Black dog! How can we get rid of it?

I have a person very close to me suffering from severe depression.
Can you share your experience so I can pass this information to the person?
This person has been to a physiologist and psychiatrist, but no improvement.
S/he is taking medication but no help.
There is no burden on you as you are not talking to a patient.
Let me assure you, it is not me.
:grinning:

6 Likes

Hi SarathW1,

it is a great thing that you care for this person and ask advice on their behalf! Thank you for that!

It is not easy however to give a good advice if you donā€™t know the person in question. Depression can have so many nuances and can occur in so many different contexts!

One possibility why the so far attempts to treatment donā€™t work could be that the depression originated in the context of another mental (or even physical) condition that has not been properly recognised so far, like for example a trauma-associated disorder or something else. If the therapist or psychiatrist are not experienced with a certain kind of disorder they will probably not recognise them when confronted to them and then donā€™t give the appropriate treatment.

On a more general level, I once came across a little book (in German) called ā€œHow to live with the black dogā€ā€”using the ā€œblack dogā€ as a metaphor for depression just as you are doing here. Maybe you know it? The overall tone of this book, as far as I remember it, is to rather not try too hard to get rid of this dog, but to find a way to make friends with it, to live with it.

This is also in line with the Buddhist attitude of metta: Accepting ourselves the way we are right now first of all, with all the weird and painful aspects that are there. Accepting these sides in us, making friends with them. Giving these sides in ourselves as much metta and care as we possibly can. And sometimes from there some change starts to happenā€¦

I donā€™t know if all this is helpful to you, SarathW1. I just would like to encourage you and your friend. It is so good that this person has a good friend like you!

Wishing you much metta! :heartpulse::heart::heartpulse:

9 Likes

I would recommend metta meditation too- maybe one of Ajhan Sujatoā€™s youtube meditations might be nice to listen to.

Just help them remember that it is impermanent, and it will get better too. :heart:

with metta

8 Likes

There is still something else that comes to mind. It is a little advice I remember Ajahn Brahm mentioning in a talk. This was for a person with anxiety, however, but I think the same idea would apply here too.

If the person with the depression can identify a place in the body where they feel the depression that would be the first step here. Usually all kinds of emotions also have a bodily equivalent, they are represented by some kind of bodily feeling in a particular place. Maybe it could be the region of the heart, or the stomach, the right shoulder, or the left little toeā€¦ anything. If this person tries to identify the place where the depression is ā€œlocatedā€, so to speak. Just sensing into the body and trying to find out where it is. This can take hours, days, weeks, or even months, that doesnā€™t matter. Just keep on sensing until they find the spot.

And the next step would then be to find out how exactly this feels like. It can be like a pressure, like a burning, like a pain, like ants crawling along, like anything. Sometimes it can also be helpful to find out things like a colour or a texture associated with that feeling. Just to get as precise a feeling as possible. And again, take as much time for this step as needed. With each person things have their own dynamic and canā€™t be pushed.

And then Ajahn Brahmā€™s advice was to sit and attend to this ā€œdepressionā€ spot in the body and very softly and gently massage it. For a little while every day. Or if that might be too dificult for that person, have it massaged by a good friend to start with. And then see what happensā€¦

This is just one possible way to give metta and care to this depressed side in the person.

Again, much metta! :heartpulse::heart::heartpulse:

8 Likes

Iā€™ve struggled a fair amount with depression. This is going to sound stupid, but when I am very upset, I try to remember to do pushups and work out. I donā€™t always have the energy to properly ā€œget into itā€, but I find even jogging helps. Being unemployed, which I was two years ago (for almost a half a year!) also plays into it, because one ends up sitting at home doing nothing. Once ā€œsomethingā€ has been done, I find my mood has marginally improved.

10 Likes

I was diagnosed with depression at age 14-- thereā€™s a lot of mental illness in my family too. I have only found 2 things that work and that is medications and meditation (and as an extention to that, following the precepts, chanting, and studying the dhamma). I did therapy for a while too, but eventually I came to see that the way I was doing that wasnā€™t helping me. I see value in therapy as a support for meditation. Medication can take years to work out, finding the right mix.

Be supportive of your friend. They may just need your kindness and support, and most specifically a friend who is a good listener and knows you will be there any time to talk to them. If you go in with a ā€œproblem solvingā€ hat on, it may not be welcomed. Ask if they want your advice first before giving it to them. Iā€™d also sat depression isnā€™t something you ā€œget ridā€ of, but more something you live with.

11 Likes

Just a quick medical thought:

Has your friendā€™s thyroid function been checked? Thyroid malfunction is one of the most frequent organic causes for depression, and is quite often overlooked.

5 Likes

ā€œThe black dogā€ was a phrase famously used by Winston Churchill, wasnā€™t it?, who suffered from bouts of depression all through his life.

2 Likes

What medication(s)? For how long?

I ask because with many antidepressants, it can take a couple weeks of taking them before a therapeutic effect is felt. Also, it sometimes takes people a few trials with different antidepressants before they find the right one. There are so many out there and each one affects the body and brain at least slightly differently.

2 Likes

Thanks for that.
I sent a text right now.
This is a very good point.
One of the ladies working in my office has depression.
She said that she got thyroid problems and take medication.
When she forgets to take the medication she behaves so unusually.

3 Likes

I have had depression many times in my life and this is what I find works:

  • Daily Exercise to get endorphins flowing (feel good hormones.
  • Twice Daily Metta (Loving Kindness Meditation) and donā€™t start with oneself, start with all beings.
  • I took Gaba for some time (amino acid supplement) and still so in smaller doses from time to time when life gets outwardly stressful to keep my nervous system calmed down.
  • This is probably the most important. Creating a sense of purpose and doing something every day. I find the depressed people, including my own experience, donā€™t move around a lot or do a lot of things that are meaningful to them. Movement is key. The mind of a depressed person is often too dull and needs to liven up.
  • Spend time outdoors in natural sunlight (the body and eyes need sun light for health
  • Gratitude practice. Each morning before getting out of bed and each night before going to sleep, think of 3 to 5 things to be grateful for ( these can be anything, eg, Iā€™m grateful I have clothes).
  • Stop being a hermit and get hugs, even if to have to ask someone (hopefully not someone youā€™re interested in romantically). Hugs are powerful hormone balancers.

These are the things that can help get the mind out of a serious funk, but the basic practice of the Buddhaā€™s teachings are essential to correct the view and cultivating real, autonomous peace that is self generated, free from all conditions, including thought.

10 Likes

I can certainly confirm that. I had a thyroidectomy and if my thyroid-replacement-medication is either not sufficient or too much, I can get really depressed, even have panic attacks. Luckily I know now to adjust my medication when this happens.

5 Likes

I agree, though with severe depression it can be hard to really ā€œdoā€ anything at times. For me a long walk is invariably helpful, ideally in the hills or by the sea, somewhere you can really connect with the natural world.

4 Likes

True. Also having meaningful work, something to wake up enthused for, that provides a structure to oneā€™s day, takes one out of the house and to meet different people- maybe help solve other peopleā€™s problems.

I always thought it must be hard for monastics even without depression, because if someone is high functioning they might find they can do more and give more to the community. It must be difficult being on the inside looking out. Grass is greener mentality is stronger than we might imagine. I think only antidote to that is to intellectually be clear about the reasons why elements of the ā€˜other sideā€™ is less desirable and find peaceful acceptance where on is now (unless itā€™s really bad, in which case, move onā€¦).

with metta,

4 Likes

Exercise and big skies are great. There are also a number of studies showing that tai chi and chi gong are effective for treating depression.

3 Likes

You are quite right that there are a lot of different types of antidepressant medication, and there is not one that suits everybody. So it sometimes has to be a trial-and-error process.

Also, usually during the first couple of weeks of taking them most antidepressants only show their side effects (like nausea for example), not the desired effect yet. This can be quite demanding for some people. The side effects however in most cases subside by the time, and after 2 - 3 weeks the actual antidepressant effect starts to develop.

2 Likes

You should add singing to this list! :woman_singer: :man_singer:

1 Like

The person concern is a singer-songwriter and got her own record produced!
Perhaps that is the cause of the depression.

2 Likes

The question is, what went wrong there?

When I was talking of singing I didnā€™t mean doing it in a professional way; this might add much more complexity to it than just doing it for the fun of it!

But taking a deep breath and allowing oneā€™s voice to come forward in a powerful way can in itself have an anti-depressive effect.

2 Likes

I think many entertainers are depressed.

1 Like