You would be forgiven for thinking that the only connections that existed between dogs and depression was Churchill's metaphor the "black dogs of depression" and the lugubrious tones of that permanently morose cartoon dog, Droopy. However, thanks to our friends at the more experimental edge of the NHS, a new connection might soon be formed. They've only gone and started prescribing pets instead of pills.
At least, they have in Lewisham. The Primary Care Trust in this London borough is taking part in a pilot scheme called Contracting Collaborative, which looks for enterprising new ways of cutting down hospital admissions of regular patients - especially those with depression. One of these ideas involves stumping up the cash to buy patients their very own four-legged friend to help them on their way to recovery.
Oliver Lake from the Lewisham Primary Care Trust explains: "Under this scheme, these patients will be assigned a case worker and a budget of up to £1,000, and the intention is that the case worker and the patient will work together to produce an action plan of how to manage their needs better and target that money at those needs. What the case worker purchases with this money is flexible depending on the situation of the patient: it may be a type of chair, funding to meet transport needs, an overnight carer or possibly a pet."
Lake is quick to point out that Lewisham Primary Care Trust is not about to start prescribing mastiffs en masse anytime soon, and he rejects outright the notion that doctors could soon be bellowing orders for 90cc of bloodhound down the hospital corridors. Despite the collective raised eyebrows from some corners of the medical establishment over this scheme, the simple fact is that the acceptance of animals as therapeutic aids has grown to the point where the collective cries of "Whatever next!" have been drowned out by those who have come out in appreciation of the NHS taking a more serious approach to alternative therapies.
Maureen Hennis is chief executive of Pets As Therapy, a charity which has been making the most of the therapeutic benefits of animals for over 20 years. The not-for-profit organisation currently visits more than 4,750 different medical establishments throughout the UK, and Hennis is convinced of the programme's efficacy.
"I'm very lucky because I've visited patients with depression with my own dogs, so I've actually seen the benefits in action. I remember at one of the places we visited there was one woman who would wait for us and when we arrived she would shout, 'There's my ray of sunshine! There's my reason to stay alive!' It was the dog she was talking about, not me."
Hennis believes that the secret of the animals' success is not just that they provide patients with some comfort and companionship. She insists that our furry friends often have unique abilities to break down the barriers that people with depression often build up.
"Very often, people who are clinically depressed go off into a world of their own and they stop communicating with other people, but it has been found time and time again that the animals can get through that barrier when human contact has failed. The patients will start talking to the dogs and that opens up the door to access these people again. What we've also found is that the benefits don't end when the animals go home. The patients still talk about the visits and perhaps start talking about pets they've owned in their life. It gives doctors a way in."
Hennis isn't the only one who believes in the restorative powers of man's best friend. Iain Ryrie is the assistant director of research at the Mental Health Foundation. He thinks that the knee-jerk reaction that follows prescribing anything other than pills is because alternative therapies are seen as "airy-fairy" practices which only have a basis in "soft science".
But as Ryrie explains, the scientific reasoning behind why a dog could help combat depression is pretty sound. The benefits of people having a relationship with an animal are borne out in the masses of evidence in scientific journals which shows that recovery rates for people who have had heart attacks are much quicker for people who own pets.
Not only do pets have a therapeutic benefit for people with depression but animals can also ameliorate the circumstances that lead to depression. "There are studies which have proven that having an animal by your side makes you more attractive to other people," Ryrie explains. "So if you think about social isolation as being a contributing factor towards depression, then simply having a dog at your side is potentially going to enable you to have contact with many more people and that in itself can be therapeutic and possibly decrease your risk of developing depression."
With depression affecting one in four people at some time in their lives, the importance of understanding the problems and learning about alternative therapies that can help cannot be overstated. Increasingly, there is a backlash against the tendency of doctors to try to use pills to combat depression and a growing acceptance of the fact that there might be other answers.
"It's never just one thing that causes depression," says Ryrie. "It may be a sociological factor that originally triggers the depression, or it might be psychological, or it may be a chemical imbalance. But ultimately, within the experience of clinical depression, all of those things are going on simultaneously and not just one thing or the other. By just prescribing antidepressant medication, we target only the chemical imbalance. For someone whose depression has been brought on by the way that they've developed a very socially isolated lifestyle, simply prescribing medication is not going to make a whole lot of difference. This is where things like dogs could be very important."
But why dogs? Why not guinea pigs or tortoises? Scientist Dr David Servan-Schreiber conducted a lot of research into this question. In his book, Healing Without Freud or Prozac: Natural Approaches to Conquering Stress, Anxiety, Depression Without Drugs and Without Psychotherapy, he comes to the following conclusion: "Get a dog. If you can't get a dog, get a cat; if you can't get a cat, get a bird. If you can't get a bird, get a fish. If you can't get a fish, get a plant."
The definition of what constitutes an alternative therapy can be a tricky thing to judge. While practices such as using animals in a therapeutic setting might still be strange enough to raise hackles, it should be remembered that the relatively mainstream practices of acupuncture, osteopathy and even physiotherapy would at one time have been categorised as alternative therapies.
One treatment making its way into the mainstream is exercise. As long ago as the first century, the poet and Mr Motivator of his day, Juvenal, was promoting "mens sana in corpore sana", or "a healthy mind in a healthy body", if you prefer. Subsequent centuries have confirmed Juvenal's advice that exercise is one of the essential ingredients in both beating and avoiding depression, and an increasing number of psychiatrists and GPs are using money from their trust's budget to help patients shape up - either in the form of gym membership or through NHS-funded exercise classes.
As Ryrie explains, "Depression is often characterised by a particular pattern of thought that is circular and negative. If we go jogging or get involved with other people in a team sport, then it puts a spanner in the works of those negative thoughts. Plus it releases encephalins and natural endorphins in the brain, which are themselves antidepressant in nature. Importantly, it actually improves our self-esteem if we're able to maintain a regime of exercise."
As society grows more accepting of other forms of medicine and the awareness that illnesses can be treated by things other than a pill increases, so healthcare providers across the land are having to follow suit. The recent instance of Cheshire West Primary Care Trust leasing two allotments for use as a "green gym" - to encourage users to get fit while learning to eat more healthily - is just one piece of evidence which suggests that prescription come increasingly in non-pill form.
It is often said of Britain as a nation that we're singularly bonkers about animals and it somehow seems fitting that, given all the love, money and time we spend clearing out their litter trays, taking them for walks and feeding them, they might be able to return the favour. Not that they seem to mind doing their bit, according to Hennis.
"I always say that using pets as therapy has all-round benefits. The patients get a massive boost from it, as do the carers, because it's a much easier job to do if your clients are happy. Our volunteers get so much out of it because they like nothing better than taking their lovely dogs and cats out to people who show them love and appreciation. And of course the animals thoroughly enjoy the visits too, because they love all the attention and cuddles they get. I'm pretty sure they enjoy the odd biscuit, too!"
