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Dog gone

Interview by Catherine O’Brien May 23, 2007

The Black Dog, symbolising depression and made famous by Churchill, was the bane of ad executive Matthew Johnstone’s life – until he put it in a book and brought it to heel.

Matthew Johnstone’s meteoric career as a creative director in advertising took him from Sydney to San Francisco and New York, earning him a clutch of awards on his way. He was a man who appeared to have it all – and yet, for many years, he hid a dark secret. He was suffering from clinical depression. “Advertising is about being shiny and up. You are a showman, a people pleaser, someone who makes life beautiful,” he says. So although he often felt flat and empty, he learnt to hide it well.

Today, at 42, he no longer has to. I Had a Black Dog, the book he wrote about his illness, has become, paradoxically, the most prominent achievement on his CV. A slim volume of 38 cartoon-like drawings about a man whose life is overshadowed by a black labrador, it is already a bestseller in Australia and his native New Zealand. According to Stephen Fry, the actor, writer and well-known depressive, it says “with wit, insight, economy and complete understanding what other books take 300 pages to say”.

Black Dogs have been used as a symbol for depression since Celtic times. Winston Churchill famously used the metaphor to articulate his own struggle with melancholia. Johnstone’s book makes the leap from words to image with the deft resonance of an ad-man’s storyboard. The strength of his illustrations is their simplicity – the Black Dog that lay between him and his wife in bed suffocating their intimacy, the dog that chased away his confidence at social gatherings and the dog that chewed up his memory and ability to concentrate at work.

Johnstone cannot remember when he first began to think about his depression in Black-Dog terms, but he can remember, with absolute clarity, how the idea of the book came about. He was living in New York at the time of the September 11 terrorist attacks and was a block away from the World Trade Centre when the first tower collapsed.

“I watched as several people jumped or fell from the large burning holes,” he wrote in a diary essay afterwards. “One man fell face down with his arms and legs outstretched, like a cat anticipating a jump, his tie flapping furiously over his shoulder. I remember thinking ‘that man is still alive’. It truly felt like the end of the world.” Like so many survivors, he found witnessing such dreadful scenes was a watershed. “I had been drifting along, not facing up to who I really was – and that was my wake-up call.” Six months later he went one Saturday to the empty offices of his ad agency “and in the space of an afternoon I wrote the book you have in your hand. It was the easiest thing I have ever done. It fell out of me like a boulder. It was like putting my lifetime’s experience on to the page.”

Johnstone now recognises that his depression first surfaced when he was in his early twenties. A farmer’s son from Christchurch, he was no stranger to the condition. His mother had been severely depressed during his childhood and his eldest brother suffered from bipolar disorder. After graduating, Johnstone moved to Sydney, where he worked for Saatchi & Saatchi. He found himself surrounded by men who “would rather pull their pants down drunk than talk about themselves sober”, and was happy at first to immerse himself in the fast-paced, work-hard-play-hard advertising industry culture. As he became more successful, however, he began to suffer from insomnia and lethargy. “It wasn’t like I was depressed all the time. It came in waves and while the waves were quite small, I could muster the energy to struggle on through. Most people around me had no idea. But the waves got bigger, and because I hadn’t taken care of myself, by my mid-thirties they were like a tsunami.” He made the classic life choices of someone with depressive tendencies. “I changed jobs regularly, relationships regularly and countries regularly. I had that thing ‘if I just do this, go there, I’ll be OK’. It was all about running away from what was happening inside.”

And his career path didn’t help. “I was a typical creative – an insecure perfectionist. Advertising is like the never-ending sand dune – you scramble to the top, only to tumble down the other side. You live in fear that you will never be as good as your last ad.”

At 32 he took a year out and went travelling. “I can see now that I was unwell. I had come out of a rough relationship, I was burnt out at work and I wanted to get away. I bought a Scooby Doo van and made plans to fly to America. At my leaving party, friend after friend told me what a brave and fantastic thing I was doing. But inside I was terrified.” He spent a year driving 15,000 miles down the West Coast from Canada to Mexico. “I just roamed and spent my time bumping into people in robes – cults and crazy people. I hung out with a guy who had spent ten years walking barefoot around America.”

He ended up in San Francisco, where he got a job in advertising again. “But then the Black Dog came back into my life.” The pictures in his book illustrate more eloquently than he can in words how his depression felt. It confronted him when he looked in the bathroom mirror in the morning. It ruined his appetite and woke him in the early hours, forcing repetitive, negative thoughts into his head such as “I am a loser”, and “I wish I could just disappear.” At its worst, he says, “depression isn’t about feeling down, it’s about being devoid of feeling altogether”. Over the years he had contemplated suicide several times, but he never attempted it. “I think suicide is like the stop sign at the end of a long road. For me, the thoughts were never about leaving people or life behind, it was about wanting peace and quiet. There were moments when I just craved tranquillity.” While in San Franscisco he finally sought help and dysthymia was diagnosed – a chronic major depression.

The condition being officially diagnosed was devastating. “Obviously I knew something was wrong, but it meant I could no longer pretend, to myself or to others, that I was basically OK.” He was prescribed antidepressants and had therapy – an experience about which he has mixed feelings. “I spent too long seeing a horrible psychiatrist who didn’t even say hello or goodbye. One of the crucial things is to find someone you can relate to.”

He credits Ainsley, the woman who is now his wife, for steering him through to recovery. They had known each other in Sydney, where they worked for the same agency and had a brief office romance. They met again in America and began living together, first in California and later in New York. “Ainsley was great. It is not easy loving and caring for a depressed person. But she is a pragmatist, very grounded and solid. I’m lucky that she was prepared to stay the course.”

About one woman in four and one man in eight will suffer from depression at some point. Research suggests that it can be triggered by chemical imbalances in the brain, but as an abstract illness it can be hard to explain to others. Paul Gilbert, professor of clinical psychology at the University of Derby, says Johnstone’s method of visualising a Black Dog helps by externalising the depression. “He presents it as something that happens to you, rather than the ‘real you’ and that can be constructive. It helps patients to see that they are not at fault or a failure, and to realise that they are not alone.”

Johnstone describes I Had a Black Dog as a “drawbridge” book. “Depression is complex, but what I think I have achieved is a way of communicating some of the feelings in simple terms.” He remembers showing it to a friend, “the sort of woman who claimed to never have understood what all the fuss was about. She read it and burst into tears. That has happened with a lot of people. Everyone who has seen it has got their own story.”

Johnstone and Ainsley moved back to Sydney and married in 2004. They now have two daughters, aged 3 and 18 months. Fatherhood proved a helpful antidote. “Depressive people are self-indulgent. We can’t help it. But children are like natural leeches, they draw you out and you have to be there for them.” He is still creating ads, but also working with Ainsley on another book aimed at those who care for depressives and is enjoying the balance that being an author brings to his life. “The ad world is sort of unreal, but this is authentic.”

Part of his wake-up call on September 11 had been the realisation that he was leading an “inauthentic life”. “Ironically, I was at the peak of my career, earning more than I had ever done, winning big business, but I wasn’t happy. It’s hugely satisfying to know now that, through the book, I am making a difference.” He no longer takes antidepressants, but he sees a psychiatrist once a month. “It is like going to the gym – a workout. I get any issues into the open before they have a chance to get bigger.” He also carefully monitors his diet and lifestyle.

“Managing depression is about good food and good rest. When I was stressed, I was drawn to carbohydrates and sugar. I avoid those now, and I’ll have a beer, but I don’t get trashed like I used to. For the depressed, alcohol is often an excuse to self-medicate.”

Churchill’s advice was: “If you find yourself going through hell, keep going.” Johnstone echoes the sentiment. “The hardest thing when you are depressed is thinking that there is no way out. But with the right steps, those Black-Dog days do pass. My Black Dog may reappear, but I’m equipped now to deal with him. I’ve brought him to heel.”

Depression in numbers
Kate Wighton May 23, 2007

One in five people are thought to be affected by depression at some point in their lives.

Over 31 million prescriptions were written for antidepressants last year in the UK - a 6 per cent rise since 2005.

Selective Serotonin Reuptake Inhibitors (SSRIs) – which include Seroxat and Prozac - are the most commonly prescribed antidepressants. SSRI use increased by ten percent last year. They prolong the effect of the mood-boosting chemical serotonin, by letting it linger in the body.

Depression costs the UK 9 billion a year in treatment, benefits and lost revenue.

SSRI effectiveness is disputed – a big cheese at drug company GlaxoSmithKline admitted that “a majority of drugs only work in 30 to 50 percent of people.”

One in ten UK youngsters (aged 5-16) has a mental disorder – nearly one in twenty has anxiety or depression. Boys are more likely to suffer than girls.

Between 1992 and 2001, prescriptions of SSRIs for under-18s increased ten-fold.

The National Institute for Health and Clinical Excellence (NICE) – the body that recommends what doctors should and shouldn't prescribe – said that SSRIs shouldn't be used as a first-stop remedy for mild to moderate depression.

93 percent of GPs prescribe antidepressants because of a lack of alternatives, according to the mental health charity Mind.

One in five mothers may suffer from post-natal depression, according to a recent survey from The Royal College of Midwives.

Prozac is the world's most popular antidepressant, with 54 million users.

Despite our depression-addled age, the UK suicide rate is at it's lowest since records began – 8.5 deaths per 100,000.

One in seven UK adults has considered suicide at some point in their lives.

Anxiety and depression is the most common form of mental illness in the UK – affecting 9.2 percent of adults. Women are affected more than men – 11.2 percent compared to 7.2 percent.

Irish-born people have higher rates of suicide than any other ethnic group in the UK.

Black men have the highest rate of admissions into psychiatric hospitals.

Depression and anxiety account for one third of all work days lost to ill health.

The sales of self-help books on Amazon rose by 40 percent last year.

Around 20 percent of a GP's time is taken up by mental health problems.

The most common causes of depression are work and relationships.

Suicide is the commonest cause of death in men under 35.

Women are more likely than men to have multiple episodes of depression.

85 per cent of people who have tried a complementary therapy for depression found them helpful, according to the Mental Health Foundation.

Even dogs get the blues – Reconcile is a newly launched beef-flavoured antidepressant for pooches.

In a recent study, 90 percent of depression sufferers said that a 30 minute walk in the park boosted their self-esteem.

The World Health Organization predicts that depression will be the second largest single cause of ill health by 2020.

Almost 80 percent of people in the UK have at least 2 friends who have experienced mental illness.

No longer a career-killing taboo – stars who have been open about their mental illness include Johnny Depp, gardening guru Monty Don, Stephen Fry and Robbie Williams.

4% of those with depression and anxiety disorders received psychological therapy in the past year.

Experts say the cost of therapy is about £750 for each patient. The benefits to the economy (less time off work etc.) would be £1,880.

Private counselling sessions cost around £40 an hour.

More than 90 percent of primary care trusts have waiting lists of over a year for cognitive behavioural therapy. Experts say we need 10,000 extra NHS therapists.

See also
Spinning the blues
Cognitive Behavioural Therapy

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