Graphic Medicine Novels: Living with a Black Dog

Author Matthew Johnstone has experienced depression for over 20 years. His approach to writing Living with a Black Dog is not exactly as a personal memoir, though, but rather a general commentary on depression. He calls it “a visual articulation of what it is like to suffer from depression” (p. 44). The power of the book, then, is often through the images, which are paired with relatable insights about depression. As the title suggests, depression is anthropomorphized as a black dog. Using this symbol, Johnstone illustrates what it’s like to have depression and what can be done to overcome it. The book concludes with a reminder that the black dog may never go completely away, but it can be tamed.

The value of Living with a Black Dog lies heavily in the images. Johnstone repeatedly uses the symbol of the dog to convey depression’s complexity. For example, one image shows the dog sitting on a kite string, effectively revealing how Johnstone has lost the ability to fully engage in enjoyable activities. Another shows the dog sitting on a plate of food, illustrating how depression can affect a person’s appetite. The accompanying text is very straightforward in its message. Overall, the book is very easy to read and understand.

One by one, Matthew Johnstone uses words and pictures to describe symptoms of depression. He touches on the loss of interest in activities, changes to diet, loss of memory and focus, social anxiety, loss of libido, insomnia, self-destructive behaviors, and suicidal ideation. In regards to the most common symptom, persistent sadness, he describes how there’s a bit of a spectrum: “There are different degrees of feeling when you have a Black Dog in your life. At one end of the scale you may feel sad, flat, teary, or blue, and at the other, you are devoid of feeling altogether, and life is overwhelmingly difficult” (p. 1).

Many of the humanistic revelations in Living with a Black Dog are contained within the artwork. Johnstone takes advantage of the comics medium to convey difficult-to-understand symptoms, such as feeling as though you need superhuman strength to move, or feeling old and beaten down. The written commentary does a nice job of elucidating certain complexities, as well, such as the common instinct to hide one’s diagnosis: “People who have a Black Dog in their lives often fear that someone will find out. They fear being judged or talked about or having responsibilities taken away. They develop incredible reserves for putting on a brave, happy face, becoming like magicians who constantly pull rabbits out of hats to please the crowd” (p. 12-13). Another compelling insight can be seen on the pages that show how depression can impact one’s ability to communicate respectfully, which can have a devastating effect on a person’s relationships.

Living with a Black Dog does a marvelous job of using images to convey what words cannot. As the author says in the acknowledgments, “you can use this book with partners, parents, siblings, friends, and even doctors and therapists…it is a visual tool that may help you or someone you know” (p. 44).