Shoot the Damn Dog: A Memoir of Depression Read Online Free PDF Page A

might work, where another does not. They know that, for some people, SSRI antidepressants work, but they have no real idea how. Or what the long-term effects might be.
    But there is hope. It is just that we need to look further for it than in a handful of pills. We need to see depression holistically, as an illness of mind, body and soul (I hesitate to use that word but I can think of no other) and treat it accordingly.
    John F. Greden, MD, the Rachel Upjohn Professor of Psychiatry and Clinical Neuroscience in the University of Michigan Medical School calls depression the ‘under’ disease—as in underdiagnosed, undertreated and underdiscussed. As for its treatment, he is on record as saying,
    If by ‘cure,’ you mean totally eliminating the condition for ever, I would suggest that’s not the way we should think about it. Indeed, it is probably inaccurate for most. If you’re asking, can you bring people with depression to a state of remission, well-being and normal functioning, and can they remain there, then the answer is a resounding yes.
     
    I believe that, just as I believe that there is no one theory or therapy or drug that can make you, or me, better. Or keep us better. There is no simple cure or magic remedy and there are no happy pills, much as we would like to believe in them. And we do like to believe. I have lost count of the number of people who have said to me, as if it is both an admission of defeat and the end to all their problems, ‘I suppose I had better go on antidepressants.’
    Well, why not? If they work, then wonderful. Every weapon in the fight against depression is worth considering and there may come a day when a daily pill is all that’s needed. Until then, for those like me who find that antidepressants are of little or no help there is a different path.
    It is not easy, but it is possible. It embraces the various talking therapies and the daily disciplines of walking, yoga and meditation. It uses love and trust and faith—not purely spiritual faith, but faith in life itself. It requires acceptance, humility and a willingness to be open as well as constant self-examination and lacerating honesty. Those are all the tools that I have used to get better and I know that they work. Not just on me but on the others who use them too. Even those who find that antidepressants are an answer to their prayers may find some of the methods in this book useful.
    The relapse rate for depressives relying on medication alone is eighty per cent. Nobody knows quite why. Some schools of thought believe that the brain becomes habituated to a particular drug, which then loses its efficacy. Still others believe that the illness mutates or that it is not a singular illness but a cluster of conditions that, at any one time, need different treatments. The illness, like the cure, remains a mystery. When I said to my psychiatrist that it seemed to me that we were no further along than bedlam and leeches, he said that at least we knew what leeches did.
    It was that, more than anything, which brought me to the writing of this book. I may have, as the scientists put it, ‘an enduring, debilitating disease’ but I prefer to think of it as an illness that never entirely leaves us but can, with full knowledge and attention, be managed with some degree of grace.
     
     
    Nigel got his test results back and they were OK. His liver is fragile after many years on a great deal of medication. He still swears by it to control the depression he has suffered since he was in his teens. I don’t, but anything that keeps him away from those sharp corners is fine by me too.

Throat Monsters and Other Terrors
     
    Where am I? Who am I? How did I come to be here? What is this thing called the world? How did I come into the world? Why was I not consulted? And If I am compelled to take part in it, where is the director? I want to see him .
    Søren Kierkegaard
     
    I am walking down the corridor in my flat. The monster is at my throat,