The Black Dog of Depression

Often overlooked and seldom detected, even by our close friends, this monster skulks amongst us daily. It is attracted to those susceptible to its influence, into whom it burrows like a worm, while normal people suffer nothing more than an occasional glancing blow.

Churchill called it his “Black Dog” and kept it at bay with copious amounts of Brandy and distractions such as the Boer, the First and Second World Wars. It quietly envelopes the susceptible with the illusion of a warm blanket on a cold evening before constricting and lowering its leaden unyielding weight. I am talking about the big “D,” depression. \

Trying to explain what depression is to someone who does not suffer from it, is like trying to explain the space time continuum to a toddler. Sure there are words we hear to which we nod wisely when we hear them as if we understand. Maybe we read them in a book, heard them on Oprah, but we can’t truly share the space of the sufferer; depression is a personal, insidious, opportunistic disease. Its complexity is individual; its power at times absolute, it is near impossible to explain. It imparts mind sheering anxiety and a feeling of utter and complete hopelessness on the sufferer. Even therapists and psychiatrists have a hard time getting their heads around it. That’s why they have thick prescription pads.

Depression has been described as a large wet carpet draped over ones body. It’s impossible to move with it; harder to remove it. Sometimes the only solution is to go with it and lie down - stay in bed. Fighting depression can be a futile and infuriating action and rarely works except to increase its intensity. Depression, like an enemy in warfare, is best dealt with at a distance and by avoidance.

True depression can be fatal; a natural born killer if left unattended. Leaving someone who you know is in an episode of severe depression alone may be the last time you see them alive. Trouble is you never know what’s going on in their minds, how severe it is, or if indeed they’re depressed at all. They’ll rarely tell you. Generally you learn to notice through their behavior or body language. You’ll develop a nose for it, if you care to.

People who have severe depression rarely see themselves as victims, though many do struggle in the quicksand of self pity without truly understanding why. Rather they see themselves as the cause of their problems and therein lies the rub. A depressive’s universe is torture by a thousand cuts as the whirlwind of the disease swirls around the afflicted, reinforcing negative thoughts that assemble to become a harsh - authentic - reality in their minds.

Depression magnifies the perceived cause of the negativity or life problems completely out of proportion, as if viewing a speck of dust through an electron microscope. The depressed can feel completely alone in a crowded room. They feel isolated; isolation is their bedfellow. Indeed bed is where they retreat to hide in the hope that depression will forget them and leave them alone. Eventually it does. And when it does the sufferer must act quickly to stave off the next onslaught.

What helps? Martin Luther King Jr told us that the best 10 cures for depression are “do something for someone less fortunate. Repeat that nine more times.” Good advice.

Deep melancholy can last from days to months. It can wax and wane like an irregular and unpredictable tide. Its severity can eviscerate the minds and souls of those who have it and those who live with the suffering – it’s merciless, intense and its effects cumulative for all concerned.

At times it can drive the sick insane - to the brink of suicide; to a point where suicide as an option is perfectly logical in the mind of the sufferer. They’re convinced absolutely, that ending their life makes perfect sense. For example, they believe that their family would be better off without them; that the pain is too much to deal with; that there is no purpose in living – there are a hundred variations. It can be like a light bulb of realization going off. It makes perfect sense.

Sometimes - rarely - there are a number of indicators of a terminal decision. Subtle signs such as giving away personal property; a sudden change from melancholia to calm; a tidying of affairs. An intervention helps as it buys time; time for the mind to re-address its warped logic.

Whether they push beyond the brink and commit suicide is only determined by results. If they’re alive, they didn’t go through with it. In simple terms, given time the mind will turn the thought around and the instinct of self-preservation returns and they go on to live another day. About 30,000 people commit suicide in the US annually for various reasons many stoked by depression, which, in case you haven’t already figured out, is a mental illness. Older white males are the leaders in succeeding at suicide while white females attempt suicide the most often, most times unsuccessfully. Perhaps the availably of means is why men have a higher success rate.

Why do people with severe depression stay alone? Many reasons; mainly it’s a coping mechanism. Sometimes it’s to avoid the plethora of advice from the amateur psychiatrists that fill the world who cheerily advise “oh, just shake it off…go for a walk…mind over matter…fight it, man, fight!...you’re letting it get the better of you…you’re weak.” There is a simple two word response to these pieces of advice and the second of the words is “off.” To a depressed person the advice – while well meaning - only increases they’re own feeling of worthlessness.

Medication can help. It is, I believe, the unmonitored medication of depression that leads down another fatal path, the path of addiction. Booze, pot ‘n pills, all work, albeit temporarily, to alleviate the symptoms of depression. The mind figures “if it worked last night, let’s do it again tonight, and tomorrow.” And you’re hooked. Alcoholism - addiction - in time intensifies the depressive cycle – drinking to fight depression; depressed because you drink, both chemically and emotionally. On and on – an initially unconscious but vicious cycle.

The few who succeed in getting out of this addictive cycle can enjoy a newfound method of harnessing, anticipating and, to some degree, controlling depression. A 12 step program promotes three key components; belief in a higher power (thus giving purpose to life); advice to help someone less fortunate (purpose and measurable outcome promoting self worth) and enforced humility by tidying up the past through facing past problems squarely and making amends for harms done (responsibility). Effective. Not bad advice for regular folks too. If we all did it the world might be a better place. Therapy and exercise are a key component in recovery as is prescribed non-addictive medication if needed. To work, the recovery tools are a life long daily process. Sometimes the dog slips its leash and bites again. It happens.

Next time you’re feeling blue and you wonder if you know how it feels to be truly depressed, you are as likely to be right as a person with a head-cold when comparing their symptoms to a person with terminal cancer.

If you want to help, be a friend, shut up and make them a cup of coffee. Oh, telling them you love them helps too. As does a hug.

And don't judge.