The Black Dog of Depression

“I don’t like standing near the edge of a platform when the express train  is passing through… A second’s action would end everything. A few drips of desperation.” 

Winston Churchill called his depression the Black Dog.  Churchill self-medicated to fend off the dog’s visits:

“my rule of life prescribed as an absolutely sacred rite, smoking cigars and also the drinking of alcohol before, after and if need be during meals all and the intervals between them.”

His preferred spirit-lifting tipple was whisky and soda. The sharpness of his tongue undoubtedly also offered some immunity from handmaidens of the Black Dog. To a woman that did not hide her disgust at him appearing drunk, he spat back:

"and you, madam, are ugly. But I shall be sober in the morning." 

Although Churchill was singularly instrumental in buoying the spirits of an entire nation in the Second World War, there were times when the Black Dog came and sat upon him and would not budge. Then, no amount of spirits were enough. The Black Dog is very heavy, very stubborn.   

Depression’s compounding misery is this stubbornness - a seemingly intractable stuck-ness. It takes superhuman effort to do anything under the burden of depression's weight – at a point in time when you feel the opposite of superhuman – hence stuck-ness. Although the enemy is the depression, the immediate tactical objective in the fight against it is the stuck-ness. If you can mount a successful assault on that, perhaps you can outflank the enemy. Churchill might have approved. 

Brain-imaging research is providing evidence that people with depression genuinely do see the world differently. This is hardly surprising. What is new is the research suggests depressed people see the big picture in the same way as others but have poorer appreciation of details. In other words, stuck-ness – ‘details’ change more rapidly; the bigger picture changes too, but slowly, and more imperceptibly. 

Psychotherapy for depression can then make an effective start by inserting a lever under the dead-weight of the Black Dog. It can effect this by working on the depressed person’s awareness (of details). Thereby it is possible to lever up the burden sufficiently for the person to crawl out from underneath and get life going again. But to fully effect the escape, the depressed person needs to be gently coaxed towards re-engagement with what is most vital in life – interaction with other people. 

The isolation depression engenders plays a huge role in ensuring it stays stuck. The relationship with the therapist can be the first, and most instrumental, of the many human interactions that will mark the depressed person’s passage from the loneliness of the doldrums to greater participation in life.

Once a depressed person starts being interested in life again, building on these gains involves managing excitement. Excitement, in this context, is used as understood by particle physics - any rise in the level of energy. Note how this is very much the polar opposite of the flattened experience of excitement when depressed. It is the experience of excitement when it is given the space to expand, not kept depressed. 

Learning to stay in touch with the excitement and the emotion that results rather than shrink back to the depressed state again, is the next vitally important component of the experiential learning of the therapy. Excitement will inevitably lead to emotion, because really being alive (having energy, wants, likes, dislikes and dreams again) inevitably produces emotion in human beings. It is what makes us human.    

Incorporating emotion, as a useful component of everyday experience, is then,fundamental to human well-being, as well as crucial to avoiding the depths of depression. Depressed people suppress emotion out of their experience by depressing excitement. So, to come alive again, you have to both think AND feel your way to what you want – to manage that excitement.    

Slowly then, from a pretty unpromising starting point as a depressed individual, you can begin learning about your particular brand of depression. The Black Dog may be a useful metaphor - but if your depression is a dog, What breed of dog is it, for you? How big is the dog? How old? What’s the dog like? The process of therapy involves the gentle bringing into awareness of many details to bring to light what is distinctive about your depression and distinctive about you.   

All this is not a road leading to “happiness ever after,” but to “a life of emotional ups and downs forever after.” Note again, that ups and downs are very definitely NOT the stuck-ness of depression. The balance of ‘up’ against ‘down’ will depend on you (and on luck). But you will no longer be stuck. If you are no longer stuck, you will no longer be so depressed because you can go towards what is most enlivening for human beings – engagement with other human beings and pursuit of what is of interest to you. 

You have traded depressed numbness for managing excitement and emotion, if that excites you, great…