professor of kinesiology at the University of Maryland in College Park. “But it’s actually a very complex dynamic” involving a person’s current level of physical conditioning, mental health status and personality traits.

“One of the players in the orchestra are neurotransmitters, like serotonin and endorphins, that are released as a result of physical activity,” Hatfield says. These brain chemicals can have a powerful, mood-enhancing effect.

Exercise also raises body temperature, which may relax muscles and calm body and mind. “Any kind of repetitive rhythmic stimulus applied to the brain stem–such as walking, swimming laps or cycling–can have a tranquilizing effect on the nervous system, like rocking a baby,” he says. Plus, exercise enhances sleep, allowing people to “recharge their batteries” more fully.

And simply escaping temporarily from problems, accomplishing a goal, being in the fresh air and sunshine, mastering a new skill, interacting socially or getting away alone are all possible reasons exercise improves mood. Exercise is generally something people can control, which boosts self-confidence and feelings of competence, says
Hatfield, who admits that his personal workout is “sometimes the only thing in the day that makes any sense.”

“I can’t think of any condition that physical activity wouldn’t be good for,” adds Dr. William Stockton, psychiatrist and clinical professor of psychiatry at George Washington University.

 “When I get out and walk my 2 1/2 miles in Rock Creek Park, it’s the only time of the day when I feel in charge of my life,” he says. “I can take one foot and put it in front of the other and I’m not in a struggle with the forces of the world. It’s not going to solve any long-term problems. But I feel better.”

Some experts speculate that regular exercise, which is a type of physiologic stress, may help people develop a more efficient biochemical mechanism for handling life’s pressures. Over time, exercisers may develop a kind of “stress hardiness” that protects them from depression.

“We know that rats who exercise are more resistant to stress,” notes Keith Johnsgard, an emeritus professor of psychology at San Jose State University and author of “The Exercise Prescription for Depression and Anxiety” (Plenum Press, 1989). “It’s possible that exercise might protect us from the kind of stress response that would bring on
depression.”

Too Much Exercise

Despite the upbeat effect of exercise, too much of a good thing can have a downside. While regular physical activity appears to boost mental health, excessive exercise can lead to mood disturbances such as loss of libido and appetite, fatigue and lethargy.

Known as “overtraining,” excessive exercise can be a problem for some competitive athletes who must learn to walk the fine line between commitment and compulsion. In addition, a small proportion of recreational athletes take their healthful habit to an unhealthy extreme, becoming “exer-holics” who use sport as a way of escaping from their
lives.

For both conditions, overtraining and exercise addiction, cutting back on physical activity can relieve symptoms and restore health. Compulsive exercisers also may find therapy helpful in examining whether they are running toward health or running away from problems.

The complexity of the exercise-mood connection presents a challenge for researchers, who are studying a broad array of topics.

One of the most perplexing questions, which some experts consider the most important, is: “If exercise makes people feel good, why do so many people remain sedentary?” Typically, humans tend to do things that feel good and avoid things that feel bad–an observation Freud called “the pleasure principle.”

Yet even though exercise has a well-documented “feel good” effect, the majority of Americans get little or no regular physical activity. And half of all people who start a new exercise program quit within six months.

The reason, suggests Bill Morgan, a professor of kinesiology at the University of Wisconsin, Madison, is that “exercise must be purposeful, as opposed to getting on a treadmill to nowhere. Most people in adult fitness programs drop out before it becomes meaningful to them.”

He adds, “If people find an activity that they enjoy and need, so that it has meaning, it can provide a sense of accomplishment.”

Regular exercisers come to rely on this boost they get from their activity “fix.” In a study published in the journal Medicine & Science in Sports & Exercise, habitual exercisers who were deprived of their regular workout for three days reported a variety of mood disturbances, including tension, depression, anger, fatigue and confusion. This is why many committed exercisers say they work out regularly.

Exercise doesn’t need to be strenuous to have mental health benefits, says Norway’s Martinsen. Even easy activity, like a casual stroll, can help people feel better. “Doing anything is better than doing nothing,” he says.

   Especially when people are hospitalized for mental illness, he says, “we must not let the body get worse while we try to restore the soul.”

 

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Depression, child-rearing in the 21st century

MORE than 100 academics, teachers, psychologists, children’s authors and other experts yesterday called for a major public debate on child-rearing in the 21st century. The escalating incidence of childhood depression is caused, they suggested, by a lack of understanding, by both politicians and public, of the realities and subtleties of child development.

Exposed as never before to iconimagery, txt spk, 24-hour TV and targeted marketing, especially of dubious food products, where are children to go? What happens to the senses and the imagination? Does the fast, technology-driven and competitive world really suit a fragile, developing mind? The letter, published in the Daily Telegraph, was instigated by former head teacher Sue Palmer (author of the book Toxic Childhood) and Dr Richard House of Roehampton University: signatories included Baroness Susan Greenfield, director of the Royal Institute, children’s authors Jacqueline Wilson, Anne Fine, Philip Pullman and Michael Morpurgo, childcare expert Penelope Leach, nutritionist Patrick Holford and environment guru Jonathon Porritt. They wrote: “Since children’s brains are still developing, they cannot adjust to the effects of ever more rapid technological and cultural change. They still need what developing human beings have always needed, including real food (as opposed to processed ‘junk’), real play (as opposed to sedentary, screen-based entertainment), first-hand experience of the world they live in and regular interaction with the real-life significant adults in their lives. They also need time. Today’s children are expected to cope with an ever earlier start to formal schoolwork and an overly academic, test-driven primary curriculum.”

Palmer cited research by Michael Shayer at Kings College, London, which showed that 11-year-olds measured in cognitive tests were “between two and three years behind where they were 15 years ago”. Childhood is not a race, she said; and its physical and psychological growth cannot be accelerated. Some of the areas of concern in the letter are on the Government agenda in Scotland and, in a general response to the issues raised, the Scottish Executive points out that its policy document, Vision for Children and Young People, promotes ambition, learning, confidence, responsible citizenship and effective contributing. A spokesperson says: “The Executive aims to support parents to fulfil their role and we also seek to create a positive environment for children in areas such as provision of leisure opportunities, open space. In 2005 the Executive developed Children and Young People’s Mental Health: A Framework for Promotion, Prevention and Care to assist local health, education and social services in delivering integrated approaches to young people’s mental health and wellbeing.”

In response to the criticism that high educational expectations are being placed on children at too young an age, the spokesman: “The Curriculum Framework for children aged three to five already recognises the powerful contribution that play makes to children’s learning, and we plan to extend approach into primary [education].” The Executive is also working on turning around Scotland’s eating habits and health. “We want to establish healthy lifestyles as early as possible. Strategies to improve the health of children and young people are already being successfully implemented across Scotland, and to build on this momentum we introduced the Schools (Health Promotion and Nutrition) (Scotland) Bill on 8 September. Among other measures, it will ensure food and drink served in schools meets tough nutritional standards.”

The Executive’s claim that it has been successful in tackling childhood obesity and bad eating habits is harder to swallow, however. An independent report published yesterday states that, despite spending 100 million in ten years on the problem, Scots are eating even less fresh fruit and veg than a decade ago. Although the Executive claims to be addressing many of the concerns raised in the open letter, there is still patently much work to be done.

Parental relationships are the real problem

CONSULTANT psychiatrist at the Maudsley Hospital and Gresham professor for public understanding of psychiatry, Raj Persaud is critical of the letter which, he says, plays on middle-class anxieties. “CHILDHOOD depression is on the up, but I disagree with the letter’s view of the causes. There’s a basic flaw in the reasoning: if a factor is widespread in society – such as junk food and electronic games – then how come large numbers of children don’t get depressed? They may not be the best things for our children, but it doesn’t mean they cause clinical depression.

Rising rates of depression are a problem, but the majority of children are not [afflicted]. This letter tries to lay the blame on various themes, all things that middle-class parents are worried about, but it allows parents to escape the responsibility for their child’s mental health. Factors that are definitely linked to childhood depression are rising rates of drug and alcohol abuse: children have more pocket money and are choosing to spend it in this way. People are also having sex at a younger age, and we have the highest rates of teenage pregnancy, often followed by termination, in Europe. I’m much more concerned about how this affects mental health.

Lower levels of parental surveillance can be a factor. I’m not against childcare for working parents, but the quality of that childcare is important, as is the quality of a child’s relationship with its parents (something that the letter does promote). There is evidence to suggest that the IQ of children has been going up each generation for the past 40 years, and this during the digital age. Expose a child to a faster information stream, and it could actually increase its IQ. A junk-food-eating, electronic-game-playing teenager can actually be quick and bright – and not at all depressed. It’s easier to blame electronic games, TV and junk food than to examine the more uncomfortable but realistic truths closer to home.

One danger is leaving children to it, the TV or computer being a convenient place to dump them

ALTHOUGH not a signatory to the letter, children’s author Julia Donaldson (who wrote The Gruffalo) has some sympathy with its basic call for greater awareness and a full debate. “IT SEEMS to me the letter lumps a lot of things together that are not necessarily related, except under the umbrella of ‘modern life’, so it’s not very focused – I’d have wanted to re-word it.

But I do agree that the most important aspect of a child’s development is the quality of its relationships with parents and others. I also agree that children need real play, and have felt for a long time that TV is sometimes used as a substitute for this. In the days before we had DVD players, 24-hour schedules and dedicated children’s channels, TV programmes for youngsters would only come on at a certain time of day, so for a playleader there couldn’t be any choice – at other times you had to play. Now it can be on all the time, and there may be lots of good programmes, but it’s unremitting, and probably isn’t great for your physical health, let alone mental state, being able to sit in front of a screen for so much longer.

A good relationship between parent and child can certainly be fostered by reading together, but equally by looking at pictures together. It’s the sharing that is the point, and an awareness, on the part of the parent, of what is in the child’s mind. I call it ‘active sharing’, and it can give you many points of reference in common that contribute to a high-quality relationship. “I fell down, just like Jack and Jill,” for example. One of the dangers is in just leaving children to it, the TV or computer being a convenient place to dump them – then parents get out of touch. Children’s channels are not selective either; at least with a book or DVD you can control what they’re seeing or reading, and I don’t think there’s really anything intrinsically bad about the best of film, TV or computer games.

I agree that secondary schools are too test-driven, and that pre-teen ‘mini-adults’ are awful. But there are other factors, surely, that affect children’s mental health: an unhappy home can have an effect; or two absentee parents; or a favourite childminder who leaves. You could argue that more choice makes children more adaptable; it does mean that books have to compete harder for attention – but I still think that nothing can beat a good book, and it is totally the best entertainment there is. You can enter another world; and to my mind film can’t quite compete.”

We just don’t know the effects of computers

DISTINGUISHED neuroscientist Baroness Susan Greenfield, author of Tomorrow’s People, instigated a debate in the House of Lords in April on the impact of the screen on the developing brain. She had no hesitation in signing Sue Palmer’s letter when it arrived on her desk. “A LOT of research has been done into the effects of, say, cannabis or Ritalin or fish oils and we now know all about Turkey Twizzlers. But there’s been a lot less [research into] computer-screen culture. We don’t know how an average of six hours a day in front of a computer screen may be affecting the developing brain, especially compared with previous generations.

For example, computer-screen icons could be detracting from abstract ideas such as democracy or love, and it may be that we’re breeding children to think literally and not in the abstract. It’s a gratifying, easy-sensation, ‘yuk-and-wow’ environment, which doesn’t require a young mind to work. It’s good [for a child] to be bored, because boredom empowers the imagination. If you are overpowered by limitless information, you are not in control. In the future, we could find ourselves so sanitised by screen culture that the notion of a real-time, real-life conversation, complete with body language, becomes as alien as hunting for food would be to us now.

I’m not saying we should smash up our computers. But there are grounds for concern, and we shouldn’t be complacent. It would be helpful if the Department for Education and Skills commissioned research to discover just how vulnerable and sensitive to inputs a child’s brain might be. We need to be aware we cannot park our children in front of the TV and expect them to develop a long attention span.”

If we don’t change our food culture now, by 2020 we will be in an intolerable position

NUTRITIONIST Patrick Holford, the chief executive of the Food for the Brain Foundation, and author of Optimum Nutrition for your Child’s Mind, is leading a new schools campaign to show the positive impact of good nutrition on mental and physical health. Parents can go to www.foodforthebrain.org to get a personalised report for their child, and tips on how to improve: 15,000 have done so already. “THERE is an epidemic of mental-health problems among children. One in three has difficulty with learning, reading, writing or attention, and children with special educational needs now number one in six. Some 250 million children worldwide are on stimulant drugs such as Ritalin; and last year 250 million prescriptions for anti-depressants for children were issued. If we don’t act now to change food culture, by 2020 we’ll be looking at an intolerable position for society. “On the one hand we still don’t have enough evidence, and need more studies on the effects of sugar and fats. On the other, controlled trials have shown that the non-verbal IQ goes up with increased vitamins and minerals; children with hyperactivity problems respond to a low glycaemic-load diet, keeping their blood sugar even; and autistic children are almost all allergic either to wheat, milk or both. “We have done studies which correlate sugar and caffeine to mental health. A child who drinks a two-litre bottle of cola ingests the equivalent of 45 spoons of sugar and five espressos – and I frequently meet people who do this every day. We need to change the culture: don’t give sweets as rewards or treats. Surround healthy food with positive messages. Take away the dependence on high-sugar foods. Make bad food less attractive. “Do we want to wait ten years or do something now? Our Food for the Brain Foundation has started a schools campaign, and we have good results after four months in a school of severe special-needs children, where we held workshops for parents and radically changed the diets, adding vitamin, mineral and essential fat supplements. The children have responded phenomenally well – they are now telling their parents what’s good to eat and what’s not. We’d like to extend it.

I’d also like to see the Government’s current healthy eating guidelines go even further. Children who have fish three times a week do better than those who have it twice; they in turn do better than those who only have it once. I’d even advocate a tax on sugar. “There is also an exercise system we use, SAQ (Speed, Agility, Quickness), practised also by Arsenal football club, which teaches co-ordination and balance; it particularly helps dyspraxic children, and encourages them to want to do sport – obviously one way to combat the threat of childhood obesity. Once 50,000 people have used our online questionnaire, we’re going to see which foods relate to which symptoms. It’s never been done before.”

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Depression fuels risky behavior in gay men, new study claims

Depression is fueling risky sex and drug use in gay men, according to a new report by a leading gay men’s health group. Living on the Edge: Gay Men, Depression, and Risk-taking was released Wednesday by the Medius Institute for Gay Men’s Health, a health advocacy group in New York City. The study pointed out that 17% of gay men have depression, approximately twice the rate of depression among the general public. The study found strong links between depression and high-risk behaviors, including substance abuse and unsafe sex.

“Clearly, depression and related disorders are a major challenge for gay men’s health,” said Spencer Cox, executive director of the Medius Institute. “For the most part depression doesn’t seem to cause high-risk behavior directly, but it certainly pumps up the volume on risk-taking.”

The institute advised integrating mental health care referrals with programs combating HIV and other sexually transmitted diseases, as well as making mental health opportunities and educational programs specific to gay men more accessible. (The Advocate).

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Robbie Williams being treated for depression, cancels tour

Pop star Robbie Williams is reportedly being treated for depression at a top London clinic after cancelling the Asian leg of his world tour earlier this month. Williams, who has battled depression in the past, is struggling in the charts with new single “Rudebox” and is facing legal action from ex-manager Nigel Martin-Smith over a song Williams wrote about him in his new album reported contactmusic.com. Williams told a BBC documentary this month: “I could get up in front of 35,000 or 40,000 people and go, ‘Look at me, I’m ace’. Then I’d get in the tour coach, go back to my bedroom and pull the duvet over my eyes.” An informed source said: “He has suffered from depression before, but feels things are getting much worse and the tour was too much.”

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Daniel Smith died from overdose of depression meds

LOS ANGELES, Sept. 28 (UPI) — The private pathologist hired by Anna Nicole Smith to perform a second autopsy on her son said that Daniel Smith most likely died of cardiac arrhythmia.

Dr. Cyril Wecht said the arrhythmia was caused by a combination of Lexapro, Zoloft and methadone, Us Weekly reported Thursday. It is known that the Lexapro was prescribed to Daniel Smith but it is unknown where he got the other two. Wecht also told Us Weekly that there is no doubt in his mind that this was an accidental death. Methadone, Wecht said, is “a legitimate prescription drug for pain relief” and that Smith had “no known history of morphine addiction,” reported People magazine. Smith died in the Bahamas while visiting his mother in the hospital Sept. 10, three days after she gave birth to baby girl.

 

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Olivia Newton-John’s battle with depression

AUSSIE singer Olivia Newton-John has revealed she has turned to anti-depressants to cope with the loss of boyfriend Patrick McDermott. But she said she didn’t believe McDermott, who disappeared on an overnight fishing trip off the coast of California in July last year, faked his death. In an interview with People magazine, Newton-John said the loss of McDermott was tougher than her battle with breast cancer and her divorce from actor Matt Lattanzi. “I’ve been through cancer and divorce, but nothing compares to this,” she said. “I took anti-depressants – I had to.”

This year The Sunday Mail reported McDermott had been seen by up to six witnesses in Mexico in the months after he went missing. When he disappeared, the former lighting technician had been living in a modest home, was thousands of dollars in debt and facing jail over unpaid child support payments. But Newton-John said McDermott loved his son Chance, 14, too much to pretend he had died. “He just wouldn’t do that – his son was everything to him,” she said.

Newton-John has also revealed she’d broken up with her boyfriend of nine years before he disappeared. “We were on a break but we had been on breaks before and we got back together,” she said. “We had a wonderful relationship – he had a good soul, a good heart.”

To preserve her memories of him, Newton-John has made a rock garden in her Malibu home and is “moving forward in a positive way”.

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Alastair Campbell’s battle with depression

HE WAS once dubbed the second most powerful man in Britain, rebuking Cabinet Ministers and striking fear in the hearts of newspaper editors.

But Alastair Campbell, Tony Blair’s formidable spin doctor for seven years, has revealed that, far from being invincible in Downing Street, he suffered clinical depression. At one point he missed a media briefing because he was unable to “face doing it”.

In an interview to mark World Mental Health Day, he admitted: “When I worked for No 10 I had periods when I knew I was depressed, but you just have to keep going.”

He discussed his mental health issues with Mr Blair, whose support was one of the things that kept him going. Mr Campbell, a former alcoholic who suffered a mental breakdown when he was 28, spoke about his mental illness to help to remove the stigma from it.

“I was very depressed for a long time. You wake up and can’t open your eyes, you can’t find the energy to brush your teeth, the phone rings and you stare at it endlessly,” he told the Independent on Sunday.

He said that the lowest point was during the “nightmare” of the Hutton inquiry into the reasons why Britain went to war in Iraq. The worst day, he said, was when Dr David Kelly, the government adviser, committed suicide.

“The Hutton saga was one of those episodes where things were spiralling out of control. I felt completely confident in relation to the facts, but during the whole period it was a nightmare,” he said. “The day he [Dr Kelly] killed himself was without doubt the worst day. It was about the sadness that someone felt driven to do this.”

He added: “I did feel if the inquiry had gone against us that it would have been really bad. If it had gone against us, it was not just me who was out of a job, it was Tony.”

Mr Campbell had a nervous breakdown in 1986, when he was the news editor of a Sunday newspaper. He realised he was having the breakdown when he was driving repeatedly around a roundabout. He was arrested and ended up in hospital for several months. He had been drinking from “day to night”, and had a “work-induced, drink-induced, pressure-induced, depression-induced psychotic breakdown”. He said: “It was unbelievably scary. At one point, I thought I was going to die.” The now teetotal Mr Campbell said that having come through the mental breakdown made him far stronger, and memories of it helped him to cope in Downing Street. “At points of real pressure, I always say to myself this can’t be worse than 1986,” he said.

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Jean Rhys wrote her way out of depression

TAUNTED with the cruel nickname the “white cockroach” as a child, the author Jean Rhys grew up on the Caribbean island of Dominica. She was the daughter of a Creole mother and a Welsh father and always felt distant from both the black and white communities. Her complicated childhood was to continue to influence one of the most intriguing literary lives of the last century and inform all her writing.

Rhys’s exotic background and the violent mood swings of her adult life make her a figure who still mesmerises. At one time a chorus girl in London, she went on to wrestle with a depressive streak that saw her briefly locked up in Holloway women’s prison, north London. Her powerful books, while rated as among the most accomplished of her era, have rarely been adapted for television, but now her most famous work, Wide Sargasso Sea, is to be brought to the screen in a lavish new BBC film shot in Jamaica. Adapted by Stephen Greenhorn, it has been made by the team behind the mainstream hits Spooks and Life On Mars.

Attention will also be focused on Rhys by a biography due out early next year. Lilian Pizzichini’s The Blue Hour, to be published by Bloomsbury, will attempt to unravel her life and explain themes that haunted her. The biography will take its title from Rhys’s favourite French perfume, L’Heure Bleue, and will show for the first time how the novelist’s obsession with the female form and damaging relationships between mothers and daughters directed her writing and caused, in part, her terrible depressions. “Her own relationship with her mother had been harmful and I don’t think enough has been understood about her preoccupation with women and her fascination with the effect of a bad relationship with a mother,” said Pizzichini this weekend.

The book will also chronicle her relationship with the writer Ford Madox Ford and his partner, Stella, and reveal the depths of Rhys’s pessimistic world view. “I wouldn’t say she was bipolar or borderline necessarily, but she had a very bleak vision and I think she was brave to express it because it doesn’t always make comfortable reading,” said Pizzichini.

Rhys was born Ella Gwendolen Rees Williams, the fourth surviving child of a doctor, William Rees Williams and Minna Lockhart, the Creole (a person of mixed European and black descent) granddaughter of a colonial landowner. Rhys left her Caribbean island home in 1907 for schooling in England, her head full of the books of Dickens and the Brontes. But the London she found was unexpectedly grey and full of tired, poor people. After school in Cambridge she went to drama school in the capital, and enjoyed a period working as a chorus girl in musical comedies, calling herself Ella Gray, before she was rapidly absorbed into the half-lit world of the bohemians in Paris. She became the wife of a Belgian conman and adventurer. While in France, she met Ford, who took her on both as his creative protege and his girlfriend, changing her name to the modern-sounding Jean Rhys.

In the Seventies, Diana Athill, of Rhys’s publishers, Andre Deutsch, wrote of her regret that the company did not treat the impoverished Rhys better or pay her more. According to Athill, the author was remarkable for her incredible attention to detail in her books. In a foreword to Rhys’s unfinished and posthumously published autobiography Smile Please, she gives an example of this “perfectionism”: “Some five years after the publication of Wide Sargasso Sea, she said to me out of the blue: `There is one thing I’ve always wanted to ask you. Why did you let me publish that book?’… I asked her what on earth she meant. `It was not finished,’ she said coldly.”

Even in later life, once she had become a celebrated talent and a London socialite, Rhys was dogged by self-loathing and depressive rages which alternated with phases of creative activity. These bouts of illness saw Rhys briefly imprisoned in Holloway but also drew her, most famously, to write about the best known madwoman in literature: the incarcerated Mrs Rochester.

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