Why don’t doctors prescribe this miracle Black Dog treatment?

Black Dog

I recently experienced a bad bout of depression which I shared via my blogI’m not OK – and why you should care. I’m delighted to confirm that I have now fully bounced back and am enjoying robust mental health again. My sincere thanks to everyone who reached out to offer support and encouragement.

As it had been 11 years since I last had a depressive episode, it was a reminder of how compromised your thinking and outlook is. Depression is a huge problem for the world and the workplace.

The World Health Organisation recently announced that depression had just become the most disabling illness in the world. It is a common worldwide issue, with more than 300 million people affected. It also has major productivity cost at work, and is estimated to account for 34% of lost productivity through absenteeism and presenteeism.

Depression is a complex illness as I know only too well. When you hear most “experts” describe how it can be treated they usually say “the only evidenced based treatments we have are antidepressants and seeing a counsellor or psychologist”.

Most people then make an appointment with their GP, and after a very short examination are prescribed medication. Medication works well for some people and not for others. It is usually best combined with working with a psychologist, but even this is far from the full picture.

I put into place 4 strategies to help with my depression – I reached out to family and friends and asked them for support, I saw a psychiatrist who prescribed me medication (which I hadn’t taken in 6 years), I walked 10,000 steps every day in September, and I re-commenced daily meditation.

I have no doubt that each of those 4 strategies played a role in my recovery, but today I want to focus on one miraculous strategy which I believe is not prescribed nearly enough.

What is the miraculous Black Dog treatment strategy?


If you want to feel better, get moving!

The link between physical activity and positive mood is beyond doubt. A meta-analysis of 25 previous studies looking at exercise as a depression treatment published in the Journal of Psychiatric Research concluded “Our data strongly supports the claim that exercise is an evidence based treatment for depression”.

In my previous book BACK FROM THE BRINK, I surveyed 4064 people who live with depression or anxiety and asked them “of everything you tried what worked the best”. I provided people with 60 options including specific medications, counselling interventions, and lifestyle strategies.

Vigorous exercise (running 40 minutes 4-6 days per week) came in at #4 and moderate exercise came in at #7. To place this in context, the first counselling intervention was #5 and first medication was #21. You can download a free copy of this research here.

Exercise was a fundamental element of my own recovery.

Why steps?

Of course any regular exercise has mood improvement benefits. I think walking is fantastic because it is free, can be done just about anywhere, and is easy to monitor. Every smart phone monitors the steps you are taking each day so it happens automatically. With steps we can start small and build our activity.

For example if you are catatonic in bed, in the first week you might just commit to getting to the letterbox. If you are moderately fit you may commit to doing 5,000 steps per day and gradually build it up to 10,000 steps. If you are fit you may go straight to 10,000 steps per day.

I found to walk 10,000 steps each day took approximately 90 minutes. The added benefit of this goal is that you have to plan when you will have that time to do your steps. This has the added benefit of providing structure to your day, which can be sadly lacking when someone is depressed.

Why should a doctor prescribed steps?

I think writing the amount of steps to take each day on a prescription pad adds gravitas to this depression treatment. In the patients mind, daily steps become a proven depression treatment to be taken seriously. It could look something like this:

Days 1- 3: 4,000 steps per day

Days 4-7: 7,000 steps per day

Days 8-30: 10,000 steps per day

Why nature?

Trees and green spaces are unrecognized healers find a recent European study which reviewed 200 academic studies for the report. It found:

“People living close to trees and green spaces are less likely to be obese, inactive, or dependent on anti-depressants.

“Overall, nature is an under-recognised healer, the paper says, offering multiple health benefits from allergy reductions to increases in self-esteem and mental wellbeing.”

Previous US research has found that that hospital patients with tree views from their windows were discharged a day earlier than those whose rooms faced walls.”

Even if you aren’t able to access a nature reserve close to home, walking in the park or in leafy street has similar benefits. Avoid busy streets.

If you are in bad shape and committing to regular exercise sounds too hard consider the following.

Start small

Starting small helps us get started and getting started is 50% of the challenge.

The idea of regularly doing repetitive exercises can be off-putting, even if we know it’s good for us. Even the phrase ‘exercise regimen’ sounds stern and gruelling. If your mood is very low, working up the energy to do much at all can be difficult.

But with small consistent effort we can take the first steps (literally) towards gradually being more active on a regular basis.

You can start by walking to the mailbox outside, and then back to your house. If you’re in a unit, walk up (or down) one flight of stairs .That’s your exercise for the day and maybe the next day. After that, maybe walk to the end of your block. The day after, to a shop a block or two away – make sure to reward yourself with a treat or your favourite snack!

These initial steps (literally) help you ease into exercise without it being too much of a big deal, and we prove to ourselves that doing it isn’t nearly as daunting as thinking about it.

Find exercise you like

Don’t like walking? Don’t do it. You can swim, cycle, or dance but it must be at least 5 times per week. If you enjoy it, you’re more likely to stick at it. Again, use whisker goals: start small and scale up.

Introducing rituals

Changing behaviour requires more than intention. To make it stick, it is essential to introduce daily rituals that prompt the behaviour. For example, rituals could include:

  • Laying your clothes you use for walking out each night when you go to bed so that when you wake up you can dress without thinking and head off.
  • Put your phone into a pocket after brushing your teeth each morning. When you brush at night, take it off and record the steps taken.
  • Set a regular time to walk with a friend or work colleagues. Consider walking meetings.
  • Work out the day before how you can walk in a park, nature reserve, or a leafy street.

Key Lesson

Physical activity is a huge boost to our mood and overall well-being, and it doesn’t have to be high-intensity or exhausting. Starting now – and starting small is key.

Could your leaders and employees benefit from more resilience strategies?

  • You can register for a free 30 Day mood boost challenge here
  • I CARE: 5 ways to help a stressed workmate– we regularly run engaging presentations, workshops, and webinars. Please email Jenny Thomson at jenny@graemecowan.com.au for further details.
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