depression: the way out of your...

DEPRESSION

First published in 1983 when it won the MIND book of theyear award, this best-selling book has helped thousands ofpeople leave the prison of depression. Dorothy Rowe givespeople a way of understanding their depression whichmatches their experience and which enables them to takecharge of their life and change it. She shows that depressionis not an illness or a mental disorder but a defence againstpain and fear, which we can use whenever we suffer adisaster that our life is not what we thought it was.

Depression is an unwanted consequence of how we seeourselves and the world. By understanding how we haveinterpreted events in our life we can choose to change ourinterpretations and thus create for ourselves a happier, morefulfilling life.

Depression: The way out of your prison is for depressedpeople, their family and friends, and for all professionals andnon-professionals who work with depressed people.

http://www.routledgementalhealth.com/dorothy-rowe/depression/


DEPRESSIONThe way out of yourprison

Third Edition

Dorothy Rowe



First edition published 1983 by Routledge and Kegan PaulSecond edition published 1996 by Routledge

Third edition published 2003by Brunner-Routledge

27 Church Road, Hove, East Sussex, BN3 2FA

Simultaneously published in the USA and Canadaby Brunner-Routledge

29 West 35th Street, New York, NY 10001

Brunner-Routledge is an imprint of the Taylor & Francis Group

© 2003 Dorothy Rowe

Typeset in New Century Schoolbook byRefineCatch Limited, Bungay, Suffolk

Printed and bound in the UK byTJ International Ltd, Padstow, Cornwall

Cover design by Lisa Dynan

All rights reserved. No part of this book may be reprinted orreproduced or utilised in any form or by any electronic,

mechanical, or other means, now known or hereafterinvented, including photocopying and recording, or in any

information storage or retrieval system, without permission inwriting from the publishers.

British Library Cataloguing in Publication DataA catalogue record for this book is available from

the British Library

Library of Congress Cataloging-in-Publication DataRowe, Dorothy.

Depression : the way out of your prison / Dorothy Rowe.—3rd ed.p. cm.

Includes bibliographical references and index.ISBN 1–58391–286–X (pbk. : alk. paper)1. Depression, Mental. I. Title.

RC537 .R66 2003616.85′27—dc21 2002151126

ISBN 1–58391–286–X



CONTENTS

Preface viiPreface to the second edition ixPreface to the third edition xAcknowledgements xiv

1 The prison 12 Inside the prison 43 How to build your prison 124 The depression story 1015 Why not leave the prison? 1146 Why I won’t leave the prison 1197 Outside the wall: living with a depressed person 1628 Suppose I did want to leave the prison, what

should I do? 2089 Leaving the prison 292

10 The prison vanishes 301

Notes 305Index 317



PREFACE

Depression is as old as the human race, and rare is the per-son who has not felt its touch. Sometimes, suddenly, withoutapparent reason we feel unbearably sad. The world turnsgrey, and we taste a bitterness in our mouth. We hear an echoof the bell that tolls our passing, and we reach out for acomforting hand, but find ourselves alone. For some of usthis experience is no more than a fleeting moment, or some-thing we can dispel with common-sense thoughts and prac-tical actions. But for some of us this experience becomes aghost whose unbidden presence mars every feast, or, worse, aprison whose walls, though invisible, are quite impenetrable.

Depression, in this century, [the twentieth] has beencalled an illness and treated with pills and electroconvulsivetherapy (ECT). Some people are greatly helped by this treat-ment. Their depression vanishes, never to return. However,for some people, pills and ECT bring only temporary relief orno change at all. For these people something more is needed,and this is not surprising, since being depressed is somethingmore than being ill.

If we have measles or a broken leg, we may feel miserableand inconvenienced, but, unless we feel we are so ill that wemight die, we do not spend our time worrying about our sins,or contemplating the futility of existence. Yet if we aredepressed this is what we do. In our own way and in our ownterms we think about, agonise about, the issues of life anddeath – which are about what purpose life has, what faith wecan live by, whether our life ends in death or whether some-thing lies beyond death, what we have done and our feelings



of shame and guilt, fear and courage, forgiveness andrevenge, anger, jealousy, hate and love. For some of us, out ofthis period of painful turmoil comes a measure of peace andwisdom; for others, the confusion continues.

Depression is so common in all cultures and throughouthistory that it seems to be more than just a painful illness. Itseems to be a universal experience, a period of unhappywithdrawal, an uncomfortable hibernation where the personcomes to realise that something has gone wrong with his lifeand that something needs to be put right. Why is it, then,that some people going through this experience do discoverwhat it is that needs to be put right, while others go on andon in miserable confusion?

Over the past twelve years I have had long conversationswith people whose depression has persisted despite all thebest medical treatment. I have also had long conversationswith people who have had their fair share of problems butnevertheless still cope. People who cope and people who getdepressed see the issues of life and death in very differentterms.

Some of the depressed people I have talked with havefound their way out of their depression. Others still getdepressed from time to time, but they now have some ideawhy this happens. Depression is a prison which we build forourselves. Just as we build it, so we can unlock the door andlet ourselves out.

Dorothy RoweEagle, Lincolnshire, 1983

viii PREFACE



PREFACE TO THE SECONDEDITION

When in 1983 I was writing this book I never anticipated thatit would still be being read a decade or more later. In thattime my life changed, as did the National Health Service.The substance of the book remains as valid as ever, but thereare some things which I now know are important but whichwere not in the first edition. Many people have told me thatthey have been greatly helped by this book, but depressionremains as common as ever because we fail to understandourselves. The cure for depression is not pills but wisdom.

Dorothy RoweLondon, 1995



PREFACE TO THE THIRDEDITION

Ideas permeate throughout society slowly. When this bookwas first published in 1983 an idea held by very few peoplewas that depression could be understood and dealt withsolely in terms of how we live our life. Nineteen years later itis a far from rare idea, although it still causes controversy.

Some ideas permeate society from the top down. Fashionidols such as the famous Beckhams start a fashion andothers follow. Scientists invent a theory, create new jargon,and gradually the whole world starts to talk of holes in theozone layer, global warming and greenhouse gases. Someideas begin at the bottom and permeate up. People discoverfrom their own personal experience that what those at thetop, the ‘experts’, say is not right. When someone like me, anunknown psychologist, puts what they have discovered intoan accessible book they are delighted, and they tell theirfriends.

It is this word-of-mouth, grassroots publicity which hasensured the longevity of this book. I have not been showeredwith recognition and honours by my psychologist colleaguesand certainly not by psychiatrists. But what has happened,time and time again, some complete stranger has written tome or accosted me after a lecture with the words, ‘You wrotethat book about me.’

When ideas develop at grassroots level they flow aroundand we ingest them, often without knowing that we do. Weproduce the idea and feel that we have invented it. When weknow that we got the idea from someone else we acknowledgethis at first but then we stop doing this and pass the idea off



as our own. An idea which is central to this book, thatdepression can be our response to the discovery that there isa serious discrepancy between what we thought our life wasand what it actually is, I got from Phillip Hodson, now Fellowof the British Association for Counselling and Psycho-therapy. In the first few months of talking about this idea Iused to acknowledge Phillip as its author, but, as I once toldhim, I stopped doing this. Phillip did not mind because, likeme, he sees his ideas as children. You create them, and thenyou have to let them go. If they go out into the world anddo good, you can feel happy, even though you cannot takethe credit.

Often grassroots ideas inspire people, who otherwisewould have lived quietly, to do brave things. One such personis Terry Lynch, an Irish GP. Psychiatry in Ireland is still verytraditional, and this is the kind of psychiatry which TerryLynch would have learnt in his training. As a GP he couldhave enjoyed a hard-working but quiet life, tending the phys-ically ill and sending those with troubled minds to the psy-chiatrists, but he found that what the psychiatrists did didnot accord with his experience. So he encouraged histroubled patients to talk to him, and out of these talks hewrote his book Beyond Prozac: Healing Mental Sufferingwithout Drugs, a book which he knew would not please hispsychiatrist colleagues. In this he said,

I now believe that depression is not a ‘psychiatric illness’.Depression is a coping mechanism, a withdrawal withinoneself when reaching out to others has become toopainful, too risky. Depression is an unhappy place to be,but for the person who suffers with it, depression is thelesser of two evils. . . .

Doctors believe that depression serves no purpose. Wehave had ‘Fight Depression’ and ‘Defeat Depression’campaigns, as if depression were an enemy to beexterminated. These campaigns have received greatpublicity. But they have made little impression, either ondepression or on the suicide rate. I believe that even themost severe depressions make sense, and are

PREFACE TO THE THIRD EDITION xi



understandable in the context of the life that person haslived and experienced.1

In his book Terry Lynch told the story of Jean whompsychiatrists had diagnosed as having a severe anxiety dis-order. They had spent no time listening to her and trying tounderstand her story. Terry Lynch wrote,

Had they focussed on the real issue – her total lack ofinner safety and security – they might have gotsomewhere. Jean’s anxiety was not her problem – quitethe opposite: it was her protector. Feeling constantlyunsafe and under threat, her anxiety protected Jean fromtaking risks which would have left her open to furtherhurt. Even simple things like going for a walk hadbecome very threatening to her. While becoming arecluse was painful to her, it was less painful than takingany risks.2

That depression and anxiety, and other mental dis-orders, are defences, not illness, is an idea that is spreadinggradually.3 Different people in different places can come tothe same conclusions. While Terry Lynch was dealing withthe pregnancies and births in his practice, Paula Nicolsonat Sheffield University was researching the problem ofpostnatal depression and writing an excellent book formothers and fathers, essential reading for any family wherepostnatal depression is, or could be, an issue.4 They bothcame to the same conclusion. Terry Lynch wrote,

What women with post-natal depression need is social,emotional and psychological support. Post-nataldepression is not a ‘mental illness’. It is an understandablehuman response to one of the most challenging humanexperiences of all – becoming a mother. Why do we needpsychiatric reasons when there is a perfectly adequatehuman explanation?5

The Welsh poet Gwyneth Lewis told me that she had notread any of my work until after she had gone through a longdepression, emerged from it, and then written what isundoubtedly the best book I have ever read about one per-

xii PREFACE TO THE THIRD EDITION



son’s experience of depression. It is Sunbathing in the Rain:A Cheerful Book about Depression. Gwyneth wrote,

We are all the artists of our own lives. We shape them, asbest we can, using our experience and intuition as guides.But we’re also natural liars and we get things wrong. It’s soeasy for the internal commentary that forms how we live tobecome a forgery. Approached in a certain way, depressionis a lie detector of last resort. By knocking you out for awhile, it allows you to ditch the out-of-date ideas by whichyou’ve been living and to grasp a more accurate descriptionof the terrain. It doesn’t have to come to this, of course, andmost people are able to discern their own truths perfectlywell without needing to be pushed by an illness. But myimagination is strong and it takes some people longer thanothers to sort out pleasing fancies from delusions.

If you can cope with the internal nuclear winter ofdepression and come through it without committingsuicide – the disease’s most serious side effect – then, in myexperience, depression can be a great friend. It says theway you’ve been living is unbearable, it’s not for you. Andit teaches you slowly how to live in a way that suits youinfinitely better. If you don’t listen, of course, it comesback and knocks you out even harder the next time, untilyou get the point.

Over twenty years I’ve discovered that my depressionisn’t a random chemical event but has an emotional logicwhich makes it a very accurate guide for me. It kicks inwhen I’m not listening to what I really know, when I’mbeing wilful and harming myself. Much as I hate goingthrough it, I’ve learned that depression is an importantgift, an early warning system I ignore at my peril.6

When you become depressed you have a choice. You canchoose to make your depression a lifelong prison from whichyou get rare glimpses of sunlight, or you can make it a toughschool which teaches you wisdom. If you choose the toughschool you will find this book to be a useful textbook.

Dorothy RoweLondon, July 2002

PREFACE TO THE THIRD EDITION xiii



Chapter 1

THE PRISON

What is the difference between being depressed and beingunhappy? There is a difference, and when you have experi-enced both you know what this difference is.

When you are unhappy, even if you have suffered themost grievous blow, you are able to seek comfort and let thatcomfort come through to you to ease the pain. You can seekout and obtain another’s sympathy and loving concern; youcan be kind and comfort yourself. But in depression neitherthe sympathy and concern of others nor the gentle love ofoneself is available. Other people may be there, offering allthe love, sympathy and concern any person could want, butnone of this compassion can pierce the wall that separatesyou from them, while inside the wall you not only refuseyourself the smallest ease and comfort but you also punishyourself by words and deeds. Depression is a prison whereyou are both the suffering prisoner and the cruel jailer.

It is this peculiar isolation which distinguishes depres-sion from common unhappiness.1 It is not simply loneliness,although in the prison of depression you are pitifully alone.It is an isolation which changes even your perception of yourenvironment. Intellectually you know that you are sharing aspace with other people, that you are talking to them andthey are hearing you. But their words come to you as ifacross a bottomless chasm, and even though you can reachout and touch another person, or that person touches you,nothing is transmitted to you in that touch. No humancontact crosses the barrier. Even objects around you seemfurther away, although you know it is not so, and while you



are aware that the sun is shining and the birds are singing,you know, even more poignantly, that the colour has drainedfrom the sky and the birds are silent.

How can you describe this experience and convey itsmeaning, to someone else? Saying that you are depressed, orreally down, or fed-up, can mean to another person no morethan the Monday morning blues, or something you couldsnap out of if you really tried. But you know that it is not apassing mood or something that will vanish if you try to ‘pullyourself together’. The turmoil of your feelings is so greatthat it is impossible to know where to begin to describe them.So it is better to remain silent.

Yet there is a way of conveying what you are experi-encing. If you were an artist or a film-maker, you would beable to create an image which would convey at least some-thing of what you are experiencing. It is for this reason that Ialways ask my depressed clients, usually at our first meeting,this question. If you could paint a picture of what you arefeeling, what sort of picture would you paint?

Some people answer immediately and describe theirimage, often in a complex way. Some people are rather shyto answer and fumble for words, sketching their imagein very simple terms. But no matter whom I ask, it seemsthat a person’s image of being depressed will be one of thefollowing kinds.

First, there are the images of the person alone in a fog.The fog may be grey, or black, or a tangle of violent colours.The fog may be swirling round the person or still and thicklike cotton wool. The person may be trying to find his wayout of it, or he may be frozen in fright and hopelessness.

Next, there are the images of empty landscapes, water-less deserts or frozen wastes, or images of boundless oceans.The person sees himself trudging alone towards an emptyhorizon or caught in a violent storm, or sitting helplesslyimmobile on a burning rock or a melting ice floe.

Then, there are the images of the person, alone in aspace, wrapped tightly in something or pressed down bysome heavy weight. The wrapping may be a shroud, or a thickblack cloth, or some encasing garment. The weight may be acrushingly heavy box, or a stone lodged over one’s heart, or a

2 THE PRISON



bird like a heavy black owl which perches on one’s shoulders.Andrew Solomon saw his depression as a heavy vine thatwraps itself around an oak tree and sucks out its life, ‘asucking thing that wrapped itself around me, ugly and morealive than I.’2

The most elaborate images are those where the personfinds himself trapped. He may be travelling along an endlessblack tunnel, or clinging to the sides of a bottomless pit, orgrovelling in the crater of a burnt-out volcano, or locked in acold dungeon, or sealed in a metal sphere or a black balloon.Cages come in many shapes and forms. A person may seehimself alone in a diving bell deep in the waters of the coldNorth Sea, or abandoned high on a Ferris wheel in an emptyfairground, or crouched in a small cage which is suspendedby a fraying rope over a bottomless abyss.

All the images are terrible. Some contain a modicum ofhope. Perhaps you could find your way through a swirlinggrey fog, or lift a weight from your shoulders. Help mightcome from outside – a friendly Eskimo might chance alongor someone arrive with the key of the Ferris wheel. Perhapsyou could gain the strength to help yourself – to clamber outof the pit or unwrap the heavy cloth. But, however the imageis expressed, all the images have one thing in common. Youare enduring a terrible isolation.

You are alone in a prison.

THE PRISON 3



depression: the way out of your...

Documents