The black dog

Sometimes people talk about the "black dog" in relation to depression, but what do they mean? This video explains it brilliantly and gives a real flavour of what depression feels like.

WHO black dog video

When the black dog comes to call it's difficult to do anything - just getting out of bed requires superhuman strength. I know of someone who had to leave home because their partner would constantly moan that if they were home all day, then why couldn't they do something useful while they were there - put the washing on, mow the lawn - anything. I don't suppose the partner meant to be hurtful but they were actually making them worse - made them feel even more of a failure than they already felt. If you were ill in bed with the flu, you wouldn't be expected to do anything. Just because you can't see the illness doesn't mean it doesn't exist.

Another good example of what depression feels like is in this excerpt of Marian Keyes book This charming man. Theres a few things in this that are classic depression symptoms - putting on a face, not being able to do the simplest of tasks, overthinking everything, feeling anxious, looking for quick solutions, sucidial thoughts. When I first read this book, it was like reading about my own mind. 

This Time to Change advert also gives some good insights into what depression feels like. For example - feeling so fragile that you feel you may disappear into dust if someone says "boo" or wanting to hide in the smallest, darkest hole you can find (I wanted to hide in the wardrobe although other people have said they wanted to hide under the duvet). Some other examples in this video are what people think depression is - ie a form of "madness" (but its not). And, the end shows what happens when you're feeling a bit better - absolutely nothing, you are exactly the same as everyone else.

What is depression like?

Depression is not about being sad or a bit fed up, indeed, there's nothing much worse you can say to a depressed person than using the word "depressed" in an insignificant way eg "Yeah I'm so depressed Eastenders isn't on tonight".

You can be depressed when you have everything you could want - Hollywood stars like Catherine Zeta Jones can have depression. Just as someone living on the street with nothing can be entirely depression-free. 

Depression isn't something you can control - you cant "pull yourself together". Just as friends and family cant fix it by giving you a gift, or taking you on holiday or talking through your problems. 

Depression isn't constant - the phrase "good days and bad days" is used in connection with depression and it is very relevant. Just because someone seems happy or has managed to get through a challenge doesn't mean they are "fixed". One therapist I saw suggested marking the days on a calendar - a smiley face for a good day and a sad face for a bad day. In the beginning the calendar may consist entirely of sad faces. You know you are getting better when the good days outnumber the bad days. But both will still exist. 

I know of someone whose work colleagues got frustrated with her because she was always posting on Facebook about the things she'd done, places she'd been and photos of her smiling and happy (and yet she was off work with depression). But that's typical of depression - you do have moments of "happy" but you are also very concerned about how you appear to the outside world - you want to appear "normal" so you will only venture out with your face (and often smile) on, you willing only show the world your happy face, even if you're not feeling happy - you pretend, which makes going out difficult and hence you'd rather stay in (which makes you even more proud of yourself when you do go out).

Another symptom of depression is self medication - in my case, its alcohol and shopping; but it can be drugs, exercise, food, energy drinks, over the counter medication like st johns wort or vitamins. Anything to make you feel in control or that bring on the happy hormones even for a short time. Unfortunately that is why depression and addiction often go hand in hand. 

So how can you help? I went to a conference about how to deal with mental health in the workplace, and the answer was simple - ask the person, as each case, each person, is different. Some things are universal though - keep lines of communication open. Just because someone doesn't want to talk today, that doesn't mean they'll never want to talk. Depressed people often have phobias of phones. I have one friend who will arrange to meet up and then not turn up and not answer the phone or respond to text messages. We just write it off as a bad day and try again next week. Of course "asking the person" isn't always helpful since you can never be sure you are asking the person or the "face". At my worst, whenever anyone asked me how I was, I'd smile and say "fine". Depressed people will often miss doctors appointments - either because they didn't have the energy to get there or because they didn't want a light shined on what feels to them as the black, disgusting side of themselves. Of course that makes everyone think they are faking or better which means every more work the person and even harder to seek help next time. The system doesn't work well for mental health - its designed for physical health where the person hurts and wants help, mentally ill people feel abnormal and ashamed and will do everything to avoid "help" until its too late or they are so low it is a very difficult (and long journey) to get back from.  Anti depressants (and talking therapies) are not quick fixes - you should probably allocate at least a year to them.

That's why I am writing these blogs and supporting the Time to Change campaign. We need to be able to talk about mental health more openly so you can recognise symptoms in yourself, or others, quicker which will allow you to stop the illness before it gets too strong. if you find a lump - you go to the doctor straight away or it may be difficult or impossible to remove, the same is true for depression. Go and talk to someone!