It's like a bell jar, it's like a prison: descriptions of depression are of entrapment. Yet the victim rarely has any gaoler but himself. The third part of our series explores the routes to freedom
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I'VE BEEN happy and unhappy and I know which I prefer. When I'm happy I feel free. When I'm unhappy I feel weighed down and trapped. But I've always known that I have a choice about being happy or unhappy. I had the great fortune to be born to two inconsistent parents, an optimist and a pessimist. For Dad, a wet day was "good for the garden", while for Mother it "always makes me feel miserable". Then there was my big sister's interpretation (usually "what's in this for me"), and my own. So right from the beginning I knew that different people interpret things differently and that we choose our own interpretations.

Many people are not as fortunate as I was. They are born to consistent parents who, like their teachers, tell them there's one right way of interpreting each event, that there are immutable rules which govern the way things are and should be. They grow up believing that all the important aspects of life are fixed, and that we have no choice in the matter. A friend, telling me about her unhappy marriage, said to me: "It was my duty to stay with him. I thought that that was what you did."

Fairly early on I made a choice that I wanted to be happy. However, not everyone wants to be happy. Some people think they don't deserve to be happy, so they react to any good fortune with the misery of guilt. Some people are convinced that life has a fixed pattern whereby good times are inevitably followed by bad; they spend their good times in the misery of expecting the worst. Others would rather be right than happy. They try to make the world into what they want it to be, and, when the world doesn't respond to their wishes, they cannot bring themselves to admit they have made a mistake. Instead they create misery for themselves and often for the people around them by going on trying to prove that they are right.

All this shows that you can make yourself unhappy just by the way you think. The potential for happiness or unhappiness is built into the stories we tell ourselves about our lives and what our future will be. I've met many people who've preferred to construct a story about being a tragic hero pitted against a malign fate rather than a story about being an ordinary person enjoying ordinary happiness. It's impossible to take their suffering away from them.

Some people suffer terrible disasters and, of course, they must feel sad about who or what they've lost. But there's one kind of unhappiness, an unhappiness quite separate and distinct from all other kinds of unhappiness, which occurs when we blame ourselves for the disaster that's befallen us. This is the intense, utter, total misery of being depressed.

When Margaret Tebbit was interviewed on Desert Island Discs, she described what happened when, in the bombing of the Grand Hotel in Brighton by the IRA in 1984, she and her husband Norman were trapped in the rubble. They both survived, but she was badly injured and remains unable to walk and frustrated by how little she can do with her arms. Sue Lawley then asked her about her childhood, teens and twenties and how she had met the dashing airline pilot who became her husband. She described a happy life and a romantic, joyful marriage - until her first baby was born and she plunged into a deep depression. In the years that followed, depression and the fear of depression were always present in her life. Towards the end of the interview, when Lady Tebbit was asked to sum up her life she said that, terrible though the bombing and the after-effects were, nothing she suffered from the physical injuries was as bad as what she suffered when she was depressed. Given the choice of severe physical injuries or being depressed she'd choose injury and illness every time.

Anyone who's been depressed would agree. When we're suffering physical pain, no matter how severe the pain is, it is always possible from

time to time to separate ourselves from the pain and put ourselves mentally somewhere else. We can enjoy a joke or a cuddle. But when we're depressed there's no way we can separate ourselves from our misery. Our depression is us.

Being depressed is very different from being unhappy. When we're unhappy, other people can comfort us and we can comfort ourselves. But when we're depressed no one else can reach us, and we persecute rather than comfort ourselves. In depression we become our own worst enemy. The experience is of being completely isolated in some kind of prison. Your common sense tells you that nothing around you has chan- ged but what you feel is that there is a bar- rier around you, cutting you off from the rest of the world.

If you've never been depressed and you'd like to try it out, here is the recipe. (This recipe also gives you the recipe for happiness.) To get depressed you must hold two beliefs which you regard as absolute truths, and which you would never question. They are:

I am in essence bad and unacceptable, so I must always work hard to be good.

I live in a just world where goodness is rewarded and badness punished.

All you have to do then is wait for a disaster to occur to you and the walls of the prison of depression will close around you.

Where does this experience of isolation come from? Many psychiatrists explain depression as being a chemical imbalance in the brain caused by a gene, and believe that anti-depressant drugs put the balance right. This claim is based on studies of the brain chemistry of depressed and non-depressed people. However, the fact that two events occur together does not mean that one has caused the other. A cause must precede an event but no chemical change has been shown to precede the onset of depression.

The fact that the ingestion of a substance alleviates a symptom does not mean that the cause of that symptom was the absence of that substance. Headaches are not caused by a lack of aspirin. Anti-depressant drugs can give you the lift you need to tackle your problems but they don't solve your problems.

As for the gene, geneticists like Steve Jones, Professor of Genetics at University College, London, points out that it is a nonsense to say that complex behaviour can be explained by the presence of a gene. In his book, The Language of the Genes, Jones writes: "There have been announcements of the discovery of single genes for manic depression, schizophrenia and alcoholism. All have been withdrawn." There is, however, a genetic component to depression (and happiness), but it is the complex of genes that enable our species to develop language and thought, especially concepts like the past and the future, or like "I am" and "I ought to be". Out of these we construct the beliefs of not being good enough and of a universal justice.

As small children we inevitably discover that we are not satisfactory and that there are rules about behaviour. If we behave well we are rewarded by our parents and if we behave badly they punish us. Some parents define the rules solely in terms of "this is what we do in our family" but others encourage their children to generalise the family system of justice to encompass the whole world. Every religion has its own version of the belief in a just world, and there are many people who would say that, while they are not at all religious, they believe that somehow, in the end, the good are rewarded and the bad punished. To think otherwise, they say, would make life intolerable. Part of being happy is accepting without anger and resentment that life isn't fair, but sadly many people never reach this understanding.

Whenever something bad happens to us, there can only be three answers to the question we all ask: Why? It happened by chance; it was someone else's fault; or, it was my fault. But for those who believe in a just world nothing happens by chance, so you are left with "it is someone else's fault" and "it was my fault".

Many people are expert in blaming others. Our society is full of people who are bitter, resentful, envious, even paranoid. They complain about how much they have suffered and other people (like the youth of today) haven't; how some people get things given to them (asylum seekers, the people next door) and nobody ever gives them anything; how some people (Prin- cess Di, Joan Collins, Cedric Brown) deserve to suffer; how someone (God or the boss) is out to get them. Whatever the complaint, the underlying message is the same: "I've been good and I've never got my rewards." These people aren't depressed but they sure are unhappy.

Many people have grown up believing that it is wrong to blame others. So, believing in a just world, when disaster strikes them, they have no option but to blame themselves. They turn against themselves and hate themselves. They say: "This disaster is my punishment for being so wicked." These are the depressed. Understanding how this world view is constructed helps everyone, not just people suffering from depression, because it offers the escape route from beliefs that can entrap us all.

If you turn against yourself and hate yourself you cut yourself off from everybody and everything. You become frightened of other people in case they see how bad you are and reject and hurt you. You cut yourself off from your past because all you can see there is evidence for how wicked you are. You cut yourself off from your future because you know that all that lies ahead of you is punishment for your wickedness. You cut yourself off from yourself because you hate and reject yourself. Cut off from every aspect of your existence you are now alone in the prison of depression.

Each person describes this prison differently. To Sylvia Plath it was a bell jar enclosing her. One man told me he was on a treeless, windswept terrain that stretched into infinity; the more he hated himself the more desolate it became. Whatever form it takes, you can lock yourself in your prison in a matter of seconds because you are so practised in blaming and disliking yourself. You don't even have to go through the process consciously because you are so good at being good. Only good people get depressed.

BABIES don't come into the world worrying about whether they are good enough. They arrive pleased to be here and unsurprised when people are nice to them. Yet within a few short months the babies who were full of unselfconscious confidence have become unconfident, self-conscious toddlers who know that there are standards to be met and that they don't always measure up. Some of these toddlers know that they have choices about how they behave and how they think about themselves, but others have been taught that there is only one way to think and behave.

To understand ourselves we have to understand something very basic about the way our minds are constructed. Whatever we perceive, whatever we know or believe, is something we have learnt to perceive, or know, or believe. We can't ever know directly what is happening. All we can ever know are our interpretations of what happens. So, what determines what we do is not what happens to us but how we interpret it. Herein lies our freedom. Because we create our interpretations, it follows that we have a choice of how we perceive events and we can always change our interpretations. When you fall ill you can choose to see it as "bad luck", "my deserved punishment", "a sign I'm getting old" and so on. If you win the Lottery you can celebrate it as your just reward, feel undeserving and guilty, or feel joyfully indulgent. The interpretation you choose determines what you do and how you feel.

People get into difficulties when they don't understand this and, instead, think that the world and they themselves are exactly as they experience them to be. They are then unable to use the one freedom we all have all the time: we might not be able to change the conditions of our life but we are always free to change how we interpret the conditions of our life.

When Lady Tebbitt realised that she had been badly injured in the bomb blast she knew that she had a choice about how she could interpret what had happened to her. She rejected blaming herself because she had chosen that in the past and she knew the misery that followed. She rejected blaming others although the culprits were known. She was not going to expend her precious energy on anger, resentment and bitterness. Ins-tead she chose chance. lt was just one of those things that happen, but this disaster she would interpret as a challenge, something to be overcome and mastered. Lady Tebbitt was able to make this choice - something that when she was young she did not know she was free to do - because, out of her experience of depression and other events in her life, she had gained the wisdom which gives us freedom. The wisdom is knowing that, when events disrupt the unfolding of the story we have told ourselves about how our lives are and are going to be, we simply create another story.

Everything we know comes in the form of a story, a narrative with a beginning, a middle and an end. Delia Smith's recipes and the Windows 95 Handbook are stories just as much as Coronation Street. A thing becomes meaningful only when we can embed it in a story.

We are fascinated by stories, but the story that fascinates us most is the story which we tell ourselves about ourselves. We begin creating this story when we are little and the adults around us tell us about ourselves. We create a past, where we came from; a present, where we are and who we are; and a future. Throughout childhood and adolescence we might try out many scenarios but sooner or later we settle on a basic plot. Most of us choose the same plot though we each work out our story in our own individual way.

The most popular basic plot is: "When I grow up I shall be recompensed for my suffering and rewarded for my goodness." It is formed in childhood, a time of great joy but also of great suffering. Even if you were lucky enough to have parents who were unfailingly kind and loving, you very likely suffered at the hands of others. Adults made it very clear to you that you were not satisfactory. Rules and expectations were imposed on you and often you felt humiliated and helpless. However, the fairy stories you were told promised you that if you were good you would be rewarded. If little girls were sweet, kind, unselfish and feminine one day they'd meet Prince Charming and live happily ever after. If little boys were strong, brave and manly one day all men would admire them and all women love them. You mightn't have chosen such a common story, but you did choose a story which gave you courage and hope.

Perhaps, out of the millions of us that have ever existed, there's been one person whose life was exactly as his story foretold. However, the rest of us usually discover that life, as John Lennon said, is what happens while we're making other plans. If we know that our story is a construction, not reality, then when our life diverges markedly from the plot we might be sad and anxious but we accept that we have to change the story. If, instead, we think that our story is an absolute reality, then when our life and our story diverge we feel ourselves falling apart and we are filled with terror. What quicker way is there of holding ourselves and our story together than choosing to interpret the divergence between our life and our story by saying: "This disaster is my punishment for my wickedness." That is certainly the common interpretation among those who judge events as if they lived in a just world.

Tim Lott, in his book The Secret in the Scent of Dried Roses (to be published by Penguin in August), examines his mother's suicide and his own depression and attempted suicide. He concluded that depression "is the illness of identity, it is the illness of those who do not know where they fit, who lose faith in the myths they have so painstakingly created for themselves...

"Depression is not grief, it is terror, terror of losing your sense of self. lt is a reaction to a very particular type of stress, the kind of stress that brings into question the world that you, being human, have to imagine, maintain and defend every moment of the day, in order to keep chaos at bay. When that defence fails depression follows...

"[My mother] hanged herself because her story, her idea of herself as a successful wife and mother - the only test of self-regard she knew - had no longer become sustainable in her shocked mind..."

Tim now saw that: "[My mother and I] had beliefs - in my case, secret, even hidden from myself - in a kind of immutable order that held us accountable. But let go of that childish belief, accept randomness, tolerate chaos, and the whole thing slides into place. That place is shapeless, that place is always moving in and out of chaos, but it is the reality of things."

Accepting randomness requires courage, and finding courage is difficult when you hate yourself. So finding your way out of the prison of depression requires not only accepting randomness but also accepting and valuing yourself. To do that you need to recall those events in your childhood which led you to think that you were bad and unacceptable. Then you can see that your feeling of badness is not an essential, immutable feature of you, but simply a result of the conclusions you drew as a child, with a child's limited experience. When your father deserted the family, did you blame yourself? When your mother took her angry feelings out on you, did you believe what she said about you? Now you are an adult you can see things dfferently.

Thus we can write the recipe for happiness as:

Accept and value yourself.

Accept that we live in a world where things happen by chance.

Of course accepting yourself and accepting the uncertainty of the world does not mean that there won't be times when you'll be sad. But in sadness you can be close to other people.

Accepting the uncertainty of the world means that you can hope and you can be free. Hope and freedom can exist only when there is uncertainty. Accepting yourself means that you no longer have to live in the past, feeling guilty about your wickedness, or in the future, fearing what is to come. Instead, you can live in the present and be happy, for happiness exists only in the here and now. !


Dorothy Rowe is a clinical psychologist and writer. She worked in the NHS for 18 years and is well known for her research on depression. Now she concentrates on writing and is author of 10 books; the latest, `Dorothy Rowe's Guide to Life', is published by Harper Collins at pounds 17.99. (The paperback is out in June, at pounds 6.99)

1 Treat yourself as your own best friend.

2 If disliking yourself is a tough habit to break, practise acting as if you are your own best friend. One morning you'll wake up and find that you are.

3 Write a description of yourself but as your best friend would write it.

4 Make a list of all the pleasurable things you can do just for you alone and do at least one every day.

5 Every day do something physical (a short, brisk walk is enough), something intellectual (like reading a newspaper article right through) and something spiritual (like listening to music,reading a poem, watching the trees and sky).

6 Limit how much time you spend thinking about the past and the future and concentrate on enjoying the present. (If you find this hard to do take up yoga and learn how.)

7 Write an account of you and your `story' (see main story).

8 Identify the immutable assumptions your story is based on, like `if I don't win, I'm no good'

9 Create some alternative assumptions, especially ones which give you more choices; eg, change repeated thoughts like `people like me can't/don't do that' to `try anything once'.

10 Now see how many alternative stories you can construct and decide which one you'd like to live.