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Depressive Illness: The Curse Of The Strong

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This book has helped many thousands of those who have depression. This new edition, written by a leading consultant psychiatrist, explains that depression tests the strongest of us. Dr Cantopher guides the reader through the nature of depression, its history, symptoms, causes and treatments. He covers the latest information on medications, new guidelines as to the management of depression, and stresses that no one should be to blame for succumbing to depression.

160 pages, Kindle Edition

First published April 1, 2003

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About the author

Tim Cantopher

17 books11 followers
Dr. Tim Cantopher studied at University College, London, and University College Hospital. He trained as a psychiatrist at St James' Hospital, Portsmouth, and St George's, University of London. He has been a member of the Royal College of Psychiatrists since 1983 and was elected fellow of the college in 1999. He worked as a consultant psychiatrist with the Priory Group of Hospitals from 1993 until his retirement from clinical practice in 2015. Depressive Illness: The Curse of the Strong was Dr. Cantopher's first, and remains his bestselling, book.

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5 stars
447 (46%)
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318 (33%)
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149 (15%)
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Displaying 1 - 30 of 79 reviews
Profile Image for Songs and Sonnets.
11 reviews6 followers
October 8, 2011
This book has revolutionised the way I view myself and my depression.

It’s not a self-help book as such. It provides information on stress-related depression, with occasional bits of advice. There are no exercises to complete. Intead, Depressive Illness: The Curse of the Strong helps you to understand how your illness developed, why you need to be gentle with yourself and what you need to do to get better.

I first developed severe depression after pushing myself too hard during my final year at university. For years, I thought of myself as weak. I struggled to cope with everyday life, was often too depressed to work, and I hated myself for not being able to function like a “normal” human being. Tim Cantopher turned that view of myself on its head. He argues that those who develop stress-related depression are actually hard-working, perfectionistic people with a strong work ethic who burn themselves out. This was very true of me but in the mire of negative thoughts that’s part and parcel of depression, I hadn’t been able to see it until someone else pointed it out.

Before reading this book, I’d tried many CBT-based self-help books with practical exercises to complete. These were very helpful on one level – challenging negative thoughts makes a huge difference – but on another level they just fed into my perfectionism issues. I always felt like I should be doing more to fight against my depression. I pushed myself too hard and it was a vicious circle. Since reading this book I’ve completely changed my approach to depression.

Cantopher advocates rest as an essential part of depression treatment. He actually recommends a wall-to-wall diet of Australian soap operas as a distraction from how you feel (not my thing, but hey). As you start to feel better and to want to get things done, he suggests leaving tasks half-finished as soon as you find yourself becoming tired. If you push yourself too far, he says, you’ll end up feeling much worse for the next 36-72 hours. Apparently a pattern of good days and bad days is normal in depression recovery, but if you overdo it on the good days, the pattern becomes exaggerated, you’ll have more bad days and take longer to recover. It literally can be a case of one step forward, four steps back.

The book is not without its flaws. Firstly, Cantopher makes a lot of assumptions about the depressed reader. One of the reasons I found The Curse of the Strong so helpful is that they all applied to me, but if they don’t apply to you, you’re likely to feel pissed off, not to mention disturbed that he “almost never bother[s]” to make enquiries as to his patients’ personality because he knows it all already. Secondly, he states his own theories and beliefs about the biological side of depression as though they were undisputed scientific fact. Although this sort of thing is common within the medical model, I don’t believe there is sufficient evidence to claim that depression is a physical rather than a mental illness; nor do I believe that in almost all cases it could be diagnosed with a lumbar puncture showing reduced levels of serotonin and noradrenaline. (Surely if that were the case, LPs would be performed in cases of diagnostic doubt. I realise it’s an unpleasant and risky procedure, but then severe depression is just as unpleasant and life-threatening.) I think this is all part of Cantopher’s rhetoric to convince the reader that they are not weak or to blame for their illness, but frankly, any scientific “facts” that you come across in his book I would check elsewhere.

Anyway, despite these problems, Cantopher’s theories on how stress-related depression develops and how to recover from it make a lot of sense to me and have probably been instrumental in helping me cope with and recover from my depressive episodes.
Profile Image for Craig.
13 reviews6 followers
July 27, 2013
I was initially drawn to this book because the author, Tim Cantopher MD, makes it apparent in his introduction that clinical depression is a physical illness. This assertion really spiked my interest. However, it soon becomes apparent that Cantopher's 'physical illness' is a byproduct of the demands of modern-day living. Essentially, he argues, that depressives 'catch' depression by leading lives which are too demanding. This hypothesis, however, fails to satisfactorily account for dysthymia and/or chronic recurrent unipolar depression. And, of course, since depression, in this paradigm, is a physical illness caused by a traceable personality trait - working too hard, it can be treated satisfactorily by 'learning' to not work too hard and taking anti-depression medications (SSRIs, TCAs, SNRIs etc). These medications, Cantopher claims, work best when augmented by talking therapy, particularly CBT. This, of course, is all standard, party-line stuff, and may be a bitter pill - no pun intended - for the sufferer of recurrent unipolar depression and/or dysthymia, for whom anti-depression medication may well offer no relief whatsoever. (Indeed St John's Wort may be more efficacious!). Nevertheless, the consideration that depression may have a physiological basis, rather than a purely psychological one, is intriguing, given that in today's CBT-centric Britain, depression is increasingly seen as a fleeting low mood that 10 sessions of 30-minute-long CBT can 'cure'. However, Cantopher's insistence that depression is a physical illness leads, predictably, to the claim that taking ones anti-depression meds WILL make everything better. Andrew Solomon's comparison of SSRIs to vine-hacking tools in his book on depression was cringe-worthy. Fortunately Cantopher doesn't go that far, but his faith in pharmacology and modern psychiatry is slightly nauseating. With that said, this book is, ultimately, more of the same: Take your SSRIs and go for 10 sessions of CBT and you'll be 'all better'. Oh, and remember to relax every now and then, because modern life places stress on your limbic system, which is the ultimate cause of depression. My rating is two stars: "It was OK". (For those with a deeper interest in the 'biological psychiatry' vs 'anti-biological psychiatry' debate consider comparing and contrasting the works of Peter Kramer and Peter Breggin.)
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Profile Image for Zechy.
172 reviews
April 2, 2013
So, my sister recommended this book to me, and I really didn't get it. Because, I wasn't depressed, was I? Obviously not. Anyway, I was halfway through the first chapter when I first realized that he was describing my life of the last few years word for word. So much information in such a small book. So, yeah. Definitely recommended for anyone who has depression, or knows anyone who has depression, or is at all interested in depression, or anyone else really. It's just that good.
Profile Image for Tanya Marlow.
Author 3 books37 followers
December 17, 2015
It’s written by a psychiatrist. He makes clear that he is talking about the kind of depression that is ‘stress-related’ (as opposed to bipolar or other types of depression which are part of a person’s chemical make-up), which is to say that it is caused by overloading the system repeatedly until a fuse blows. This is why, he argues, depression affects the strong, not the weak – for it is they who constantly take on the burdens of others as well as themselves, until their body snaps and they develop a depressive illness.
He is very helpful at striking the balance in describing depression as a physical condition, which is not your fault, whilst at the same time offering suggestions of lifestyle changes you can make to give your body the best chance it can have to heal. Obviously, it is just one person’s philosophy about depression and its causes and cures, so should be treated as such, but I found it very helpful.

Some of the things I found most helpful: he is very good at explaining what the different anti-depressants do, and the fact that they don’t ‘artificially raise your mood’ but restore it to what it should be; he is also good at explaining the principle of pacing, not doing more than your body can manage, and listening to your body. From this point of view, his advice is good for anyone with a chronic illness which causes them limitations and requires them listening to their body – it’s one of the best descriptions of pacing I’ve found. (NB he is careful to state that he is not addressing M.E. or chronic fatigue syndrome, just depressive illness). If there is someone struggling with being diagnosed with depression for the first time, feeling guilty or like there’s a stigma to taking medication, I would recommend this book.
Profile Image for Lauren.
20 reviews
March 30, 2019
This. Book. Changed. My. Life.
It's as simple as that. Seriously, everybody should read this book. I don't usually say that, but I'm saying it now! Reading something which is honest, kind and compassionate about mental illness makes a refreshing change. From understanding what depressive illness is, what causes it, how to recover to how to stay well, Cantopher gives a clear message: you are ill because you have been too strong and this is how you recover. It has helped me work through some very difficult issues with my own health and I hope to make a full recovery.
Profile Image for Oksana Piddubna.
32 reviews3 followers
July 14, 2025
Excellent reading for those who guesses the disease in themselves or others, as well as for the beloved ones of the diagnosed. Depression is not that visible as other diseases and there is still a huge stigma about it, so this book should educate the ones in disbelief.
Special thanks for explaining the affect of antidepressants- despite being diagnosed with a depression second time, I was trying to get through it without the meds, because “pills are not good in a long run”. 🥲
Profile Image for Derek Baldwin.
1,268 reviews29 followers
February 2, 2013
Quite short, and at times a little simplistic, but a valuable book nevertheless which I shall certainly dip into many more times, just as I already read some sections several times along the way. the central thesis is that it's the very resilient people who seem to cope well with what life throws at them, seemingly without complaint, who may end up disastrously unwell when things finally reach tipping point. this certainly resonated with me.
Profile Image for Emma .
93 reviews3 followers
June 7, 2024
This is by far the best book I’ve ever read on depression, it’s so easy to read and gives practical and realistic advice for anyone struggling with low mood/ depression. It also suggests that only strong people suffer from depression which I think is a helpful way to think about it as often when struggling with your mental health you feel the opposite of strong.
‘The world has goodness, kindness and fun mixed in with the badness, cruelty and oppression. Your task is to sort out the one from the other, while accepting your body’s design limits. If you don’t overload the fuse, it won’t blow; if you do it will, it’s your choice’
Profile Image for Nalu.
125 reviews14 followers
Read
September 10, 2023
A short summary of stress-induced depressive illness and possible treatments.
Profile Image for Emma.
147 reviews4 followers
Read
June 30, 2024
Recommended by my GP and I do think this has changed the way I view my depression. Definitely recommend for anyone with depression themselves or someone close to them.
Profile Image for Mariia.
18 reviews2 followers
September 15, 2025
такий собі 101 про депресію. короткий екскурс по антидепресентах і методах лікування. Розглянуті етичні питання щодо поводження з людьми з депресивними розладами. Швидко читається, дуже легкий наукпоп.

Під час війни статистика діагностованих птср та депресивних розладів дуже лякає, тому важливо бути обізнаним в цьому питанні ну і подавати руку допомоги або, звісно, просити про неї.
Profile Image for Shona Moyce.
Author 3 books43 followers
May 26, 2014
I read this book in bursts. Every time I picked it up, it presented me with a gift. I feel like I've done myself a huge favour simply for having read it. The author and doctor, Tim Cantopher, has a brilliant no-nonsense voice, and more to the point, that voice comes from a place of sound understanding.

Never before have I come across something, or someone for that matter, who could sum up this illness in a way that didn't feel belittling or judgmental. It's usually one or the other. To be perfectly honest, I've never made it past chapter two in any other self help book for depression. I've found them either too patronising, or lacking any kind of understanding.

This man however, this author - I want to write him a damn thank-you letter or something! He really gets it. Really and truly.

"'Oh, no! It's Monday morning. I don't want to get up. It's too early, the week is too long, I've got too much work to do and I need a holiday. I feel so depressed!'

Every Monday morning starts this way and I refuse to rise until I am running late, but after a while I drag myself grumpily out of bed and start my week. I have never been good at Mondays and it takes a while for my mood to pick up through the day. It isn't that I don't like my job; I do, very much. It is just that I like rest and recreation even more and on a Monday morning the next opportunity for these pleasures seems an awfully long way away.

Everyone has suffered spells of low mood of this type at some time or other and some people think that this means everyone has suffered from depression. It doesn't, or at least, not clinical depression or depressive illness. The truth is that clinical depression is a horrible illness of which most of us, thank goodness, have not the faintest inkling. This is one of the many trials sufferers from the illness have to face: people looking at them knowingly and saying, 'Oh, yes, I've often had that. I find the best thing is just to pull myself together and get busy.'

No you haven't, so stop making things worse with your ill-informed advice. If you really want to help, try to understand that sufferer of this illness is going through torment of a pretty awful kind."


Anyone who has ever suffered from this illness will appreciate the approach of this book. It allows for reflection and it offers up more advice and support than I could ever have hoped for. If you find yourself faced with well-meaning but desperately clueless folk, or a therapist who pushes you too hard, too soon, or friends and family who want you to 'pull yourself together' - READ THIS.

Seriously.

It will help.
Profile Image for Nynke.
219 reviews26 followers
November 21, 2017
Please, everybody who knows someone with depressive illness, read the intro and chapter 1 of this book! Apparantly lots of tips for healthy people in here too. haven't gotten to that bit yet (only at chapter 4).

written in easy to understand English yet informative and accurate.

The only thing that really bugs me about this book is it's title. I can see it is fitting in relation to the content, however it is literally stopping me from getting copies for the people in my life whom i would really like to read this book so as they might understand my illness. If i would pass this book to some of my friends with the message to please read the intro and chapter one, they would surely label me as cocky.
Profile Image for Lorelei.
459 reviews74 followers
February 11, 2013
I'm so happy to have read this book. While I don't seem to suffer from depression generally, I did have a terrible bout of it a few Januarys back. So much of what is in here is applicable to all sorts of things, including my own I.C.I. (Invisible Chronic Illness) multiple sclerosis - about choices and about pacing yourself. The parts that dealt specifically with depression weren't terribly helpful to me personally, but are probably good to know. And if you are dealing with depressive illness in your own life, or in the lives of anyone who is a part of your life, this book could be invaluable.
Profile Image for Wendy.
5 reviews
June 14, 2013
I bought this book after I listened to an interview of Tim Cantopher. I now have to keep track of who I have lent it to! I guess this book provides different things to different people but what I like about it is the logic and explanation to a topic that is very taboo at times. 'Stiff upper lip' and 'we all get low' was part of my upbringing; depression was not an option. I believe this book is a fabulous opportunity to start understanding depression whether you suffer or know someone who does.
Profile Image for Karin Jenkins.
839 reviews6 followers
June 17, 2019
This book deals specifically with stress related depression which should perhaps be clearer in the title but for that particular illness it is excellent. It’s not too long so even someone who is feeling low can get through it without feeling too overwhelmed. He helps you understand what’s going on in your brain to make you feel the way you do and emphasises the need for lifestyle changes to help prevent recurrence.
Profile Image for Alyssa.
36 reviews
December 29, 2016
While I did like this particular doctor's view of depression, I don't think it needed to be 112 pages long.
I do trust the insight, Dr. Cantopher has years of experience and seems to be a reputable Doctor, but a lot of the book seemed more like opinion and thoughts rather than researched based.
I would say read it, the book is pretty short and I did get some helpful insight.
Profile Image for Bookish.
30 reviews67 followers
May 6, 2015
a very good read: short sentences, logical and easy to take in

Tim Cantopher has a really good way of explaining things and it's quite a small book so not too overwhelming to digest if your concentration is a bit limited
5 reviews
April 17, 2020
Best book on depression that I have read so far. Easy to understand, language and tone is spot on, despite struggling with this illness on and off for years, working with therapists and reading about it, I learnt something new from reading this.
Profile Image for Lynne.
395 reviews2 followers
March 5, 2022
A friend with depression lent me this book. Its writer has different views on the causes of depression and on treatment than writers I'm more drawn to. Yet much of what he writes helped the friend who lent it to me and rings true - depression happens when strong people "blow a fuse."
Profile Image for Denise.
33 reviews
January 20, 2013
Excellent little book; very insightful - not only for sufferers but anyone living with someone prone to depressive episodes. Very readable, and highly recommended !
Profile Image for Raphael Knight.
185 reviews1 follower
January 2, 2025
Nice lil book if you find every small inconvenience in life makes you want to pack up shop and become the next Ted Kaczynski
Profile Image for Dana Iacomi.
184 reviews7 followers
January 5, 2024
“E ca și când ai cădea într-o fântână fără sfârșit; întunericul te înconjoară, iar micul cerc de lumină se diminuează tot mai mult, până când dispare cu totul.”

Depresia. Deși fiecare om a experimentat în cursul vieții episoade de tristețe acută sau chiar stări depresive, această maladie a secolului nostru încă rămâne un subiect tabu și greu de abordat.
Din păcate, depresia este reală, nu este o stare psihologică sau emoțională, nu este o formă de nebunie, ci este o maladie fizică, în care este perturbată sinteza unor neurotransmițători de la nivelul sistemului limbic, și anume: serotonina și noradrenalina, iar de curând s-a descoperit că ar fi și dopamina și melatonina.

Vinovăția și disprețul de sine sunt într-o anumită măsură un simptom al bolii, dar în același timp o și provoacă.

Autorul ne poartă pe un traseu în care ne prezintă natura depresiei, istoria, simptomele, cauzele și tratamentele ei. Ne sunt oferite informații despre medicamente, noile linii de urmat în managementul depresiei și importanța ințelegerii motivului care a dus la “arderea siguranței” , pentru a face schimbările necesare.

Mi-a plăcut foarte mult cum a conturat faptul că afectează mai ales persoanele puternice, responsabile, cu anumite trăsături de personalitate, deși o persoană afectată de depresie se blamează, se tratează cu dispreț și se consideră slabă.

Am citit cartea pe nerăsuflate, mi-a ajuns direct la suflet, e scrisă foarte concis , plină de empatie și compasiune și foarte utilă celor aflați în mrejele depresiei. Cred că ar trebui citită de toată lumea, chiar dacă nu au experimentat un episod clar de depresie clinică, sănătatea mintală este parte integrantă a bunăstării fizice.
Profile Image for Brandon Oliver.
14 reviews
September 9, 2024
This book was a gift from my stepdad, as I had briefly discussed the topic of depression and the use of medication. Its aim is to help people understand what causes depression and its nature, with a focus on the experience of depression in high functioning individuals.

The book flows well, following a simple structure of causality, recovery methods, and how to maintain wellness. The author does a very good job of providing examples of typical archetypes of people who often suffer from depression, making it relatable to many readers who are likely to seek out this type of book. It’s also easily digestible for those who may be struggling with depression, allowing them to benefit from the information presented.

However, with this balance being so fine, I feel that more emphasis could be placed on recommending a focus on diet, physical activity, and connections with others before resorting to medication. This opinion may be influenced by research on the over prescription of medication, which is itself linked to the broader issues within the healthcare industry.

Overall, I think this was a great read and may help soothe the souls of those who feel unsure about why they feel the way they do, reminding them that there is a light at the end of the tunnel.
6 reviews
September 19, 2023
I currently suffer from depression and anxiety and often over exert myself. I found this book very easy to understand and had a few nuggets of useful information I will adopt in my journey to better mental health. The information is presented in quite a concise way with it being a fairly short book it was easily read by myself with a limited attention span. There were a few moments in this book that made me laugh out loud, which I did not expect. I quite enjoyed the use of diagrams to help visualise some concepts. I would recommend this book to anyone suffering themselves or for anyone supporting someone with depression. It helped me better understand my own behaviours and things that can seem very frustrating to the sufferer and supporters.
Profile Image for Захарченко Віктор.
Author 1 book67 followers
November 22, 2025
Припустіть, що вам скажуть: ваша депресія —це не слабкість, а перевантаження від надмірної сили. Звучить парадоксально, але саме цю тезу доктор Тім Кантофер ставить у центр своєї книги "Depressive Illness: The Curse of the Strong". На відміну від більшості авторів, які розглядають депресію як психологічну проблему, британський психіатр наполягає: це фізичне захворювання, яке вражає тих, хто занадто багато бере на себе. Книга, що стала бестселером у Великій Британії та США, пропонує радикально інший погляд на клінічну депресію та шляхи виходу з неї.
Profile Image for David Ward.
Author 2 books18 followers
July 2, 2024
This is a readable, informative and often funny book.

It is packed with information for those who suffer from depression and those who care for them. Discussions range from how to avoid sleeplessness to the variety of medication available.

I found it most encouraging to find advice on re-ordering life.

A very practical book.
8 reviews
April 29, 2025
If you're a high achiever and burn yourself out in the process of achieving, then this book is for you. It's a short read, but well worth it because it might change your perspective on how you look at depression and burnout.

In addition, there are also techniques to help yourself.

Recommended.
Profile Image for Catherine.
392 reviews7 followers
June 29, 2024
I am fortunate enough to not be currently affected by depressive illness but working in the emergency services I think its key for me to have some level of understanding of clinical depression and they ways in which I can try and support those around me.
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