Depression: running from the black dog

I first heard "black dog" as a reference to depression several years ago from an online friend from Australia. He used to say he was being "chased by the black dog" when he fell into depression. I find it to be a good description of how I experience depression. I feel like I'm trying to stay ahead of depression--trying to figure out when and how it will strike next and trying to prevent that from happening. I barely feel like I'm keeping ahead of it. If I'm caught, it feels like I've been attacked and have fallen. It takes great effort and meds to get back up and am able to get ahead of it.

A doctor first diagnosed with me with depression in 1996. I made an appointment with a psychiatrist when a friend strongly encouraged me to. I had expressed to her that I wanted to commit suicide, and she insisted I needed to see a doctor.  I didn't think feeling suicidal was abnormal and was surprised to find out that some people don't ever feel suicidal. I assumed it was something everyone dealt with. Not that I was constantly making plans how to off myself, but I admit, it was a place my mind went to repeatedly at least once or twice a year. The psychiatrist prescribed me an antidepressant and I began attending therapy shortly thereafter. I quickly learned that I had been suffering from depression on and off for much of my life.  Most of that time, it was a low level of depression, but at least once a year, I'd experience a deeper depression.


When I say depression, I am not referring to feeling down. Instead I refer to the Diagnostic and Statistical Manual IV (DSM) diagnosis of Major Depressive Disorder. Briefly, the DSM is a classification of mental disorders used by mental health professionals in the USA. When I was first diagnosed with depression, I had a hard time distinguishing from MDD and being sad. Over time, I learned more about MDD and myself. 


I now can more accurately assess when I've falling into MDD rather than a period of sadness, feeling bad about myself, etc. At such times I find I have most of the symptoms listed in the DSM IV. I know I've fallen into MDD when I feel an inability to pull myself out of the negative thinking, low self-esteem, loss of interest in activities, almost daily uncontrollable crying, feelings of despair, feeling unmotivated, and feeling like my mind has slowed down. I no longer have issues with wanting to commit suicide. I sometimes feel passively suicidal, but I only feel this way a few times a year for brief periods of time. For example, I would not mind being hit by a bus but I wouldn't do anything to make it happen. Normally practicing self-care prevents me from falling into depression. My self-care includes bubble baths, reframing my negative beliefs, meditating, reading, spending time with my husband and my cats, exercising, watching tv, etc. If I am unable to stay ahead of the depression for a few weeks, I call my psychiatrist to have my medication tweaked.

I am currently fighting to stay ahead of the depression. Since I've been getting frequent migraine attacks, it has been much more difficult to keep ahead of the depression. I've had a migraine for 15 days this month. That isn't to say that I've had a migraine 24 hours a day for 15 days. Many days I feel I'm at about a 5-7 out of 10 where 10 is feeling great and functioning normally. On those days, I sometimes have a migraine in the evening or the morning. Even so, I feel worn out and tired of trying to stay okay. My thinking and memory are boggled. I have a difficult time reading because I get mixed up and cannot remember what I read. I know the migraine attacks are diminishing in severity, so I keep reminding myself this. I know if I can just get through each day, I will continue to improve and will eventually be back to less than a dozen migraines a month.