OBJECTIVES Mental illness is widespread, with 1 in 3 people worldwide reporting symptoms indicative of a psychiatric disorder at some point in their lives. The use of antidepressants has risen globally and within Europe has been reported to be correlated with a reduced suicide rate. The aim of this research is to analyse the use of antidepressants in England and identify any trends. METHODS Antidepressant prescribing data for National Health Service (NHS) England from 2003–2012 and from all Primary Care Trusts (2010/11–2012/13) and Clinical Commissioning Groups (2013/14) were obtained from the Health & Social Care Information Centre. Data were collated for the four NHS regional area teams (North, Midlands & East, London, and South) and analysed against population size and suicide rates. RESULTS Antidepressant use in England has increased dramatically in recent years and coincides with a year-on-year drop in ingredient costs, with 27.7 million prescriptions in 2003 and a net ingredient cost of £395.2 million, to 50.2 million prescriptions in 2012 and a net ingredient cost of £211.1 million. From 2010 to 2014, almost £1 billion has been spent on antidepressants by NHS England, of which almost a third is accounted for by the North region. Over 4 years, the average number of prescriptions per 1,000 population was 1,140.7, 987.4, 888.2 and 540.5 in the North, Midlands & East, South and London, respectively. These figures were correlated with a suicide rate of 9.87 and 7.05 per 100,000 people in the North and London, respectively.  CONCLUSIONS There is a clear divide within regions of England regarding antidepressant use and suicide rate, and the correlation between these two measures was found to be opposite to that reported for Europe generally. These findings highlight the importance of understanding mental illness and the underlying reasons for the wide disparity in England.