Beginning Treatment for Depression

Before we can construct a programme for taming your depression you need to sharpen your knowledge of yourself. This means becoming consciously aware of your present circumstances and lifestyle and how this is interacting with your depression. You are now going to undertake an interesting research project which will reveal to you the nature and habits of your own Black Dog.

To start with you will need to have a one-page-a-day or two page-a-day pocket appointments diary, ideally with the hourly time slots already printed. In it record the time, circumstances and nature of your Black Dog attacks, from the moment you awaken to going to bed. There is no need to write an essay, just a few jottings are more than adequate. At the same time record what you eat and drink.

Wednesday 21/04/04

7am Woke up. Black Dog. Frightened of getting up. 10 mins to creep out of bed. Tea, dress, toast and marmalade, coffee.

8am Walk 30 mins.

9am Office, feeling better.

11am Project meeting. Felt incompetent. Everyone else chirpy.

1pm Half bottle of wine and sandwiches with the guys.

2pm Weary. Long afternoon. Fearful, can't cope.

6pm Two pints of beer with the guys, feeling better.

7.30pm Chinese takeaway, half bottle of wine. Slept in front of television.

11pm Bed. Weary and down-hearted.

Alcohol

There are many contributory causes of depression, irrespective of whether the affliction is temporary or whether you have inherited a propensity for the beast. Keep an accurate account of what you drink, how much you drink, when you drink and why you drink. Be honest with yourself - there is no reason why you should not be. Nobody else will know.

Food

Similarly, meal times and menus should feature in your daily diary, as well as snacks and comfort eating. Skipping breakfast, snacking and eating late evening meals will impair your defences significantly.

Leisure time

Record when, how and with whom you spend your leisure time. Note down how you felt before, during and after.

Drugs

Have you started to use drugs to assuage the pain of depression? If you use drugs, keep an accurate account in your diary of what you take and when.

Weekly and Monthly Digest

Each Sunday write down in your diary those features of your depression which are recurring and the current status of the things that are threatening and worrying you, like credit card payments, your partner's behaviour, salary or promotion - any of your fears. Similarly, at the end of the month write up a digest of the four weeks. You should now perceive a pattern, revealing the days, times and circumstances when depression strikes.

What to do Next

When the Black Dog is prowling again you will know the unresolved issues that are encouraging it. The sooner you can shake them out and rectify them, the sooner you will have tamed or perhaps even defeated your depression.

When you wake up feeling weary and fearful, or are unaccountably filled with apprehension about an impending telephone call that you have to make; when you feel overwhelmed by the schedule of tasks before you; when you experience rising panic and screaming incredulity because your partner or colleague cannot immediately recognise your view point, you know that it is the Black Dog and you now know the likely causes of depression, so you are in a position to handle them and tame it.