In "Fever Pitch," Nick Hornby reflects on the experience of depression, particularly the sense of shame that can accompany it. He expresses the feeling of being undeserving of such emotions, especially when there seems to be no clear reason behind them. This sentiment resonates with many who have struggled with mental health issues, as they grapple with feelings of guilt for experiencing depression despite having a relatively stable life.

Hornby's insight highlights a common internal conflict faced by individuals who find themselves in a down state without an apparent trigger. The metaphor of feeling like one has "come off the rails" captures the sudden disruption of normalcy that depression can bring. It emphasizes the confusion and disorientation that often accompany mental health challenges, pointing out that such feelings can occur even when external circumstances seem favorable.