Nothing but time. My psychiatrist and I agree that there is not a mental hospital, at least in DFW, that would be helpful for me. So we have an agreement that I will take meds to make me sleep. I sleep all the time for a few days, if I can, and eventually the black dog steps off my shoulders.
When I am in that black abyss, I have no interest at all in taking a walk, watching a movie, etc. I am not even capable of some of those things. My husband once asked me what I thought about when I was depressed. I truthfully answered "Nothing." He says that he can tell before the depression comes on, just by a "for away" look in my eyes. Sometimes it comes on so fast it feels like I have been suddenly hooked up to an IV.
What is dangerous for me during a black cloak, black abyss depression is that I feel I must do something about it. I feel that something is wrong and that I must fix it. I don't think rationally at all. I feel that it would be better off for everyone if I were dead. I am convinced of that. Firmly convinced. I don't leave the house, and I will tell any lie to avoid doing so. I don't answer the phone.
When that fog lifts with time, maybe just three or four days, rationality comes back. I really think my type of experience with this is different from others who are able to keep a sense of presence and rationality when they are depressed. It is not better or worse, just different.
I do have what I call a "more normal" depression. I am sad and feeling hopeless off and on for two or three weeks, but at least I can function. I wonder if that kind (for me) is depression without psychosis.
Writing this self-indulgent tripe has helped me analyze the phases of my mental illness. Perhaps some of you recognize a bit of this in yourselves.