This is a video that I’ve watched several times, both on my own and for my Master’s program. It’s one man’s experience with depression, where he likens his struggle to that of a black dog who follows him around, acting like a shadow that hovers over everything he does.
I really relate to this video because he says that some days the black dog is bigger and some days it is smaller, but it’s always there. For someone like me, who technically has “double depression” – that is, dysthymia (a persistently low mood throughout one’s life) and major depression (which is diagnosed when you’ve had one or more major depressive episodes but have never had a manic episode in your life) – this especially hits home. For about 90% of my life my mood has been manageable but still kind of “in the dumps.” And then I have periods where everything – my emotions, my thoughts, my behaviors – just seem to be completely hopeless, worthless, and out of my control.
During these times I can be really hard to deal with. Heck, I find it hard to deal with myself. My emotions go through the roof with any tiny negative comment, and I can’t control it. The best I can do is control my reactions to people, which usually means isolating myself until I can calm down. My number one worry during these times is that I’ll say or do things I don’t mean. Luckily, after years of practicing dealing with depression I have a pretty good handle on some of the tools I need to keep myself safe and my relationships minimally tumultuous. Usually.
Here’s the thing that people without depression don’t usually realize. When you’re in a depressive episode, you can have near-delusional levels of guilt, fear, shame, or hatred toward yourself. You can fear that you’ve never done anything right in your entire life. You can be completely and utterly convinced that you’re worthless, everyone knows your worthless, and you might as well just end it all now. When others reassure you it can feel like they really are just lying to make you feel better. It all feels very real, even for someone like myself who is able to recognize when my emotions are running out of control.
So, you ask, how does somebody deal with something like this? Well, practice makes perfect. There are lots of different methods, tools, professionals and medications that are specifically designed to help you practice managing your depression. For me personally, the right medication gives me enough stability to go to therapy and use Cognitive Behavior Therapy and positive psychology techniques to sooth myself when I’m upset. Many times a day I practice countering my unrealistic thoughts (also called “Cognitive Distortions,”) and this helps me give the big middle finger to my depression. A typical intervention goes like this:
Me (in my head): God, you got points taken off your assignment for getting something wrong. You’re so stupid. How did you even get into this program?
Me (in my head): Woah there, that’s a little harsh.
Me: But it’s true! You’re stupid and lazy. They must have made a mistake letting you go to graduate school.
Me: Okay lady, you’re taking this way out of hand. You got 5 points taken off a 100 point assignment for a typo. Let’s just calm down. Everyone makes mistakes.
Me: Not as many mistakes as you do.
Me: Again, that’s just not true. You’re human. All humans make mistakes. Your classmates make just as many mistakes as you do. Let’s focus on the 95 points you DID get instead of the 5 you got taken off. You still got an A! Good job!
And so on and so forth. Now, if I wasn’t on medication that would be a very different conversation. It would also be different if I wasn’t attending therapy to get the feedback and encouragement I need. It also would be different if I didn’t know the specific ways to recognize and counter the cognitive distortions I’ve got.
Something else I wanted to address – some people feel as though being on medication for depression is a weakness. I want to try and dispel that.
Evidence is not 100% clear about what causes depression. We do know that certain chemicals in the brain, certain life events, patterns of thinking about or engaging with the world, core beliefs, environment, and family / genetics all contribute. While medication may not be much help to some people, it can make all the difference for others. I want to stress that this is similar to other diseases we know about – for example, the different forms of diabetes can have several complex causes. Medication doesn’t cure it, and diet and exercise are important factors in managing the condition. Would you call a person who is taking insulin for their depression weak? Hopefully not. So I encourage you not to think of yourself as weak if you take medication for depression, or any other treatment for mental illness.
At this point you might be wondering – Is there a cure for depression? Well, usually if it’s clinical Major Depressive Disorder, the answer is probably no. Odds are that there is no curing your depression. However, with proper treatment lots of people can go a very, very long time without having a depressive episode. When they do have an episode, the episode is a lot shorter and less intense when treated. Like the black dog, it does tend to follow you around. But also like the black dog in the video, it can be trained, managed, and shrunk down so it doesn’t interfere in your daily life. There have been periods of my life where I went for months at a time without thinking about my depression at all. It was almost like a memory of the dog instead of the actual thing.
I say all this to educate and inspire hope in those of you who have depression, or have a loved one with depression that you’re struggling to understand. I hope it helped a little.