Get thee behind me, black dog

Recognizing when you need help and getting it.

By Emily Willingham, DXS editor-in-chief

[Trigger warnings: language about depression.]

Unless you know me well, you might not be able to tell. I smile, I laugh, I get my work done and parent and teach my children and get dinner made (almost) each evening. Yet for about three months, I’ve been struggling every day, with every thought, against what Winston Churchill called the “black dog” of depression, a family legacy that until now has visited me only on a rare day of the blahs here and there. But this dog seems to have come to stay, and the effect is pervasive and persistent, washing all of my experiences, little and large, of their life colors.

I’m not sure what triggered this episode, or if there even was a single trigger. There’s no doubt that my life has been chaotic recently, with a long, complex move and a few weeks of uncertainty about everything from where my family would live to what my husband might be doing for a living. But this particular dog came to visit before all of that chaos and uncertainty set in. I could also blame various factors about my personal life and career–or lack of–which have left me with a sense of anhedonia so heavy that even the simplest, loveliest episodes in my recent experience have left me remarking, like a stoned college student experiencing a nihilist epiphany, “So what? None of it matters anyway.” The horrific tragedy in Connecticut and shameful, nauseating turns the subsequent conversation has sometimes taken might be a factor. Or it could be my health, my age, being peri-menopausal, my encroaching midriff that makes me think of the Michelin man when I sit down, my sense that somehow, I’ve just left my prime behind me, and what comes next?

The thing is, because of the pervasiveness and persistence of this particular visit from the black dog, I’ve decided to abdicate to a professional much of the responsibility of figuring out the whys. For the first time in my life. It’s the right thing to do for me, and it’s the right thing to do for the people who love me and whom I love. My self-talk has become downright abusive, I think so little of who and where I am right now. I’m naturally impatient, but my impatience and irritability have me snappy and irascible with my spouse and children beyond my own norm. I’m always, always exhausted and can’t remember the last time I woke up from a night of rest feeling like I’d had one. I’m not a morning person, but I keep waking up two hours earlier than usual, unable to fall asleep again.

All of these things–irritability, poor sleep, a persistent feeling of fatigue, early waking–are signs of depression. Did you know that? This information and these essays that we’re planning to publish in the coming weeks are intended to serve two purposes: We hope to educate people about what having a mental illness means and how to recognize when you might have one and seek help.

Kathleen Sebelius, U.S. secretary of Health and Human Services, wrote recently in a USA Today commentary about our nation’s progress in mental health research. She noted that “people will only take advantage of this progress if they are not afraid to seek help. Now is the time to work together to banish those fears and bring mental health out of the shadows once and for all.”

I agree. I don’t know that I have a mental illness. What I do know is that if I had been experiencing any other derailment of my capacities for this period of time, most clinicians would consider that an indication to seek professional help. Have a cough that lasts more than a week? See a doctor. A physical pain that persists beyond a few days and doesn’t respond to over-the-counter relievers? See a doctor. Shouldn’t we have the same straightforward advice–and support and coverage–for people whose mental pain persists past a certain period of time or reaches a certain intensity?

So I’m taking Sebelius’s advice, which has proved timely for me, and am seeking to shake off the shadow of that dog. I have recognized that I might be struggling with something that my usual coping tactics can’t manage, and I am turning to help. If anything I’ve written here twangs something in your psyche, please consider doing the same.

U.S. Resources: National Alliance on Mental Illness, National Institute of Mental Health

Image credits: Labrador teeth by Oakey Originals, Hound of the Baskervilles plate, public domain in US.

[Editor's note: We began our "I Am Mental Illness" series with this post by Carrie Arnold about her battle with anorexia, which meant also battling a lot of other unexpected foes. Friday, we post the next installment in our series, addressing bipolar disorder.]

This entry was posted in Health, I Am Mental Illness by Emily Willingham. Bookmark the permalink.
Emily Willingham

About Emily Willingham

Emily, co-founder and editor in chief of DoubleXScience, is an editor and a research scientist whose investigations involve sex determination/differentiation and developmental endocrinology, toxicology, genetics, and physiology. She also is the ambigendered partner of a Viking and the mother of three very interesting sons.

13 thoughts on “Get thee behind me, black dog

  1. It’s terrible and ironic that depression often robs you of the agency and motivation needed to take steps to get help. Unlike an ache or pain that might motivate one to seek medical help, depression demotivates you. I’m glad you’re taking the first step, Emily.

  2. Your first three paragraphs sound so familiar I could have written them myself (though much less eloquently!)

    However, for me, a further barrier to seeking help is skepticism about just how ‘helpful’ it will actually be. I believe there isn’t good evidence for anti-depressant medication compared to placebo, especially in mild-moderate illness. And while some may talking therapies useful, I wonder if there’s much in them that can’t be gained by reading a book and some self-reflection. I plan to carry on doing all the ‘right’ self-help things, and hope the clouds lift eventually.

    I do wish you the best with finding the help you need though, and thank you for sharing this.

  3. I have also struggled with depression. I have been able to evaluate the efficacy of various purported natural remedies and, to my delight, some really work well in my case (YMMV of course!). I have compiled a list of depression remedies here: http://bit.ly/M4nytr. Just scroll down to the depression section. Good luck.

  4. Beautifully said. So true about how damn hard it can be to acknowledge mental pain, let alone seek treatment. Oh, for the day when people realize that dismissing mental imbalances/anomalies/disorders of ANY kind with, “It’s all in your head” makes as much sense as telling someone with nephritis, “It’s all in your kidneys.” Hope this gets you where you need to go.

    And for what it’s worth, your writing’s terrific. I’ve been reading your posts since Science Online last year, and would have told you so at the conference last week—except I’m an enormous dork who’s still working on that whole talking-to-people-you’ve-never-met thing.

  5. This is a beautifully written piece, but at least one sentence needs to be placed in context. Physical symptoms of depression such as fatigue and sleep problems are transdiagnostic meaning they are also symptoms of many different diseases. It is tragic when they are misdiagnosed – either way.

  6. Thanks for all the kind comments and information. @KAL … excellent point, and thanks for highlighting that. @Sarah … with total respect, do you have any links for studies that bear that out? It’s been my understanding from the literature I’ve seen that a mix of pharmaceutical intervention and non-pharm intervention shows greatest efficacy in many situations, so I’m interested in seeing the reports finding no difference between pharmaceutical interventions and placebo. In my case, at least, reading a book and engaging in self reflection has not proved efficacious.

  7. Excellent post – particularly the use of ‘anhedonia’. ‘Acedia’ can also be a problem (precursor to anhedonia – see Kathleen Norris’ ‘Acedia and Me’). Thanks for posting this under your own name – people need to understand that the person they see as functioning perfectly on the outside may have some serious internal issues.

  8. Pingback: I’ve got your missing links right here (9 February 2013) – Phenomena

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