There has been a lot of internet discussion following the great Philip Seymour-Hoffman’s death, on whether addiction is a disease, and how ‘responsible’ he was for his death.

People talk about spoiled celebs and free will and life choices and all that. Though part of this is automatic bollocks, our determination to believe that celebrities are somehow ‘other’ and that fame and money are total salvation. But  yes, from the outside, it always looks like these Bad Things the famous or unfamous addict chooses (alcohol, coke, heroin, sex, money spent on a roulette wheel, whatever) are consciously chosen.

It’s a tricky issue. One that probably involves far more understanding of neurological networks and processes than I have at my disposal, as I don’t have a PhD in neuroscience.

The thing is, whether or not addiction is a ‘disease’ or not, depression and anxiety undoubtedly ARE. And they are deadly and unbearable at times. People actually jump under trains to end the pain of these diseases. They don’t want to die, anymore than the person in a burning building wants to jump. They HAVE to.

Short of suicide, the only way sometimes to numb pain is through unhealthy comforts.

It’s a gamble.

Sometimes I have binge drank to fight off anxiety and it has actually worked and broke a cycle. I didn’t wake up the next day needing more alcohol, either. In the long term, it makes you worse, but pain ignores the long term. What I am saying is, do not judge someone until you have been where they are, until you have felt the fierce intensity of the mind. It is nice to believe in free will. It is itself an addictive comfort. But neuroscientists (like David Eagleman) and philosophers (like Julian Baggini) alike are wondering if it is yet another arrogant human delusion.

Never judge. (‘If you’re a human walking the earth,’ said PSH, ‘you’re weird, you’re strange, you’re psychologically challenged.’)

Personally, I believe addiction is a disease. One that causes involuntary dis-ease. ‘Ah, but people choose to have their first drink/line/shot of heroin’ people say. That is a choice. Yes, well pretty much everyone made a choice to drink alcohol at some time. You might have felt it relaxing your mind. You might never have needed that sense of relaxation, and so for you it remains a choice. But what if you felt the full stormy ferocity of the human mind at its bleakest and knew you could find shelter under the shade of a substance. If your leg is on fire, you pour water on it.

Whatever, some things are certain:

We are what we need to be. We do what we need to do. We are not all in the same reality.

My first YA book, Echo Boy, will be published on March 27th in UK by Bodley Head. Here’s the proof cover:

The Humans has been nominated for an Edgar Award. The shortlist can be seen here. The awards will be presented at the association’s sixty eighth gala dinner, in New York, on 1 May.

January is not a good month for me. Traditionally, if I dip back into depression or anxiety it will happen in October or January.

And this year it happened. Just anxiety, but that is bad enough.

Two weeks ago I started to get that familiar tightness and tingling in my chest. My dreams dove into surreal nightmare territory. I’d wake up at three in the morning and battle with my breathing and my mind to stay in control.  I’d feel like an internal Russian Doll version of me was trembling all the time, a kind of vibration that couldn’t be seen (my hands were steady as a rock), but which I felt humming inside me.

Now, for people who don’t know the difference between anxiety and Anxiety I’ll explain. Normal anxiety – the kind I pretty much always have – is when you worry about things, but you can still distract your brain away from things via such anaesthetics as television and books and Twitter and the folks you love.

Capital A anxiety is different, because you are inside your fear. You can’t stop worrying for a second any more than you can stop having flu for a second. When I am in this state, everything has to be perfect. I have to eat healthily, have to be in bed by eleven, and exercise just the right amount (for me, a morning 5k run is the right balance between two much and too little). If I mess up it gets worse. If I think of an actual worry, however minute (an email that hasn’t arrived, a negative comment a publisher said) it hurts like salt in an open wound. But mainly, the worry is the worry. Anxiety is the most postmodern illness. It is entirely self-referential.

Normally, I would be in this invisible nightmare for three weeks. This time, it was more like five days. And you suddenly look at the world in bewilderment, like people must feel after they’ve been to war. Everything – friends, trees, shops – looking exactly as they did before, as if nothing had happened. Still, calm, blades of grass, as calm and green and unknowing as ever.

I’ve worked out that anxiety can be beaten by believing it can be beaten. The more times I get anxiety and then get over it, the easier it is to believe this. Anxiety is the illness that feeds on itself. I was once trapped inside it for nearly three years. It nearly took my life, because it is an illness that can be infinitely horrible, because it is a disease of thought, and thoughts are infinite.

To paraphrase Horatio, anxiety is bad because thinking makes it so. You can’t simply think yourself out of it, but you have to hold on to the idea that it is beatable, and that it can be conquered.

Because even though anxiety feels like everything, it is also actually nothing.

Sometimes, just sometimes, a cloud can be banished just by knowing there is a sun.

Suicide is on the rise, and is now – in places including the UK and US – a leading cause of death, accounting for over one in a hundred fatalities. According to figures from the World Health Organisation, it kills more people than stomach cancer, cirrhosis of the liver, colon cancer, breast cancer, and Alzheimer’s. As people who kill themselves are, more often than not, depressives, depression is one of the deadliest diseases on the planet. It kills more people than most other forms of violence – warfare, terrorism, domestic abuse, assault, gun crime – put together.

And, even more staggeringly, depression is a disease so bad that people are killing themselves because of it, in a way they do not kill themselves with any other illness. Yet people still don’t really think depression really is that bad. Unless they would say these things to other potentially dying people:

-       ‘Come on, I know you’ve got tuberculosis, but it could be worse. At least no-one’s died.’

-       ‘Why do you think you got cancer of the stomach?’

-       ‘Yes, I know, colon cancer is hard, but you want to try living with someone who has got it. Sheesh. Nightmare.’

-       ‘Oh, Alzheimer’s you say? Oh, tell me about it, I get that all the time.’

-       ‘Ah, meningitis. Come on, mind over matter.’

I think it is time for us to stop seeing depression as a choice. It is something that happens to people for an infinite and not always identifiable number of reasons.Yes, there are decisions sufferers can sometimes make – exercise, diet, medication, meditation, therapy – that might help, but that is the same with all illnesses. We are still in the Dark Ages when it comes to our attitudes to mental health, as anyone who saw Peter Hitchens on Newsnight last night will be aware, but the light is slowly entering.

The more sufferers who speak openly about it the better. Because stigma not only prevents understanding, but in this case can actively exacerbate symptoms. Having an illness of the brain is no more the sufferer’s fault than if it was an illness of the lungs or heart. Ill is ill. And depression is serious. We need less judgement and more help, for an illness that claims the lives of thousands every day.