Simple steps to freedom

For Dorothy Rowe, depression is a prison we build ourselves that we can escape from. David Cohen spoke to her

"I was born to a depressed mother," says Dorothy Rowe. "Of course, no one identified her as depressed then. Everyone just said, 'Ella's like that, you know'. She could fly into terrible rages and, with nobody else at home, she would take out her rage on me. She would sulk. Oh yes, my mother could sulk for six months. She would retire to her room and she wouldn't speak to anyone. But the most terrifying part was that on many occasions throughout my childhood she would say that she was going to kill me and that she was going to hill herself."

Rowe, aged 66, talks softly, her voice thin. And as she speaks it is as if the famous psychologist and writer that she has become momentarily recedes, and instead, coughing nervously, she is once again a frightened 8-year-old.

She gathers herself. "I suppose it's not unexpected that I should choose an area of work that would help me work out the puzzle of my life, which is why my mother behaved as she did. What is unexpected is that my book should still be so relevant today."

This month sees the publication of an updated second edition of Rowe's best-selling self-help classic, Depression - The way out of your prison (Routledge pounds 8.99). When she first penned it in 1983, she wrote poignantly in the preface: "Sometimes, suddenly, without apparent reason we feel unbearably sad. The world turns grey and we taste a bitterness in our mouth. We hear an echo of the bell that tolls our passing, and we reach out for a comforting hand, but find ourselves alone. For some of us this experience is no more than a fleeting moment ... but for some it becomes a ghost whose unhidden presence mars every feast or, worse, a prison whose walls, though invisible, are quite impenetrable."

Thirteen years later, Rowe is dismayed to note that depression is as widespread as ever. According to the Royal College of Psychiatrists, approximately one in six women and one in 10 men are sufferers, and latest government figures reveal that in 1994 depression was accountable for 6,454 suicides in the UK. The medical profession continues to prescribe drugs which, like Prozac, have become a multi-million pound industry, but Rowe insists: "The cure for depression is not pills but wisdom. Depression remains as common as ever because we fail to understand ourselves."

What exactly does she mean? And why does she think her book, which has already sold 60,000 copies, continues to be so popular?

Rowe, who still speaks with an Australian twang (she came over to England on the back of her divorce in 1968), runs her hand through her grey-white mane and, reclining on her sofa in her bright garden flat in Islington, north London, ponders: "Last night I was at a self-help meeting for depressed people when a woman said to me, 'I was going to write a book about the story of my life; then I read your book and found that you'd already written it'. I think that's it really. There are hundreds of books about depression, but most are about conditions and diagnoses and a particular writer's ideas and not at all about people. When I wrote my book, I was writing it for my immediate clients in my NHS practice in Lincolnshire.

"I knew my target audience very well - there were people who didn't really understand what had happened to them and were being told a lot of bamboozle by the medical profession. And that's the case today."

Rowe believes that depression is neither a "genetic fault", nor a "mysterious illness", that it's neither "endogenous" nor "reactive", but something that we create for ourselves, and that just as we use a certain skill and energy to create it, so we can use that skill and energy to dismantle it. "Depression is a defence, not an illness," she says. "You don't get depressed because a disaster happens to you. You get depressed because a disaster happens and you blame yourself. There may be more poverty and insecurity around than there was 13 years ago, but that in itself is not enough to cause depression. It is not what happens to you but how you interpret it."

Rowe has observed that with people who get depressed the pattern is always the same. Something happens in their childhood which gives them the message that they are unacceptable, but if they work hard on themselves, they can become "good". These people grow up with absolute, immutable beliefs about life, but when disaster strikes - their spouse leaves them or they're fired from their job - their structure of meaning crumbles and they blame themselves. It is because they are bad. And because they don't want the world to see how bad they are, they cut themselves off from other people and from their past and create the prison of depression which is the essence of their experience.

The first step out of the prison, Rowe believes, is to do something for yourself. It can be quite simple, like a decision to join a yoga class or go for a walk every day. Her pointers, which read like sage advice for anyone interested in "how to be happy", include: treating yourself kindly; learning how to relax; putting pills in your power (if you feel you must take them, make sure you know enough about them and that you feel in control); finding someone to talk things over with, perhaps a therapist or counsellor or friend; seeing the funny side of things; exploring new ways of thinking and doing, and turning your fate into verse by starting to write.

"These are things that should be obvious to everybody, but they're not," she says. "Also, they're not so simple as they look. I'm not advocating laughter workshops that deny reality. What we have to realise is that we're capable of holding two opposite views at the same time and they're both true. The depressed person has the skill to see one side - that the world is in a terrible state and it's not getting any better - very clearly. What they need to realise is that there is an equally true opposite truth and then the art of life begins."