A Visit from the Black Dog

Barking Dog
Barking Dog

I’m suffering a visit from the Black Dog. I’ve no idea how long it is going to stay. Fortunately for me, it doesn’t incapacitate me, and I doubt that people can detect it by my everyday demeanour.

That, in itself, is a problem. If you look ill, or you sport a bandage or crutches, or you reside in a wheel chair, people can tell at a glance that you are not one hundred per cent fit. That’s not to say that such people do not deserve our sympathy and help. Of course they do. But depression is invisible, unless it render the sufferer unable to function properly.

Rumination (?)
Rumination (?)

Much like with IBS sufferers, people cannot see that you are not well, and therefore don’t make allowances for you. This is compounded by the fact that depressed people want to be normal and therefore don’t mention it to people, and suppress, so far as they are able, any external indications of their problems. Outwardly a depressed person may laugh and joke, but, it’s almost a cliché, they are hurting inside. Of course I’m talking about those people who are less seriously affected.

When someone who has depression says that they feel worthless and that life is not worth living or wonders what if it is all worth it, those who they are talking to often nod their understanding. But I’m not sure if they really do understand what it is like to be depressed.

Cycle of depression
Cycle of depression

Thomas Nagel once wrote a famous piece on what it is like to be a bat. He argued that it is one thing to imagine what it is like to be a bat, but an entirely different thing to actually experience being a bat. It’s a similar situation to trying to describe a colour to a person who has been blind from birth. The blind person can intellectually understand the concept of colour, in that different coloured objects cause different sensations for a sighted person, but the blind person would not know what it feels like to see colours.

Like the blind man not being able to experience colours, someone who does not suffer from depression is unlikely to be able to understand the experience of depression. They don’t know what it is like to be a person with depression. I believe this to be the case.

Colour Blindness Test
Colour Blindness Test

On the other hand, maybe suffering from depression is normal, and everyone can experience it. Maybe it’s like grief. Almost everyone is capable of experiencing grief, but a person will not know what it is like to experience grief until they suffer it. Maybe everyone is capable of being depressed, but something external or internal needs to triggers it before they can experience it.

If so, there is hope for depression sufferers that some way may be found to stop an attack of the Black Dog before it appears in your life. Grief, like depression, can be alleviated by medicines, but has to run its course. Grief, like depression, seems endless at the time, but eventually passes.

Grief
Grief

Trying to operate normally while depressed is a strain. Why chat politely with people when you’d much rather be rolled up in a ball in a cave somewhere? Why bother to explain something that is obvious to you, and apparently causes another person difficulties? This leads to irritation which sometimes manifests as anger. Actually, I’m not sure if heightened irritation is a part of depression or the result of trying to battle through it.

When I’m depressed I hate to be interrupted. When I’m normal, I don’t like to be interrupted, especially if it happens repeatedly, and it may make me a little grumpy. If I’m depressed multiple interruptions to something I’m doing may lead to a minor explosion.

Grumpy Couple
Grumpy Couple

Complex tasks become more challenging during a depressive attack. I’m not sure if depression makes you clumsier, or whether it is the impatience that comes along with it that makes you rush things and therefore bungle them. All I know is that it is harder to do things when depressed. You know you should do them but it all seems pointless. Even if you do do them, you stuff up more than usual.

There is a mental fuzziness which goes along with it. Thinking clearly is harder and remembering things is almost impossible. Words and sentences come harder when I am writing and the Black Dog is around. I look at what I have written and it doesn’t make sense. Well, less sense than it usually does, anyway.

Confused family
Confused Family

There’s a sort of glimmer of light at the end of the tunnel, in that I know that I will come out of it. I’m not sure medication helps, as although it lifts the mood a little there is still a black cloud at the centre of my existence. I know that sounds overly dramatic, but that is what it seems like in some ways.

Looking at that last paragraph, it doesn’t really get close to what the feeling is for me. That’s the trouble. You can try to communicate feelings and thoughts, but when you look back at what you’ve said, you can see that it misses the essence of the thing. Even talking to another sufferer often ends in a stalemate. One’s subjective experience might be “a smothering cloth” while another’s experience might be “all sharp edges, harsh lights and obstacles everywhere”.

Sadness
Sadness

That’s not surprising really. We don’t know what it is like to be a bat, and we don’t know what it is like to be another person. We can only convey a little of our feeling through analogy and metaphor. It is impossible to communicate the essence of a feeling. It is impossible to convey a sense impression.

I don’t know what it feels like to you to experience the colour red, for example, though I expect that it is similar to the way that I experience red. That’s not necessarily true of course. I recall someone trying to convince me that certain Chinese characters conveyed an emotion. Well, not for me, but maybe they did for him.

Good luck charm
Good luck charm

One thing I’ve never seen mentioned about depression. It’s not a matter of depressed versus not depressed. There are levels of depression, and you don’t just sink down and then, some time later, rise out of it. No, you sink down, rise a little only to sink down again, so you may be almost out of it, only for it to pull you down again. At least, that’s what it seems like to me.

Black Dog
Black dog

 

Mental Illness

Woman diagnosed with mania
Woman diagnosed with mania

More and more people are being diagnosed with mental illnesses these days. At least that’t the way it appears. Depression, which I suffer from a little, is rife and almost everyone knows someone who suffers from depression or suffers it themselves.

Schools now have special teachers or teachers’ aides to assist in the management of children with autism and other similar conditions. Sometimes these children cause significant disruption in classrooms and measures to handle this are almost always put into place.

It is unclear whether or not there is a real rise in these conditions. It may be that better diagnosis of these conditions is the cause of the upwards trend in the number of diagnoses of these conditions. Certainly I don’t recall there being a lot of mentally ill people when I was growing up. There were always people who were “different” in some ways, and as a result were often teased or tormented by others of the same age. Hopefully that at least we have left behind us.

Mental illness - blanket man
Mental illness – blanket man

It’s in the lesser mental ailments that I think that we have seen more diagnosis and consequent steep rise. For instance, one hears of the “autism spectrum”. I had erroneously assumed that everyone was on the autism spectrum somewhere with most being on the very low end and that those diagnosed with “autism” were located higher up the spectrum.  Reading a few items on the Internet seems to prove me wrong and that there are people on the spectrum and people who aren’t.

When I was young everyone knew of someone whose mother always smelled of alcohol and who had perhaps crashed a car while drunk. Alcoholism was not mentioned as such, so I’m unsure if such a thing was recognised in those days. Alcoholics Anonymous was started in 1935, and I certainly heard of them at some stage when growing up.

AA awareness
AA awareness

Also most families had a creepy uncle who was kept away from the young girls and boys of the family. These days we have “online grooming” and paedophile registers. When I was young scandals were usually dealt with in the family, and steps were taken to avoid situations occurring that led to the scandal. Unfortunately this meant that the scandal was hidden and the victims were often made to feel guilty, when it was not their fault in any way.

With online grooming, the guilty person can be a complete stranger to the child, and this opens a whole new can of worms. Do parents severely restrict a child’s online access and police them every minute that they are online, or do they educate the children about the dangers? Obviously they need to do both. The first strategy mitigates the danger and the second prepares the child for those occasions when the first strategy fails.

Danger
Danger

When I was young, there was an occasional person who we learnt to avoid. The man on the corner with the fierce dog. The crazy cat lady who constantly talked to herself. The compulsive hoarder who built up a pile of junk in their front yard. These people are still with us, but now they have their own television programmes! They’ve always been with us, and likely always will. They are much more noticeable these days because the television programmes, but I suspect that there aren’t any more of them than there used to be.

I recall one old lady who lived alone. I think that she would, these days, be diagnosed with dementia or Alzheimer’s disease or similar. She would wander the streets in her nightie and her robe and have to be taken back home by someone, usually a neighbour or the police. Now and then one of these confused older people would wander off and get lost sparking full scale searches. This still happens today and sadly, not all such cases are resolved happily.

Dementia Praecox
Dementia Praecox

In some ways the rise of the nuclear family and the relative decline of the extended family may have led to the higher visibility of mental illness in society. The nuclear family, mum, dad, and kids has no room for those who mentally don’t fit in. The extended family however can handle the less mentally stable family members to some extent. Adult children can take turns at looking after granny, or maybe pay for grannies care between them. The cousin who is socially inept or who is slightly autistic can find a niche in an extended family.

This can lead to less visibility of much mental illness as the family is unlikely to mention such problems outside of the family and the ill person may be helped by the familiar and nurturing environment.

Asylum
Asylum

Some mental illnesses, however, can’t be handled in this way. The mentally ill person may be violent towards other or to themselves. They may be dangerous to the public, as in the case of the drunk or drugged driver. They may be so out of tune with the world that they need professional help.

In today’s world professional help is often available. In some cases drugs can be effective, as in the case of depression and bipolar disorder. In others there is the possibility of committal to a psychiatric hospital. Such places are generally not nice. The patients are generally gravely ill, and nursers and carers in the hospitals have utmost respect. Often such hospitals are underfunded and can be over crowded. Efforts to make them look better often make then look sad.

Sadness
Sadness

In the past, even in some cases in the near past, mental hospitals or asylums were places of horror. The patients often lived in squalor, were strictly restrained and were subjected to horrific “treatments”. Fortunately treatment of mental illnesses has improved significantly over the last hundred years or so. Let’s hope it continues to get better.

Of the two hypotheses as to why the rate of mental illness has increased, I definitely think that the better reporting has been the main cause. That is exacerbated by the reduction in the level at which such problems are reported. Depression would not have considered an illness at one time, for example, and autism is reported more frequently because people are aware of it. I certainly don’t believe that there is more mental illness that when we were young. It’s certainly a lot more visible.

Sadness or depression?
Sadness or depression?

The black dog

English: A black dog
English: A black dog (Photo credit: Wikipedia)

It is insidious. It can be attracted by the most innocuous of happenings, such as losing a sock. You can expect it after a mini-disaster, but it doesn’t come. It can come on a bright or a dark day, a high day or a normal day. It can come when you win the race, but stay away when you come last. You cannot predict when it will come.

I fully understand why those under its spell commit suicide. It makes any achievement worthless, makes the future into a black pit. Those who succumb may be weaker than most or stronger than most. Weaker because they give in to the black dog, stronger because it takes a sort of strength to kill one’s self.

Despair
Despair (Photo credit: fakelvis)

The black dog turns you in on your self, eats you up internally, until you are a shell. The world may see you smiling and joking, while inside you are decaying, eaten up inside like a caterpillar infected by an ichneumon fly. Everything is filtered through it, so it affects everything that you do. Everything is flavoured by it, or more correctly, over-flavoured by it. Sweetness is saccharine, bitterness is burning, sourness is acrid, saltiness is excessively salty, pungency is repelling. Everything is metallic in feel or taste or smell.

I call depression ‘entering the chrome world’. In the chrome world everything is a glitzy, like a 1950’s world in the ‘modern’ style. Everything is sharp-edged and out to snag you or harm you. All surfaces are slick and smooth and encourage things that you put down to slide and slip. Lights are neon bright and shine into your eyes. Voices are loud and raucous, high and penetrating. You know that if you put down a drink it will slide away or get knocked over, and a dropped coin will roll away either to an awkward place or will disappear. You know that this will happen, even if it doesn’t.

Chrome
Chrome (Photo credit: DeusXFlorida (3,454,860 views) – thanks guys!)

You don’t feel sorry for yourself. That would involve caring. You could be outwardly cheerful and sociable, (though it is unlikely) and yet be withering inside. More often you just want to be alone, which can upset loved ones who want to help you.

Depression makes you irritable. You don’t see why others care and it seems so pointless to you. If others ask how you feel it is impossible to say. They may have felt ‘down’, and they know that they have been able to overcome that feeling with effort, or maybe chocolate and a glass of wine, so they don’t realise that depression can’t be shifted simply by making an effort, or with simple treats. If you want someone to do something and they ask why, it can infuriate you. Petty things, like finding a knife to be blunt when you need a sharp one become frustrating out of all proportion.

English: Lots of frustration spikes experienced
English: Lots of frustration spikes experienced (Photo credit: Wikipedia)

Depression can only be alleviated by time or chemicals. Doctors will prescribe drugs to, hopefully, stop the onset of a bout of depression, or to dispel it. They seem to work pretty well, and with modern drugs you no longer need to be ‘doped to the eyeballs’. Nevertheless the depression still seeps through at times. If life is a switchback, up and down all the time, drugs can reduce the depths of the downs, but probably also reduce the height of the ups.

Depression is also associated with dissociation. More or less this is an extension of the lack of caring, about what other people do, what they might do to you. It’s like being in the cab of a truck, but as a passenger, not as the driver. The driver decides where you are going and you have no input into that. It’s as if the driver won’t even acknowledge your presence and indeed in extreme dissociation, its as if you have no physical presence in the cab of the truck.

1915 Packard Model E 2 & 1/2 ton C-Cab truck o...
1915 Packard Model E 2 & 1/2 ton C-Cab truck on display at the Fort Lauderdale Antique Car Museum. Cab from left. (Photo credit: Wikipedia)

This is not a form of fatalism as you don’t care what happens, whereas in fatalism, you might care keenly what happens but be unable to do anything about it.

Depression trumps love, and depressive people often push loved ones away. If the loved one doesn’t know what is happening that can be distressing to them and may actually create a split. Even if the loved one does know, the depressive person’s desire to be alone may be, will be, felt by the loved one as rejection.

A depressive episode is endless. By this I mean that the depressed person will not and cannot believe that the episode will end. The depressed person will not be aware, often, that they are suffering a depressive episode, so they do not know that it will almost certainly end at some stage.

English: Human Experiences, depression/loss of...
English: Human Experiences, depression/loss of loved one (Photo credit: Wikipedia)

I’ll wrap up with two points.

Firstly, I believe that it is impossible for a person who does not suffer from depression to understand what it is like, just as one could not imagine what it would be like to be a bat. Sure, one is a mental difference and the other is a physical difference, but to experience something is a mental experience, man or bat, depressive or non-depressive.

Secondly, I am not currently experiencing a depressive episode, or am anywhere near experiencing one. I can’t remember exactly how I got onto this track, apart from the fact that I was trying to find a subject for this weeks blog and this somehow came to mind. So there is no need to send out rescue parties!

Happy Face
Happy Face (Photo credit: Enokson)

Actually a third wrap up point comes to me. In discussing what makes a person, philosophers often conjecture what would happen if someone’s brain were transported into another body. My third point is the question “Assuming that it is agreed that the transplanted brain results in the transplantation of the person, would that person be susceptible to depression, or would it be possible that the new body’s chemistry would be different enough that the person would no longer suffer from depressive episodes?” Certainly a large part of our personalities are determined by the subtleties of the chemistry that takes place in our bodies, and depression can be alleviated by drugs. Maybe I’ll go deeper into that another time.

Phone Brain Transplant
Phone Brain Transplant (Photo credit: Sorbus sapiens)