Depression: The Black Dog and The Spoon Theory

Illustrated by Matthew Johnstone

Well, it's not something I like to comment, but since the death of my father I've  been dealing with this complex disease.

One of the most frustrating things of having this disease is not knowing how to explain it to my friends and family. As a mental illness, for most people it is very difficult to understand why you feel tired, without energy and discouraged. Constantly, they think depression is a state in which "you want to be" or "you are not doing enough to leave it behind". In addition, Chile is a country where there is not much knowledge of mental illnesses; so many people just stigmatize you and they think you're exaggerating your situation.

One of the first resources I used to explain this disease was the following video which made an analogy between depression and living with a big black dog that obstructs your life. The original idea came from Matthew Jhonstone and you can read more about his works in his page.

  Video by Alemar Psicologos

  

And a couple of days ago, surfing in Internet, I found a document written by Christine Miserandino on her blog. This document explained how is living with Lupus, but I think it also helps to understand, in a certain way, what happens when you have depression.

In this document, Christine wrote how she managed to explain to a friend of her how she felt living with Lupus. Facing not knowing how to explain to her the feelings and sensations, she grabbed every spoon on the table and also those of the surrounding tables; she handed the spoons to her friend and said, "Here, you have lupus". And so was born the "Spoon Theory".

Photo by http://fibromialgiamelilla.files.wordpress.com/

Below, there are a couple of excerpts of this document (the full text can be seen in this link):

"I asked her to list off the tasks of her day, including the most simple. As, she rattled off daily chores, or just fun things to do; I explained how each one would cost her a spoon. When she jumped right into getting ready for work as her first task of the morning, I cut her off and took away a spoon. I practically jumped down her throat. I said ” No! You don’t just get up. You have to crack open your eyes, and then realize you are late. You didn’t sleep well the night before. You have to crawl out of bed, and then you have to make your self something to eat before you can do anything else, because if you don’t, you can’t take your medicine, and if you don’t take your medicine you might as well give up all your spoons for today and tomorrow too”

“We went through the rest of the day, and she slowly learned that skipping lunch would cost her a spoon, as well as standing on a train, or even typing at her computer too long. She was forced to make choices and think about things differently. Hypothetically, she had to choose not to run errands, so that she could eat dinner that night”

When you have depression, one of the most common symptoms is fatigue. You start the day with a limited amount of energy or "spoons" either by discouragement, drugs, secondary symptoms of them, etc. Some days discouragement wins, resulting in few spoons to spend in the day and other days you have a burst of energy, so you have more spoons to spend.

Because of this, every daily life activity consumes spoons and one becomes aware of it. Working, cooking, having fun, errands, even getting up in the bad days, become very stressful activities. Many times, to carry them out, you have to prepare mentally and convince you to do it.

You start to think things like "I do the bank paperwork  or go out with my friends?". A healthy person simply does both things, but someone with this type of disease does not have enough "spoons" to spend on both. 

I perfectly remember one day when I was looking forward to get home and work on my scrapbook album, but also I had to go to the market. Go to the market was obligatory, because I hadn't enough things for the rest of the week, so the idea of scrapbook was set aside and this frustrated me in a big way. While I was buying angrily at the market I thought "I will try to work on my album anyway". But as I anticipated, I was too tired and I just went to sleep, leaving the scrapbook for another day, though it frustrated me.

  

When someone with depression says "sorry, I can not go, I'm too tired" or "I have no energy to do X activity" is something real, not an excuse. These people spent all their "spoons" in doing things the entire day.

And where I'm going with all this? The idea of this post is that healthy people have better understanding of someone who goes through this type of disease and that people with depression or chronic diseases have a better way to explain how they feel.

Dealing with mental illnesses is very exhausting, for the patient and for the people around them. Both sides should try to communicate what they feel in the best way possible and foremost, they must have a lot of patience and love.

I have been in therapy with a psychiatrist for some time and I think I'm getting better, or at least now I realize the things that discourage and make me feel bad. I am working so the black dog leave me and to have more spoons in my life:)

Hugs for everyone!