Tag: medical

Popularised by Winston Churchill, the Black Dog metaphor for depression is a powerful image for this most disabling of mental health conditions. With spring nearly sprung, the sun is coming out and there is lightness of step again after the long grey of the Manchester winter. So let’s lengthen the leash a little on the Black Dog of depression and run him around the metaphorical park through the metaphorical daffodils.

This blog has been harder to write than my previous one on anxiety. Anxiety is full of energy, albeit misplaced energy with an inappropriate direction. There is a certain dynamism to anxiety, which when redirected can turn around quite quickly. Depression is more like an oil tanker (I know I am mixing my metaphors but indulge me…). It is much slower to react and to readjust. Sitting heavy and low in the water the captain knows to change direction; the steering wheel is on full lock but it is aeons later that the most imperceptible shifts start to happen.

So how to make those changes when feeling overwhelmed, sapped of energy and crushed by the weight of depression? Well as a GP I have discussions about depression all the time, perhaps even on a daily basis. People use a variety of strategies to cope. Increasingly they choose to get on their yoga mats. One of my patients suffering with depression, let’s call him Winston, has given the gift of sharing his experiences and talks about how yoga has helped him.

Winston’s Black Dog is a heavy, shaggy, energy-sapping mutt. He never noticed him creeping into the room but once the Dog is there he resides resolutely on the mat immovable and stubborn. He is brooding, resentful and passive. His negativity wafts around and is tangible not just to Winston but also to all those around him.

So without going into all the gruesome details, Winston has had his fair share of the usual interventions for depression. Medication, talking therapies, self-help materials, boundary setting and hiding under the duvet for weeks on end… They all have their place and sometimes a combination thereof was required. But for Winston, getting on his yoga mat has become his therapeutic intervention of choice. When depression bites the world closes in. He couldn’t imagine coping with all the responsibilities of daily life. But after trial and error with a variety of depression busting methods, he came to understand that what works for him, is to get himself onto a yoga mat.

Even the simplest of tasks in this mind state can be daunting. The thought of doing a full session of practice seemed overwhelming. So Winston didn’t approach it with such goals in mind. He just used the yoga as a framework to stand, to breathe then to move through one posture at a time. Soon he’s linking postures together and things start to flow. He gets just as far as he gets, with no self-recriminations.  But as time goes by his motivation to do a deeper practice starts to grow and the sessions get longer. While he is on the mat moving and breathing, his Black Dog depression is temporarily banished. So Winston explains “I feel good when actually doing my yoga practice, but initially my mood slides away and it feels like I am back to square one by the next morning”. But experience tells him that he is not back to square one. As he does his practice day by day, his dark mood lifts little by little, confidence grows and the changes move off the yoga mat into his day to day.

For Winston, the act of bashing out a few sun salutations gets him on his way. The discipline of yoga pays dividends over time.  It is by no means a quick fix. Just like the slow-to-turn oil tanker, the practice of yoga can steer you back to a healthy balanced mind and perspective. It might take weeks or months but trust that it always will. The Black Dog can be turned into a down-dog and maybe even an up-dog.