Dr Dorothy Rowe, an Australian psychologist and author based in London, was listed in November 2007 as one of the top 100 living geniuses by global research firm Creators Synectics.

Rowe is known mostly for her groundbreaking and often controversial work on depression.

She believes depression is not a physical illness to be treated with medication but a self-made prison you can leave, if you choose to change the way you interpret your life.

Rowe also supports the growing research that shows not all people diagnosed with depression are in fact depressed – more often than not, “dispirited” would be a better term to describe how they feel.

What is depression, I ask Rowe during her recent visit to Australia. “Depression is clear-cut. It’s very specific,” she says.

“You’re in a prison with an invisible wall around you; no one can get in and you can’t get out. I recently met a man who described his experience of depression as being covered by a big wet blanket he couldn’t remove.

“People who feel dispirited can be comforted. They may feel low or irritated but they can still talk about their feelings. However, talking to someone who is depressed is like talking to a brick wall. They’ve lost interest in life.

"Depression can come on quickly, but many people are slow to realise that’s what they’re experiencing. What usually happens is one day they notice that the strange feelings they’re having aren’t passing.”

GROWING AWARENESS

The work of charities and government initiatives has brought depression into the open.

Initiatives such as Out of the Blue (New Zealand) and Beyondblue (Australia) are doing exceptional work to bring awareness to the issue of depression and to let people know help is available.

“Today people feel they’re able to talk about depression,” says Rowe. “It has lost its stigma and shame, whereas in the past women were written off as ‘depressives’ and men were labelled ‘alcoholics’.”

Now that there’s awareness, Rowe says we need to take another look at the treatments available.

“There is an ever-increasing number of people heading to the doctor, being told they are depressed and given a prescription for an antidepressant,” she says.

“Antidepressants can give a person breathing space but they offer only short-term relief. Depression tells you that there’s something wrong with the way you’re living your life, that there’s something wrong with the way you make sense of the world. But drugs don’t turn an unhappy marriage into a happy marriage; they don’t turn an unhappy childhood into a happy childhood.”

Much to Rowe’s relief, the treatment for depression is finally starting to change. Treatments are starting to focus more on ‘talking therapies’, such as psychotherapy and counselling, rather than just relying on antidepressants.

Several pilot studies, the results of which look promising, are being conducted using different kinds of talking therapies rather than the traditional treatment with antidepressants and electroconvulsive therapy (ECT).

While Rowe advocates therapy for depression, she believes it’s the person with depression who needs to be the instrument of change.

“A good therapist goes on a journey with their client and neither person knows where this journey is going to end. But the therapist can read some signposts, can suggest one path over another,” she says.

“A challenge with therapy is that often a client will go to a therapist saying, ‘Take my pain away, but don’t change me.’ The hard part is accepting that the pain won’t go away unless you are willing to change.”

REALITY AND PERCEPTION

“Human beings cannot see reality directly – whatever reality is,” Rowe says. “What we see is what we’ve learned to see, and what we experience are perceptions that have been constructed by the brain based on past experiences. If you don’t understand this about yourself, you grow up believing the world actually is the way you see it.

“There will always be painful experiences, but it’s how you interpret and respond to them that determines whether or not you become depressed. When you suffer a loss, the natural response is to feel sad. The way this sadness can turn into depression is if you blame yourself for the loss.

“Guilt is a defence mechanism against feeling helpless. When you feel responsible for what’s happened, you deny that you feel helpless; you’re saying you had some control over the situation. So regardless of what happened, you’re saying it’s your fault – and that’s the quickest route to depression.

“We need to feel we have some control over our life, that we’re not blowing in the winds of change. But we’re not responsible for everything that happens and we certainly can’t control the actions of others. However, time and again I see women staying in bad marriages and people living unfulfilled lives because they feel responsible for their situation and believe it can’t be changed.

“This belief usually stems from childhood. We’re brought up to believe that if we’re ‘good’ we’ll be rewarded, and if we’re ‘bad’ we’ll be punished. [It follows that] if your mother hated you, your boss took away your job, and your wife left you, it must be your fault.

“Suffering can be caused simply by the ideas we hold. But if we understand that we create our ideas, we know we are free to change them.

“People often don’t appreciate that at every moment you have the option to respond differently to a situation than you usually would. It’s natural to interpret new situations based on past experiences, but you can always alter the way you respond.

“Unfortunately there are many people who don’t know who they are. They’ve been told there is a ‘right’ way to do things and they never question it. Deep down they may feel that something isn’t right but they’re too scared to do anything differently.”

WISDOM THROUGH EXPERIENCE

Rowe’s own life has certainly provided her with material to develop her work. In her most recent book, My Dearest Enemy, My Dangerous Friend (Routledge, 2007), Rowe tells of her cruel childhood and unhappy marriage.

Rowe’s mother was depressed. “She let me know I was fat, ugly and lazy and went into a crazy rage and would beat me and declare she was going to kill me and then herself,” she writes.

Her elder sister, her only sibling, “would look at me curiously and comment with the fascinated disgust of someone who had inadvertently kicked over a stone and found a particularly strange and loathsome slug hiding there”.

Rowe suffers from the severe lung disorder bronchiectasis, which her family completely ignored. She decided to address the problem herself and saved up to have a major lung operation after she graduated from her psychology studies.

Then there was Rowe’s passive father and, later, her cheating, lying husband. When Rowe’s husband fathered a child with another woman, she knew she had no choice but to leave the life she knew.

So in 1968, aged 38, with a degree in psychology and a Diploma of Education under her belt, she packed up her 
11-year-old son and moved to England to accept a National Health Service post at Whiteley Wood Clinic, Sheffield, which was attached to Sheffield University’s Department of Psychiatry.

Rowe now thinks that what prevented her from becoming depressed was the fact she never felt guilty about disappointing her mother, largely because her primary concern was to keep herself safe from her mother’s violence.

“My great fortune, by chance not design, was to become a clinical psychologist. At Sheffield I spent hours talking to depressed people and it certainly put my family in proportion – my family was not the worst out there by any means. It gave me an opportunity to look at my mother from a different point of view, not just as the child of this woman but as an adult observer.

“Many of my patients had depressed mothers and I would tell them about mine. If you tell a story again and again, finally all the emotion goes out of it, so what was once too terrifying to talk about becomes something really quite funny. When you laugh about somebody, you reduce their size.”

After completing a PhD on the “psychological aspects of regular mood change” in England in 1971, Rowe set up the Lincolnshire Department of Clinical Psychology. It was here she obtained a research grant that enabled her to continue her research and write her first book, The Experience of Depression, now called Choosing Not Losing.

Now writing her 15th book, What Should I Believe? (Routledge, October 2008), Rowe is looking at the role religion plays in modern-day life.

“Thirty-five years ago religion was a private matter. Now it’s political,” Rowe says.

“I’ve always said that a person’s religious and philosophical beliefs play a tremendously important role in creating who they are, but what we need to do is to evaluate those beliefs, to question whether or not they make sense. If you have beliefs that make you feel guilty and frightened, well you need to think again.”

Rowe believes that people have the ability to change the way they experience the world. While many of her ideas force us into unnerving or uncomfortable places, her words ultimately empower us to create a more enjoyable reality.

The countless lives she has improved are testimony and she certainly doesn’t plan on slowing down. “The only time I’ll stop being interested in people’s behaviour is when I’m dead,” she laughs.

Listen to Dr Rowe's discussion on sibling relationships here.