Dorothy Rowe

You: Mail on Sunday

13th September 1998

Women and Depression

Libby Purves is one of the nicest, friendliest, most cheerful, most attractive, most competent and hard working women I know. She combines very successfully the roles of wife, mother, friend, career woman with many outside interests, something that many women nowadays try to do. I'm sure that when she was a little girl everyone must have loved her because she was so nice, friendly, cheerful, pretty and good. However, I didn't know that Libby had been through what so many women - good women - go through, the experience of being depressed.

Libby knew what unhappiness was. She'd encountered loss and disappointment. But depression was quite different. Life had no colours but grey, and she hated herself.

Kate made the same discovery. Like Libby she had good friends she could always turn to. When she and her first boyfriend split up and later when she missed out on a job she wanted she poured her heart out to her friends. They listened and told her she was wonderful and would always be successful, and she felt greatly comforted. But when the doctors told her she could never conceive a child and all attempts at in vitro fertilisation failed she felt an invisible but impenetrable barrier come down between her and the rest of the world. Friends and family offered her comfort, but nothing got through the barrier to warm her and ease her pain. She was in the prison of depression.

This prison is the essence of the experience of depression. Every depressed person can describe this prison, but no two people describe it in exactly the same way. Patricia told me, "I'm curled up like a baby in the corner of a bare, locked room." Janice said, "I'm just a black dot in the middle of an infinitely large, empty space."

Depression isn't an illness. Depression is a defence which we can use when we discover that there's a huge discrepancy between what we thought our life was and what it actually is. When this happens we feel ourselves falling apart and we're terrified. Then we can use the prison of depression to hold ourselves together, but it's a very painful place to be. However, in it we can learn great wisdom and so leave this prison behind us forever.

To understand how this happens we need to know something very important about ourselves, which is that what we do isn't determined by our genes, or our parents or even our stars, but by how we interpret what happens to us. As the ancient Greek philosopher Epictatus once said, "It's not things in themselves which trouble us but our opinions about things." Recently I did some work on a television series about lottery winners. One of these winners was a woman who'd always believed that life should be enjoyed. Another winner was a woman who'd always believed that to be good she had to work hard. Can't you guess what they decided to do with their winnings? The first woman took her friends on holidays, and the second woman bought a large hotel where, she said, "I've never worked so hard in all my life."

No two people ever interpret anything in exactly the same way. However, many of us create the kind of interpretations which can lead us into the prison of depression. These aren't strange, way-out interpretations but the kind of interpretations which arise quite commonly in our society. These interpretations go right back to the day we're born.

A baby is born knowing how to create interpretations and is eager to do so. A newborn baby looks around eagerly, working out that the voice she got to know while she was in the womb comes from a face - and babies love faces - that keeps coming back again and again. Little babies can do amazing things, like recognize their mother's photograph from a set of photographs of women who look their mother. However, no newborn baby is busy wondering, "Will people like me?" "Will people approve of me?" Rather, babies enter the world full of unself-conscious self-confidence.

Alas, this soon changes. The baby forms a bond with her mother, and then becomes anxious about losing or angering her mother. Long before she can talk, the sounds of "There's a good girl" and "Don't be naughty" take on a special meaning, and thus the unself-conscious, self-confident baby turns into a self-conscious little girl who is trying to be good. This change comes so early in life that many children grow up believing that they are in their very essence bad and unacceptable, and so they have to spend their lives trying to be good.

Being good means never being good enough and always feeling guilty about not being good enough.

This process of learning to be good is the same for boys as for girls, but the way "good" is defined for boys and for girls means that more women than men become depressed. Even after two decades of feminism, studies show that mothers will tolerate their small sons being quite aggressive, competitive, noisy, selfish and dirty while they expect their little daughters to be unaggressive, co-operative, quiet, unselfish and clean. These are very high standards for little girls to reach, and thus many girls grow up feeling inadequate, lacking in confidence and feeling guilty for not being good enough.

The Duchess of Kent, in an interview last December, talked about the depression she suffered in 1977 after her much wanted baby was stillborn. She said, "I can still be very shy walking into a room full of strangers. I know how to do it, but I have never gained confidence. It is one of the reasons I am always trying to boost other people's self-esteem - because I know what it's like not to have it." She went on, "I don't think I have ever felt extremely confident. It would probably be awful if I did, because I might then do what I was required to do extremely badly."

Here the Duchess reveals why she had never become self-confident, despite all the evidence that she is very competent and very much liked. She believes that to be confident means doing things badly. She can't afford to do things badly because she has set herself impossibly high standards. As she said, "I am a perfectionist."

Whatever interpretations we create they all have implications, often with results which we don't want. If you believe that you are not good enough and have to work hard to be good, and that everything you do must be done perfectly you have ensured that you live a life of hard work with constant self-criticism and much unhappiness.

How you feel about yourself is central to every decision you make, whether it's about buying a new pair of shoes or deciding on a career. It's quite a complex feeling made up of whether you feel affection for yourself, or dislike yourself, even hate yourself, whether you look after yourself or neglect or punish yourself, and how you judge yourself. Do you set yourself reasonable or impossible standards? Many women set themselves the impossible standard of wanting to be perfect in every way - the perfect career woman, the perfect wife, mother, lover, the perfect cook, the perfect friend, and of course being perfectly attractive.

How you feel about yourself develops out of how you interpreted events when you were a child. Kate saw that her father would approve of her only if she were a high achiever. Janice's parents took little interest in her but her teachers praised her for being obedient and working hard. Patricia was close to her mother and wanted to be like her, someone who devoted her life to her family. So they each defined "being good" in their own individual way and they each created a way of living where they could be good in this special way. Kate was a very successful journalist, Janice was a hard working and loyal PA to a senior executive in a large firm, and Patricia became a very good wife and mother.

In childhood we learn how to interpret the world. When we're small children life is very confusing because unexpected things are happening all the time. We're quite pleased when we discover some regularity in some events, even if it's not particularly pleasant. Mother says, "If you're naughty you won't get an ice cream," and we are naughty and we don't get an ice cream. Now we've discover a regularity which we can predict. If I'm bad I get punished, and, along with that, if I'm good I get rewarded.

In some families "bad-punishment, good-reward" is simply a rule for a peaceful family life, but in many families children are encouraged to take this rule and generalise it to the whole world, to believe that we live in a Just World where goodness is rewarded and badness punished. All religions teach this, though they differ in how they define good and bad, reward and punishment. When the Duchess of Kent was explaining why she joined the Catholic Church she said, "I do love guidelines and the Catholic church offers you guidelines. I have always wanted that in my life. I like to know what's expected of me. I like being told: 'You shall go to church on Sunday and if you don't you're in for it!'"

There are many people who don't have a particular religious belief but who still believe in a Just World. Kate told me, "I'm not religious but I do believe that somehow, in the end, there's justice for everyone." Some people don't think about whether there's a justice that's applied to the whole world but they do expect that there will be justice in their lives. Patricia expected that because she devoted herself to her family they in their turn would be devoted to her, just as Janice expected that because she worked so hard and so loyally for her firm she could rely on the firm's loyalty to her.

Believing in some kind of Just World gives a sense of security. You can think to yourself, "If I'm good nothing bad will happen to me or to my loved ones." Usually we don't spend time thinking about a Just World until a disaster happens. Then we ask, "Why?" Many of the messages left on the tributes to Princess Diana were asking the question, "Why in the whole scheme of things did this happen?"

There are only three possible answers to this question - it was someone else's fault, it was my fault, it happened by chance. However, if you believe in a Just World something happening by chance isn't an option. In a Just World nothing happens by chance. It's either someone else's fault or it's your fault. This becomes a great problem if you're a good person and you suffer a terrible disaster.

Kate, Patricia, Janice and the Duchess of Kent all suffered a terrible disaster. For Janice and the Duchess the disaster was sudden. Janice was made redundant by the firm to whom she'd given her life, and the Duchess lost her baby. For Kate and Patricia the disaster came upon them slowly. Each failure to get pregnant Kate saw as her own personal failure. Pat tried to deny every slight and betrayal that her husband and sons inflicted on her until her birthday came and not one of them remembered. She had to recognize that she was to them no more than a useful doormat.

Each of these women discovered that there was a serious discrepancy between what they thought their life was and what it actually was. They had made a serious error of judgement.

Everyone who reads this article is likely to be old enough to have made a serious error of judgement. It might be that some one you trusted betrayed you, or that something you were sure would happen didn't. Then you start to question every judgement you've ever made. You feel very shaky, and then you find yourself crumbling, fragmenting, even disappearing. Janice said, "When my boss sacked me I couldn't speak. It seemed that everything around me had disappeared and I was falling into nothingness."

When something like this happens you can think that you're going mad but you're not. All that is happening is that many of the interpretations you've made are falling apart because they don't fit what's actually happening. You have to find new interpretations and so put yourself together again.

All the while through this confusion and terror you're asking, "Why has this happened?" If you already know that life is a chancy business and that anything can happen at any time you can say, "It's just one of those things. I'll have to make the best of it." But if you believe in the Just World you can't do this. You're left with "It was someone else's fault" or "It was my fault."

If you choose "It was someone else's fault" you'll get angry. However, good people know that it's wrong to blame other people and get angry with them. Good people always blame themselves.

So when Kate, Janice, Patricia and the Duchess faced the terrible disaster that had befallen them they felt themselves falling apart. They were terrified, and asked themselves, "Why has this happened?" Their answer was, "It's my fault."

What they said to themselves was, "If I'd been a really good person this disaster wouldn't have happened. I must be even more wicked that I thought I was." Thus they turned against themselves, felt disgusted with themselves, hated themselves.

When we feel at peace with ourselves we feel at one with the world. We feel a bond between ourselves and other people. We remember pleasant events from our past and we look to the future with joyful anticipation. When we turn against ourselves and hate ourselves we immediately become very frightened of other people, lest they see how bad we are and so punish and hurt us. So we cut ourselves off from other people. We cut ourselves off from the past because all that we see there is evidence of our wickedness. We cut ourselves off from the future because all that lies ahead is punishment for our wickedness. We cut ourselves off from the world because we are too wicked to be part of society and nature. We are cut off completely, alone in our prison of depression.

The things that put us in that prison are the same things that can release us. This is the wisdom that many people have learnt in the prison of depression.

First they learn that the feeling of being bad and unacceptable isn't an intrinsic, unchangeable attribute but a set of interpretations which they'd created and so could change. Kate said, "I've learnt that it's okay to fail."

Second, they learn that life isn't controlled by a set of laws about punishment and reward but that things happen by chance and it's best to accept this. Janice said, "I no longer feel I have to control everything. I'm free and it's wonderful."

Of course leaving the prison of depression doesn't mean that you'll be blissful happy forever. You've suffered a loss and you feel sad. But the good thing about sadness is that, unlike depression, it can bring people close together.

STRATEGIES FOR CHANGE

Whenever we go on and on doing something which causes us pain, whether it's smoking, falling in love with unsuitable men or being depressed, there's something in the situation which gives us a reward. When we're depressed it's pride that stops us from changing. We take pride in being good. To leave the prison of depression behind you need to

• 1. Admit that you are depressed.
• 2. Make a list of all the things you take pride in - having extremely high standards, keeping yourself to yourself, working hard, letting others depend on you and so on.
• 3. You are faced with a choice - be a very good proud person and depressed or an ordinary person and happy. Which do you prefer?
• 4. If you'd rather be happy than good decide to act as if you are your own best friend. You don't feel like your own best friend but you are going to pretend that you are. Now you're kind to yourself, you look after yourself, you give yourself treats.
• 5. Make sure that every day without fail you do something nice for yourself - go for a walk, listen to music, make someone else do the ironing, say "No" to someone who wants you to do something you don't want to do.
• 6. Find someone to talk things over with, a friend or a counsellor. Sometimes just telling your story is enough. When you can't give up criticising yourself find a psychologist who uses cognitive therapy. Your GP can refer you to an NHS counsellor or psychologist or you can find a private therapist listed in the National Register of Psychotherapy
• 7. Keep a notebook where you can keep a diary and jot down anything you come across - a poem, a thought - which means something to you.
• 8. Helpful books on depression

Dorothy Rowe Depression: the Way Out of Your Prison Third edition Routledge

Dorothy Rowe Breaking the Bonds Harper Perennial