Four hurdles in fighting the ‘black dog’ of depression

Depression. It has multiple ways of being created. A pandemic, debilitating illness, a child with a drug problem, battles at home, deeply entrenched memories of abuse or neglect, the death of someone you’ve loved, financial worries, discrimination or genetics. The list goes on and on.

It wears multiple faces: Sadness you can’t shake, anger outbursts, a need for intense control or not feeling anything at all.

It’s denied or avoided using multiple paths: alcohol, working around the clock, having an affair, intensive gaming, social media addiction or losing yourself in your kids’ lives.

It has countless ways of getting your attention: becoming suicidal, suffering a panic attack or fighting fantasies of driving away. Feeling tremendous loneliness even when your life looks perfect or plodding fatigue that robs you of any true joy.

Winston Churchill, diagnosed with severe bipolar disorder, called his ever-changing moods his “black dog.” When the dog seemed docile, Churchill enjoyed intense bouts of energy and productivity. But suddenly and frequently, his mood darkened, and the black dog was unleashed.

Now we know managing depression involves many modalities: exercise, rest, journaling or self-expression, therapy, medications, acknowledgment of grief and trauma, and reaching out to friends. Recent treatment models also focus on the formation of new neural pathways through mindfulness, meditation, EMDR (Eye movement desensitization and reprocessing) or neurofeedback.

FOUR HURDLES TO TAMING DEPRESSION
“I’ll lose all credibility.” “I know I should exercise. It’s hard to make myself want to do it.” “I don’t like to journal. I do it, but nothing changes.” “Therapy doesn’t work. And it’s too expensive.”

Here are the hurdles these statements reflect — and what you can do about them.

1. Fearing the loss of credibility. Fear of stigma or prejudice is the most common hurdle prominent in our culture.

Here are two facts: Depression can worsen without attention and treatment, and suicide rates are rising exponentially.

Please face your fear. Ask for help. Search “historical leaders with mental struggles.” Even better — ask someone you respect who you sense might understand or have struggled themselves.

2. Waiting to feel motivated. If you’re waiting to be magically motivated to risk, nothing will happen. You’re putting the cart before the horse. Determination to do comes first.

Kate fought me tooth and nail over the importance of exercise. Then finally tired of struggling with suicidal thoughts, she came in. “Well, I made myself put on a bathing suit and get into the pool. Suddenly, I found myself energized, as I’ve always loved to swim. I have to get up really early so I can get to work … I feel so much better.”

The positive result of that determination will become self-motivating.

3. Discounting small changes. Healing usually involves a cumulative effect of many small changes. I wish I had a nickel for every time a patient had said, “This isn’t really a big deal, but yesterday I …” Any change, any risk is a big deal. And those small discoveries will move you forward.
4. Giving up because you had one experience that wasn’t helpful. You wouldn’t teach a child, “If one idea doesn’t work, don’t bother trying any others.” Nope. Persistence can pay off. And it takes courage not to give up.

If one therapist doesn’t help, find another with a different style. If it’s too hard to make the weekly basketball game, walk in the morning. If you’re nervous about prescription medications, then look for homeopathic alternatives. Sometimes you’ll be surprised at what actually helps. Sitting in the sunshine, writing a note to someone you miss, striking up a conversation with the 6-year-old next door … in fact, striking up any conversation.

Find your courage. And you’ll keep risking.

Dr. Margaret Rutherford is a private practice psychologist in Fayetteville. The opinions expressed are those of the author.