10 Ways For Lawyers to Deal With Their Depression

A lawyer with depression used to call me once a month. He’d sometimes weep as he told me about the myriad of ways that his depression was disrupting his work and personal life.

I’d listen each time, for about fifteen minutes or so.  I thought I was helping him by offering a compassionate ear.

The conversation would always end with, “catch you later.” 

This went on for six months. 

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During our talks I’d make suggestions about things he could do to help himself.  It seemed to go in one ear and out the other. Despite all the pain in his life, absolutely nothing changed for him.

I finally got to the point where I said, “Bob, what are you willing to do to change your life?”  He seemed surprised by the question.  There was a long pause on the other end of the phone. 

He then said, “Catch you later.”  And he never called again.

Making a Choice to Change Things in Your Life

A hallmark of depression is that those afflicted feel that they have no choice: they victims of their depression and powerless to change it.  In the final analysis, that’s what happened with Bob and why things never changed for him.

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In her book, Listening to Depression:  How Understanding Your Pain Can Heal Your Life , psychologist, Lara Honos-Webb, takes a somewhat unique view.

She maintains that depression isn’t just as an “illness”, but as a wakeup call; a powerful warning that we have been traveling down paths in our lives that have been untrue to who we really and, as a result, have gotten sick because it.  She encourages us not to see depression as just a disease, but as an opportunity to change our lives.  There is something in us, she writes, if we would only listen, that is telling us that we are killing ourselves. 

But depressives, like my friend Bob, often don’t listen to the early warning signs.  So that inner voice just turns up the volume until we get sick with anxiety and depression – or heart disease, hypertension and cancer. 

I would like YOU to challenge a conclusion that you might have reached about yourself: that you can’t change.

I believe if you’re going to heal and grow, however, you’ll need to come to see life as a series of choices rather than inertia.  Richard O’Connor, Ph.D. once said, “While you’re not to blame for your depression, you are responsible for getting better.”

What old behaviors are you willing to change or what new behaviors are you willing to try to help you get better?

1.   Get help

You can’t handle this by yourself.  It’s not your fault.  It is a problem bigger than any individual person.  There are Lawyer Assistance Programs in most states that can get you started in the right direction, provide resources and help you with referrals.  Click here to search by state for a program nearest you.  While this advice sounds self-evident, believe me, it is not.  Recent statistics reveal that eighty percent of Americans don’t get any help for their depression.

2.   Maybe you have to take medication

That’s okay.  You may have a chemical imbalance that you need to address.  For many, psychotherapy won’t help until they quiet down their somatic complaints (e.g. extreme fatigue, sleep problems) so that they can have the energy and insight to work on their problems. However, “one size doesn’t fit all.”  Medication can – and is – over-proscribed.  I also have a problem with family physician diagnosing depression and recommending antidepressants.  In fact, such doctors write eighty percent of the scripts for antidepressants in this country.  Better idea:  go to be evaluated by a well-regarded psychiatrist who specializes in mental health. Check out HELPGUIDE.org, a not-for-profit organization, for a balanced overview of the pros and cons of medication.

3.   Negative Thinking

Whether you will need medication or not, you will need to confront your negative thinking with a therapist.  You really can’t do this effectively with friends or family alone.  A lot of research suggests that cognitive behavioral therapy is a particularly effective form of treatment for depression.  It teaches us that a large part of depression is made up of cognitive distortions.  One example is the all-or-nothing thinking approach.  Lawyers often think to themselves that they’re either “winners” or “losers” in the law. This is a distortion because the reality is that most lawyers both win and lose in their careers. Check out this excellent website article for a list of other cognitive distortions.  I recommend interviewing a couple of therapists before you settle on one.

4.   Exercise

The value of exercise is widely known:  It’s is simply good for everybody.  For a person with depression, it becomes not just about a healthy habit, but a critical choice.  In his book, Spark: The Revolutionary New Science of Exercise and the Brain, Harvard psychiatrist, Dr. John Ratey devotes a whole chapter to the importance of exercise in treating depression.  Please check this book out.  Also check out this short article from the Mayo Clinic about how exercise can help with the symptoms of anxiety and depression.

5.   Spirituality

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If you have a spiritual practice, do it.  If you don’t, think about starting one. This could include anything from a formal meditation practice, going to Mass or just taking a walk in the woods.  A lot of research suggests that people who do have a spiritual practice do better with depression.  If you believe in God or a higher power, you can avail yourself of help and support from Someone who is bigger than your depression.  If you do not believe in God, maybe you believe in some other form of spirituality you can tap into.  Spiritual growth and development, in my opinion, is an important pillar of recovery.

6.   Join a support group 

I started a lawyer support group in my community and it has been going strong for seven years.  Such groups can be invaluable in helping you to see that you are not alone and that others share in the very same struggle.  Contact a Lawyers Assistance Program in your state.  If you don’t feel comfortable being in a support group made up of lawyers, there are plenty of other routes to go.  Check out the website run by The Depression and Bipolar Support Alliance.  They run depression support groups meetings in all fifty states.

7.   Get educated

Read some good books on the topic of depression.  As part of your education, learn about the powerful connection between stress, anxiety and depression.  I recommend you read Dr. Richard O’Connor’s, Undoing Perpetual Stress:  The Missing Connection between Depression, Anxiety and 21st Century Illness.  Dr. O’Connor opines that depression is really about stress that has gone on too long.  The constant hammering away of stress hormones on the brain changes its neurochemistry.    This can and often does result in anxiety disorders and clinical depression.  I list a number of other great books on my website at Lawyers With Depression.  The site also offers guest articles, news, podcasts and helpful links for lawyers.

8.   Build pleasure into your schedule 

As busy lawyers, we have the “I will get to it later” mentality – especially when it comes to things that are healthy for us.   We have to jettison that approach.  We must begin to take time – NOW – to enjoy pleasurable things.  A hallmark of depression is the failure to feel happiness or joy.  We need to create the space where we experience and savor such feelings. 

 9.   Restructure your law practice

Nobody likes changes.  Lord knows, I don’t.  Yet this pointer falls into the category of “what are you willing to do?”  Maybe you will have to leave your job.  Is this stressful?  Yes.  Is it the end of the world?  No.  Maybe you will have to change careers.  I have spoken to many lawyers who haven’t been particularly happy with being a lawyer since day one.  But they kept doing it because they didn’t know what else to do, the legal profession paid a good buck, they didn’t want to seem like a failure, they were in debt, etc.  I am not trying to minimize these very real concerns.  However, your good health (as I learned the hard way) has got to reestablish itself as a top priority in your life.  I changed the nature and variety of my practice and am the better for it.  I do less litigation.  As a consequence, I have less stress, which has been long known to be a powerful trigger for depression.  It can be done.

10.   Practice mindfulness in your daily life

A lot of attention has been focused on the use of mindfulness lately as a way to help depression.  In mindfulness meditation, we sit quietly, pay attention to our breath and watch our thoughts float by in a stream of our consciousness.   We habitually react to our thoughts (e.g. “I will never get this brief done”).  In mindfulness meditation, we learn – slowly – to let the thoughts and feelings float by without reacting to them.  If such an approach to depression seems far-fetched, read the compelling book, The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness, for an excellent primer on how you can incorporate mindfulness into your day. Check out this article written for my website by one of the book’s authors.

In closing, I often tell lawyers to remember, to “be kind to yourself.”  When I say this they usually look puzzled – like many a judge who has listened to my oral arguments. They’ve rarely, if ever, thought about it and don’t know how to be kind to themselves.  I believe that it first begins with a conscious intention – “I am not going to treat myself poorly anymore.” 

Depression is often built upon poor mental/emotional and physical habits.  Such inner pain can bring people to the point where we they’ve had enough.  As one friend of mine said, “You get sick and tired of being sick and tired.”

 

The Depression Machine: Why Too Much Stress Cranks It Up

I listened to a NPR segment this week about the connection between playing football in the NFL and brain trauma.

One retired running back said that each collision he suffered during a game “was like being in a car accident.” What a tremendous cost to pay, I thought.

For many of us, daily life is so demanding and stressful, that, like a football player, it’s like being in a series of car accidents. The word “stress” doesn’t even seem to do justice the corrosive experience of so much stress– “trauma” is more like it.

The trauma isn’t the type inflicted by bone jarring hits during a football game — it’s psychological, though no less real.

trauma

In his book, The Everyday Trauma of Life, psychiatrist Mark Epstein writes in a recent New York Times article,

“Trauma is not just the result of major disasters. It does not happen to only some people. An undercurrent of trauma runs through ordinary life, shot through as it is with the poignancy of impermanence. I like to say that if we are not suffering from post-traumatic stress disorder, we are suffering from pre-traumatic stress disorder. There is no way to be alive without being conscious of the potential for disaster. One way or another, death (and its cousins: old age, illness, accidents, separation and loss) hangs over all of us. Nobody is immune. Our world is unstable and unpredictable, and operates, to a great degree and despite incredible scientific advancement, outside our ability to control it.”

Such trauma not only impacts our psychological/emotional and spiritual selves, but our physical brains.

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In a brilliant article in The Wall Street Journal this week entitled, “Stress Starts Up The Machinery of Major Depression”, Robert Sapolsky, Ph.D., points out that there are many factors that increase our risk of major depression including genes, childhood trauma, and endocrine and immunological abnormalities.

But a frequent trigger is stress.

Sapolsky writes, “The stress angle concerns ‘adhedonia,’ psychiatric jargon for ‘the inability to feel pleasure.’ Adhedonia is at the core of the classic definition of major depression as ‘malignant sadness’”.

As a person who has a genetic history of depression in his family and childhood trauma, I was drawn into Sapolsky’s article. What was the connection between stress and the malignant sadness I’ve experienced off and on since being diagnosed with depression twelve years ago?

Who would have thought that rat brain research would help me understand the link?

Sapolsky gives us a little background about our brain structure by letting us know that our abilities to anticipate, pursue and feel pleasure revolve around a neurotransmitter called dopamine in a region of the brain called the nucleus accumbens. Then he turns to the rats for further illumination:

“Put a novel object – say, a ball – in a mouse’s cage. When the mouse encounters the ball and explores it, the arousing mystery, puzzle and challenge cause the release of a molecule in the nucleus accumbens called CRF, which boost dopamine release. If an unexpected novel object was a cat, that mouse’s brain would work vey differently. But getting the optimal amount of challenge, what we’d call ‘stimulation,’ feels good.”

We humans need just enough challenge and stress to make life interesting.

“CRF mediates this reaction: Block the molecule’s actions with a drug, and you eliminate the dopamine surge and the exploration,” writes Sapolsky. “But exposing a mouse to major, sustained stress for a few days changes everything. CRF no longer enhances dopamine release, and the mouse avoids the novel object. Moreover, the CRF is now aversive: Spritz it into the nucleus accumbens, and the mouse now avoids the place in the cage where that happened. The researchers showed that this is due to the effects of stress hormones called glucocorticoids. A switch has been flipped; stimuli that would normally evoke motivated exploration and a sense of reward now evoke the opposite. Strikingly, those few days of stress caused that anhedonic state to last in those mice for at least three months.”

Sapolsky concludes:

“But meanwhile, these findings have an important implication. Life throws lousy things at us; at times, we all get depressed, with a small letter “d.” And most people—as the clichés say—get back in the saddle; prove that when the going gets tough, the tough get going. What then to make of people who are incapacitated by major depression in the clinical sense? Unfortunately, for many, an easy explanation is that the illness is a problem of insufficient gumption: ‘Come on, pull yourself together.’ There is a vague moral taint.”

The trauma of everyday stress is an important player in major depression. When combined with genetic history and a difficult childhood, it can tip the applecart and result in what Andrew Solomon calls “The Noonday Demon”.   The takeaway is that the better we get at managing the “trauma of everyday life”, the better chance we have at preventing depression.

My worry is that the society we’ve created and the hectic lives we lead make the management of stress very difficult, indeed.

 

 

 

Depression’s Negative Thinking

Years ago, when I had just been told I had something called “depression,” I was having a tough time accepting it – after all, I was a litigator, a good-slinger extraordinaire.  The only thing that I thought could bring me down was a lucky pistol shot at High Noon.

During a talk with my therapist in the beginning of my recovery a decade ago, I told him all the negative thoughts I was having about my life. My counselor, a large, white -bearded older man with an Obi Wan Kenobi-like aura, gently told me, “Dan that is depression talking.” Somehow that got through to me; somehow I knew it was true.

My counselor, pillar of Jedi knowledge that he was, had helped me look through a sort of psychic telescope into the constellation that was my patterns of depressive thinking.  All people who have struggled with depression must do combat with their negative thoughts.  They must – usually with a therapist’s help – begin to see that THEY are thinking these thoughts and they’re not just HAPPENING to them.

Negative Thoughts – and Lots of Them

It has been estimated that we have anywhere from 25,000 to 50,000 thoughts a day. If your ideas about life are predominantly downbeat, imagine how many negative thoughts you are generating daily—thousands upon thousands.

In the magazine Psychology Today, Hara Estroff Marano writes:

“One of the features of depression is pessimistic thinking. The negative thinking is actually the depression speaking. It’s what depression sounds like. Depression in fact manifests in negative thinking before it creates negative affect. Most depressed people are not aware that the despair and hopelessness they feel are flowing from their negative thoughts. Thoughts are mistakenly seen as privileged, occupying a rarefied territory, immune to being affected by mood and feelings, and therefore representing some immutable truth.  

Compounding the matter is that negative thinking slips into the brain under the radar of conscious awareness and becomes one of the strongest of habit patterns. People generate negative thoughts so automatically they are unaware that it is happening; that it is actually a choice they are making.”

Lawyers are particularly prone to this type of pessimistic thinking which helps explain why their rates of depression are about twice that – twenty percent – of the general population.

In recent article in The Wall Street Journal wrote about this very topic:

“Martin E. P. Seligman, a psychologist and proponent of ‘positive psychology,’ observes that lawyers experience depression at rates that are 3.6 times as high as that of other employed people. They also abuse alcohol and illegal drugs at rates above what’s seen in non-lawyers. Why is this? In part, he says, the law selects people with a glass-half-empty attitude. His research has found that people who score low on an optimism test do better in law school. ‘Pessimism, he writes, ‘is seen as a plus among lawyers, because seeing troubles as pervasive and permanent is a component of what the law profession deems prudence.

A prudent perspective enables a good lawyer to see every conceivable snare and catastrophe that might occur in any transaction. The ability to anticipate the whole range of problems and betrayals that non-lawyers are blind to is highly adaptive for the practicing lawyer who can, by so doing, help his clients defend against these far-fetched eventualities. If you don’t have this prudence to begin with, law school will seek to teach it to you. Unfortunately, though, a trait that makes you good at your profession does not always make you a happy human being’’.

The Big Ten

For us to start making different choices about what kind of thoughts we think, it’s important to see the patterns, the way these false thought patters take place over and over again.  Here are some examples of depressive thinking:

1.      False extremes – “the tendency to evaluate [one’s own] personal qualities in extreme, black-and-white categories; shades of gray do not exist.”

2.      False generalization “after experiencing one unpleasant event, we conclude that the same thing will happen to us again and again.”

3.      False filter “we tend to pick out the negative in every situation and think about it alone, to the exclusion of everything else.”

4.      False transformation “we transform neutral or positive experiences into negative ones.”

5.      False mind-reading “we may think we can tell what someone is thinking about us, that the person hates us or views us as stupid. But such negative conclusions usually are not supported by the facts.”

6.      False fortune-telling “we expect catastrophe and the expectation itself produces hopelessness and helplessness.”

7.      False lens “we view our fears, errors, or mistakes through a magnifying glass and deduce catastrophic consequences. Everything then is out of proportion.”

8.      False feelings-based reasoning depressed persons “tend to take their emotions as the truth. They let their feelings determine the facts.”

9.      False “shoulds” – “Our lives may be dominated by ‘shoulds’ or ‘oughts,’ applied to ourselves or others. This heaps pressure on us and others to reach unattainable standards.”

10.  False responsibility – “when we assume responsibility and blame ourselves for a negative outcome, even when there is no basis for this.”

A common theme running through much of this type of thinking is a self-judgment of inadequacy and, as a result, the depressed person notices negative, misfortunate circumstances but ignores positive, fortunate circumstances.

Overachievers and perfectionist that they are, depressed lawyers may frequently receive positive feedback concerning his or her performance at work. For example, a depressed lawyer may have a caseload of one hundred cases.  He might have the upper hand on 90%, but struggles with the 10%.   This lawyer sees his struggle with the handful of cases as confirming what a loser he or she is, incompetent and unable to keep up “like everyone else.” The many positive comments made by colleagues or staff are not even remembered.

Because of the belief that he or she is inadequate, and his or her tendency to only notice negative experiences, the future is viewed as certain to be gloomy, dismal, and painful: “I’ll never make partner,” “I suck as a lawyer.”

Negative thinking sounds, to the outside observer, to be obviously false or negatively skewed. If so, just why do depressives repeatedly think like this over and over again?  Are they idiots?

No, it’s because depressive thinking is “automatic.” It is not the result of thinking the situation through objectively – ironically enough, something lawyers are trained to do.

It just happens rapidly without any reflection.

So it’s the event itself that is sad, not life in general. And even if this thought or feeling arises, it is only temporary.

Depressive thinking leads to depression, leads to depressive thinking, leads to. . .

As we explain these thinking styles you will see how each helps to maintain depression, by altering how we perceive reality.

It’s these thinking styles that make it so hard to see an end to the depression, as they limit our possibilities of thought. Once these patterns take hold, the emotional arousal they cause begins to affect us physically.

If you are thinking now “Yeah, but you don’t know my life” – remember: there is nothing so awful that you can imagine that someone somewhere hasn’t survived without becoming depressed.

It is not your fault if you are depressed, but there are concrete, effective things you can do about it.

How to Kick Negative Thinking’s Butt

Again, Estroff Marrano offers some ways to combat negative thoughts:

  • Distract yourself. Engaging, pleasant activities, such as exercise or hanging out with friends, are best. Once you are feeling more positive, you will be better able to solve problems.
  • Stop that train of thought. Think or even tell yourself “Stop!” or “No!” when you start to ruminate.
  • Write it down. Tracking your ruminative thoughts in a journal can help you overcome depression by organizing those thoughts and relieving yourself of their burden.
  • Solve a problem. Even taking a small step toward solving one problem that is weighing you down will help with overcoming depression. Data show a strong link between goals you cannot achieve and depression-inducing ruminative thinking, so start problem solving.
  • Identify triggers. Figure out which places, times, situations, or people are most likely to cause a bout of rumination, and find ways to avoid those triggers or manage them better. Mornings and evenings are the times when ruminative thinking is most likely.
  • Meditate. Mindfulness techniques can help you get some distance from the thoughts that trouble you, while at the same time reducing stress.
  • Stop linking small goals to big goals. For example, you may need to challenge a belief that achieving big goals (such as happiness) completely depends on succeeding at smaller goals (such as losing five pounds).
  • Get therapy. Seek cognitive therapy techniques to help you question your thoughts and find alternative ways of viewing your situation.

Try, day by day, to chip away at the conclusion that depression just happens to you, or that it’s just a disease.  Try to remember, that whatever it’s causes, negative thinking is a powerful fuel to help it arise and keep it going.  Think about it.

 

 

 

In the Beginning – Depression in Law School

The term clinical depression finds its way into too many conversations these days. One has a sense that something catastropic has occurred in the psychic landscape – Leonard Cohen

Everything has its beginning:  the Cosmic Bang, the French Revolution and depression in the legal profession.

There is little doubt that for many, depression begins in law school. One study of law students found they suffered from depression at the same rate as the general population before entering law school. Just two months into the school year, however, their negative symptom levels had increased dramatically.  By the spring of their first year, 32% of the same law students were depressed. By the spring of their third year, the number had risen to 40%.  Two years after graduation, 17% of the students – about twice the rate of depression experienced by the general population – were still depressed.  Such elevated levels of depression have been corroborated by later studies.

Plug in these stats and an estimated 30,000 to 60,000 of this country’s 150,000 law students struggle with depression at some point during their law school experience

Andy Benjamin, J.D., Ph.D., the lead researcher in the above study and others that have looked at law student and lawyer depression, wrote me last summer:

“Since the publication of our research about law student and lawyer depression, depression still runs rife for law students and practicing attorneys – nearly a third of all law students and lawyers suffer from depression.  The data to support this statement have been published since the early eighties when the studies were first conducted.  Several subsequent empirical studies have corroborated the grim findings up until 2010.  As the stress, competition, and adversarial nature of the profession have continued to take their toll, not surprisingly, the rates of depression have not changed.  Law students and lawyers remain at the greatest risk for succumbing to depression, more so for any other profession.  After nearly forty years of compelling evidence about the prevalence of the severity of depression for the legal profession of law, more meaningful systematic changes must be implemented throughout the professional acculturation process of law students and lawyers.”

It’s difficult for the legal establishment to face all of this. William M. Treanor, immediate past dean of Fordham Law School, told The New York Law Journal last year: “Depression is a very important issue that often gets swept to the side.  It’s a real concern and a problem in the legal profession. Studies indicate that it is common among law students and common among lawyers. Given that, it’s important to try to figure out ways to combat it and to let people know if they are suffering, they are not alone.”

As author Kathleen Norris wrote, “The religion of America is optimism and denial.”  We’re a nation of suck-it-uppers; a people who drive their inner pain deeper and deeper into themselves until they break. The denial of depression in the law is both institutional and individual.

In Institutional Denial About the Dark Side of Law School, Florida State University Law Professor Lawrence Krieger wrote:

“There is a wealth of which should be alarming information about the collective distress and unhappiness of our [law] students and the lawyers they become.  We appear to be practicing a sort of organizational denial because, given this information, it is remarkable that we are not openly addressing these problems among ourselves at faculty meetings, and in committees and without students in the context of courses and extracurricular programs.  The negative phenomena we ignore are visible to most of us and are confirmed by essentially unrebutted empirical evidence.”

Attorney Andrew Sparkler, a friend of then fellow Fordham law student David Nee who suffered from depression (unbeknownst to his friends) and committed suicide in his third year of law school, observed, “To admit that you are depressed [in law school], to yourself or to others . . .  , is a weakness and if you’re in a shark tank of hyper-aggressive folks around you, you’d be hesitant to expose it because why would you fess up to anyone that you have a problem?” Sparkler, his friends and the Nee family started the Dave Nee Foundation to address law student depression and suicide.

It doesn’t get much better when one graduates and enters the job market.  A John Hopkins study looked at 104 occupations to determine which ones had the highest incidence of depression.  Lawyers topped the list and were found to suffer from depression at a rate of 3.6 times that of other profession studies.  Other studies have found that about 20 percent of all lawyers struggle with depression.

Plug in these stats and an estimated 200,000 of this country’s 1 million lawyers are hurting.

Obviously, something is really rotten in Denmark.

There have been several theories bantered about as to why law students suffer from such high rates of depression: pessimistic thinking styles taught in law school (“learning to think like a lawyer”), personality types that go to law school, a breakdown in inner values and the current nasty economy and stress to find and maintain a good job.  The New York Times recently ran an article, No Longer Their Golden Ticket, – I was interviewed for this one – which spoke about the stress and uncertainty that law school students’ face:

“[The] days of [high pay and full employment] are over. As the profession lurches through the worst economic slump in decades, with jobs and bonuses cut and the internal pressures to perform rising, associates do not just feel as if they are diving into the deep end, but rather, drowning.”

However, there has been pushback against the theory that law school even causes much psychic damage.

In an article by University at Michigan Law Professor James Justesen White, Maiming the Cubs, he takes issue with Professor Krieger theory and argues that the law school experience does not “. . . cause permanent and irreversible change and that the ills of lawyers cannot be traced in any meaningful way to the stresses of the three years in law school.”  He concludes:

“I wonder, too, whether the anxiety and depression that we observe in some of our law students is the unavoidable consequence of the challenge of hard learning and of confronting the looming need to prepare to behave like a lawyer.  Soon after they come to law school, students must sense that however hard Contracts and Torts is, learning to be a successful practicing lawyer is harder, and that the road to success in the profession is even less clearly marked than the road to law school success.”

Sorry, I just don’t agree.

My take on law school depression

I think we must look at what makes people more vulnerable to depression before they enter law school – those 10% who already have depression or are at risk for developing it before they register for their first 1L class. For most, there is a genetic or family history of depression. Likewise, there is a history of family dysfunction: for example, alcoholism, physical and emotional abuse and/or neglect.   These folks bring those major risk factors into law school. It is my view that law school doesn’t cause depression; rather, it may be the straw that breaks the camel’s back for those who already have some risk for it. 

Pessimistic thinking and persistent stress , both powerful dynamics in law school, are known triggers for depression.  When these influences are mixed in with other pre-law school risk factors, law school creates a “perfect storm” for depression to happen.

We tend to mix up law student unhappiness and dissatisfaction with depression.

They’re not the same thing; not even close. Unhappiness and discontent are relatively transitory; other emotions aren’t pushed to the margins or extinguished. We are adaptable in response to our environment. We might feel stressed or exasperated by the law school grind, but everyone  bumps up and down throughout their days.  We deal with our stress and balance ourselves out either with exercise, socializing or just by having stress resilient genes.  Not so with depression.  Richard O’Connor, Ph.D., in his best-selling book, Undoing Depression, writes:

“We confuse depression, sadness, and grief.  But the opposite of depression is not happiness, but vitality—the ability to experience a full range of emotion, including happiness, excitement, sadness, and grief.  Depression is not an emotion itself. It’s not sadness or grief, it’s an illness.  When we feel our worst, sad, self-absorbed, and helpless, we are experiencing what people with depression experience, but they don’t recover from those moods without help.”

There is also a biochemical poverty about depression; the scarcity of neurochemicals like serotonin and dopamine that wreck havoc in our brains and set the stage for depression.  As I wrote in Trial magazine about the connection between stress, anxiety and depression, the grind isn’t just about long hours in the office or law library cubicle, but the grinding up of our nervous systems.

We have a sense that such a lifestyle can be problematic to our happiness, but we’re willing to keep marching to that beat in the hope of later rewards (e.g. money, security, partnership). Yet, I can’t help but think that we’re dimly aware, if at all, of the risk we put ourselves in for major depression.

Besides the psychological-physiological links to depression, we live in a culture that breeds melancholy.  How could this not eek its way into the law school experience?

Maybe it’s the moral and spiritual bankruptcy of our times; the torpor of the imagination which fails to inspire our young people to live an engaged and spirited life in the law, or the cynicism to think that such a life is even possible that worries me. Or, by the time young people get to law school, they’re so jaded by our consumer driven culture they just want the diploma to start making the big bucks. All of this contributes to depression, to a lonely society that undermines what it means to live a decent, healthy and happy life.

In 2008 the American Bar Association launched a Mental Health Initiative to address mental health problems on law school campuses.  See the Mental Health Toolkit for Student Bar Organizations and Administrators distributed as part of this effort.  Such initiatives’ involve mental health days (e.g. check out Marquette Law School) where they had out a document from Professor Krieger called The Hidden Sources of Law School Stress , “wellness” web pages on law school websites (e.g. check out the one at Harvard Law School) and referrals to a school’s counseling center (e.g. check out Cornell Law School).

While laudable, they’re an arm’s length effort to confronting such a deeply personal and painful human experience.  Moreover, it seems like any presentation on the issue of depression in law schools is limited to first year orientation. What about the second and third year students? Studies conclude that depression rates continue to rise into the second and third year.  If that’s true, what is being done to help these students?  Another query: Just how many of the people who speak at these programs are law students or lawyers who actually had or are currently suffering from depression and disclose it?  My hunch is few, if any.

Why should that matter?  Because the students need to hear it straight-up. They need to listen to someone in the trenches of a profession they’ll soon be entering.  Without such depression experiences, a speaker is like someone trying to enlighten someone about the dangers of smoking and cancer, but has never smoked. Wouldn’t it be a more powerful, credible and informative experience for students to listen to a law student and/or a practicing lawyer, who has depression and is willing to talk about it?

Instead, students are served up programs, usually offered up by well-meaning Dean or Vice-Deans of Student Affairs and therapists from a University’s Counseling Center. There’s a lump-it-all-together approach to it all.  I was asked a few years back, when I was just beginning my advocacy work, to give a brief, 15 minute talk on depression. The school trotted out a variety of people in fifteen minute increments to talk about stress, drinking, drugging and, eventually, depression. Speaking in that big first year classroom, I was reminded of the ancient Greek amphitheaters.  Many of the Greek dramas were tragedies.  And make no doubt about it, depression is a tragedy.

I was saddened by the whole charade, the paucity of imagination and effort that went into addressing such a critical problem; the let’s pool this list of mental ills together into a small program on “mental health.”  I sensed that the students failed to see how any of this was connected to them.  The sliver of time allocated to depression couldn’t help but leave the students with the impression that the school really didn’t take the problem that seriously.

Over 130 million people suffer from depression worldwide on a planet where it is the leading cause of disability. In our country, it’s also the leading cause of disability and some 20 million people are afflicted.  It’s been characterized as an “epidemic.”  If that’s true, what does that say about the higher rates of law student and lawyer depression?  Just what adjective could one use to describe the scope of the problem?

 Addressing  Depression In Law School – Really

Here’s what can be done right now:

1. Law Schools – show the thirty minute documentary, “A Terrible Melancholy: Depression in the Legal Profession.”   Copies of the film on DVD are available form the Erie County Bar Associaiton. Here’s a trailer clip of this recently finished film:

2. Have someone come in to speak to the students that are in the legal profession who has suffered from depression to reach these students.  Give it more than 15 minutes of your time and have programs for second and third year student on this critical topic.

3. Law Students – show up, watch the film and think long and hard about it.

Finally, I want to urge all of you reading this blog to write in and express your views about your law school experience, whether you’re in school now or it’s been thirty years.  There’s much to be gained by such sharing. Please write.

Further reading:

Todd David Peterson & Elizabeth Waters Peterson, Stemming the Tide of Law Student Depression: What Law Schools Need to Learn from the Science of Positive Psychology, 9 YALE JOURNAL OF HEALTH POLICY & ETHICS (Summer, 2009); Susan Daicoff, Lawyer Be Thyself: An Empirical Investigation of the Relationship Between the Ethic of Care, the Feeling Decision-making Preference, and Lawyer Well-being, 16 VIRGINIA JOURNAL OF SOCIAL POLICY & LAW (2008-2009); Patrick J. Schlitz, On Being a Happy, Healthy, and Ethical Member of an Unhappy, Unhealthy, and Unethical Profession, 52 VANDERBILT LAW REVIEW 871 (1999) and Depression and Anxiety in Law Students: Are We Part of the Problem and Can We Be Part of the Solution?, 8 JOURNAL OF LEGAL WRITING INSTITUTE 229 (2002).

           

                                               

 

Our Parents – Our Depression

If you look deeply into the palm of your hand, you will see your parents and all generations of your ancestors. All of them are alive in the moment. Each is present in your body. You are the continuation of each of these people – Thich Nhat Hanh, Buddhist monk

Like all parents, my mom and dad were flawed people – as I am.  Yet, they were something more than that.

I’ve struggled to understand them much of my adult life; maybe more so now that they’re both gone.  The nineteenth century German philosopher Arthur Schopenhauer once wrote: “The first forty years of life furnish the text, while the remaining thirty supply the commentary.”  Maybe it isn’t till midlife that we really work hard to interpret the stories of our past.  I believe there’s a strong urge in all of us to make a comprehensible story of one’s life at this juncture. And our parents are a large part of that tale.

The author of Slaughterhouse-Five, Kurt Vonnegut, a WWII veteran like my dad, wrote:

“The most important thing I learned was that when a person dies he only appears to die. He is still very much alive in the past, so it is very silly for people to cry at his funeral.  All moments, past, present, and future, always have existed, always will exist. It’s just an illusion we have here on earth that one moment follows another one, like beads on a string, and that once a moment is gone it is gone forever.”

Now that I’m 50, I still wonder what role mom and dad played in my depression.  Looking at the facts, I guess it’s all too obvious: drinking and mental health issues on both sides of the fence.  In my most self-absorbed moments, I blame them and feel justified in doing so.  In brighter moments of lucidity, I see that they, like me, were somebody’s children once.  They didn’t start out in life the way they ended up – nobody does.  They were, in a real sense, victims.  This fact doesn’t excuse what happened; the real pain they inflicted on their children. But it does help me to understand their plights in life.  And with that understanding comes some measure of peace, a peace of heart.

Turning the pages to our Past 

Jonathan Frazen, author of the best-selling book Freedom about a family that struggles with depression, writes:

“Depression, when it’s clinical, is not a metaphor. It runs in families, and it’s known to respond to medication and to counseling. However truly you believe there’s a sickness to existence that can never be cured, if you’re depressed, you will sooner or later surrender and say: I just don’t want to feel bad anymore.”

Here’s Jonathan Frazen talking about his novel on PBS:

How much of our life is determined by our familial past?  How much of it is spun by choices we make apart from that past?  Apart from what happened to us at the hands of parents, can we really change?  I believe that shifting through our past helps us to become “unstuck.” And after all, depression is about being stuck.  We can’t go forward, if we can’t go backwards and to see the truth of about past.

There are some things we can change and some we can’t.  We can’t change our genetics and scientists now know that the genes we inherit play a significant role in our vulnerability to depression. There is a gene that regulates how much of a chemical called serotonin is produced. Serotonin is a neurotransmitter.  The amount of serotonin that flows to your brain influences your mood, and emotional state.  Those whose serotonin transporters included a gene that was shorter than would be typically expected at a certain point had a harder time bouncing back after experiencing a stress event. Chronic stress and anxiety, as I’ve written about before, have a strong correlation to a vulnerability to clinical depression.

This bit of news makes me want to know my ancestors, these ghosts of my past.  These folks and I have something in common: irksome chromosomes that could flip off the happy switch in our brains from time to time.

I heard on National Public Radio that there have been 60 generations that have lived and died since the time of Jesus.  Since the extent of my knowledge about my family only goes back, at best, 100 years to the time of the birth of my grandparents, that leaves me about fifty-eight generations or 1900 years of emotional and genetic history unaccounted for.  I wish there was some kind of recorded history of their lives because I am a continuation of them even as my daughter is of me.

Dad’s Story

Dad was born in Buffalo in 1926, the oldest of five born to immigrants from Poland.  I never met my grandparents, but from family lore I’ve learned that they were tough people who lived even tougher lives: brute physical labor for their daily staple of meat and potatoes, playing pinochle while plumes of cigarette smoke wafted up to the ceiling and crates of cheap booze on the weekends. If you looked crossways at them, they’d likely belt you in the mouth.

Alcohol played a big role my family’s drama through the generations.  Sometimes they drank at home, but more often in what my grandma called “Gin mills.”  Men would cash their checks in these Polish joints, throw their money on long wooden bars sip draught beer as they talked about all the scraps they’d been in that week just trying to get along in life.

My dad grew up in this world.  At 17, he went off to fight in the Pacific theater against the Japanese.  War must have deeply affected him, as it does all young men.  Robert E. Lee, writing of his experiences in the Civil War, wrote his wife in 1864:

“What a cruel thing is war; to separate and destroy families and friends, and mar the purest joys and happiness God has granted us in this world; to fill our hearts with hatred instead of love for our neighbors and to devastate the fair face of the earth.”

Last year, I read a  New York Times review of a book out about J.D. Salinger, author of The Catcher in the Rye.  The article notes that Salinger, who served in the infantry during WWII in Europe, witnessed a lot of death and mayhem and struggled with depression his whole life:

“Salinger’s experiences during WWII heightened his sense of alienation.  The war left him with deep psychological scars, branding ‘every aspect’ of his personality and reverberating through his writings.  Salinger had suffered from depression for years, perhaps throughout his entire life, and was at times afflicted by episodes so intense that he could not relate to others.”

Ultimately, he stopped publishing, moved into a cabin in rural Connecticut and practiced Yoga and Zen meditation.

Dad clearly suffered from undiagnosed depression and PTSD, something that would, like Salinger, haunt him for the rest of his life.  But war can’t explain all misery, can’t explain the storms that would rage in his head.  His younger brother Roman, also a war veteran, became an alcoholic.  Dad’s younger sister suffered from depression and been treated for it with medication suggesting a possible genetic propensity in our family for the illness.

Mom’s Story

Mom, like dad, was also part of WWII generation. Her older brother Joe went off to war in the Pacific for three years.  As fate would have it, he met my future Dad aboard a ship in the Philippines and said, “If we ever get the hell out of this shithole, I’ve got this cute, blonde sister back in Buffalo.” They survived, my parents met, fell in love and married.

Mom had an alcoholic father, also an immigrant from Poland.  She recalled being asked by her mother to go find her dad on a regular basis when he didn’t return home after work.  Often, during the harsh Buffalo winters, she would find him passed out in a snow bank.  The only intimate moments she remembered sharing with him was when for her eighth birthday he took her to a Shirley Temple movie and bought her candy.

Mom and dad quickly had three kids.  Things went well the first ten years of their marriage, but the wheels began to fall off from there on out: dad drank too much, became a gambler, womanized and had unpredictable outbursts of high octane rage.  Mom collapsed back into herself and never really recovered.  She began to eat a lot, added lots of pounds to her slender frame and watched T.V. all the time.  Maybe the dopey sitcom narratives sliced through the quiet pain my mom carried – all the time – all of her life.

Dad died 32 years ago at the age of 56 (I was 19) from too much drinking and smoking. He died sort of unrepentant, never saying he was sorry for anything.  But, in my own mind at least, I think he was sorry.  I think he just couldn’t bring himself to say it because of the enormity of his sins.  But I have learned to forgive him, this enemy of my childhood who I had wished as a boy that he would just die.  The great poet Henry Wadsworth Longfellow once wrote:

“If we could read the secret history of our enemies we should find in each man’s life sorrow and suffering enough to disarm all hostility.”

As for my mom, well, she died almost two years ago at the age of 82 of brain cancer.  I devoted a  blog to her passing, but didn’t say just how difficult it was to really know mom. She was always somehow distant, like a star in the sky. She never had any friends, her family was her circle. She loved us, but often did not connect with her children; maybe because she had never been cherished as a child.  She did, after all was said and done, the best she could and, in this sense, was so much easier to forgive and let go of than dad.

Walter – Second Edition

Walter, my oldest brother at age 59 and dad’s namesake, and I were walking back the other night to the parking lot after our hometown hockey team, the Buffalo Sabres, had taken a real shellacking.  I asked him in the frosty, hidden darkness where men – – if they do at all – – share a sliver of their true inner lives: “Do you ever think of dad and what did he meant to you?” He replied, after a few huffing breaths: “Not really, just what a real asshole he was.”

My brother has never been in therapy, never taken antidepressants.  But he had heroically forged ahead “carving out a living” as he was prone to say.  Yet, I couldn’t help think about the profound effect dad’s abuse had had on him and my other three siblings.  I wonder if he sometimes thinks about it at night while lying in bed with the windows cracked open on a hot summer’s night.  Does he wonder why he can’t stop feeling bad about himself? Why he doesn’t feel more confidence?  And the toughest part of it all, the thing that keeps me up at night when I think of my burly, big-hearted brother, is that he probably blames himself for all of these feekings as adult children of alcoholics are prone to do.

My Coming Around

As for me, a real veteran of therapy and antidepressant medications, I know all too well that my parents are still tangled up with me long after their deaths.   My therapist once said that I had to work out the long buried grief of never having had the parents I needed.  Over the years, I have done a lot of grieving for the childhood I didn’t have. Yet, as I was to learn, it wasn’t only my grief about my childhood troubles that I was to deal with, but for my parents as well.  For the loss of their innocence, their difficult childhoods and all that they could have been.

Despite the pain in my family, there was love; fractured though it may have been. As he aged, I sensed that my dad knew that too much had gone wrong that he couldn’t fix.  But in small gestures here and there, he showed affection and love.  As my mom’s wake last May, I was privileged to give the eulogy.  What I said was my mom’s defining quality wasn’t success, intelligence or gardening, but kindness – that this is where she planted her flowers that continue to grow in the hearts of her children and grandchildren.  And what a gift that is.  One that’s always in bloom.

My parents were both hopeless in their own ways.  They were dealt a crummy hand in life.  They were born with certain genes, into a family and time in history that they didn’t choose.  The difference between them and me, the blessing that came out of my depression that didn’t for them, was that my pain forced me to finally confront my wounds and work hard to heal them – an ongoing project for us all.  It forced me to examine the long unexamined within me.  It gave me a choice: I could continue to live out my parents damaged views of life or embark on my own journey and discover what was real and true for me.

While it is true that none of us can avoid the pains and difficulties that come from living on this planet, what modulates the pain is love — pure and simple.  Andrew Solomon, who has suffered from depression for much of his adult life, captured this in his book The Noonday Demon: An Atlas of Depression:

“Depression is a flaw in love. To be creatures who love, we must be creatures who can despair at what we lose, and depression is the mechanism of despair. When it comes, it degrades one’s self and ultimately eclipses the capacity to give or receive affection.  It is the aloneness within us made manifest, and it destroys not only connection to others but also the ability to be peacefully alone with oneself.  Love, though it is no prophylactic against depression, is what cushions the mind and protects it from itself.”

In the end, love really is the only thing that saves anybody.

The Ghosts of Depression

Pharmaceutical wonders are at work, but I believe only in this moment of well-being. Unholy ghosts your are certain to come again – Jane Kenyon, Having It Out with Depression.

Halloween has always been one of my favorite times of the year. A time for remnants of Snickers bars still stuck between your teeth the next morning, carved pumpkins of the edge of decomposition and a chill in the spooky night that reminds you Winter is to come all to soon. As a child growing up in the country, my hooligan friends and I relished the chance to go knocking on the doors of neighborhood mothers’ in aprons doling out nocturnal goodies.

When satisfied with our sugar-laden sacks of booty, we would scamper to our local graveyard full of old tombstones.  Once there, we would dare each other to run through as fast as we could, each privately fearing the claw of a bony hand that would pop out of a grave to drag us to some subterranean place where the dead lived and ate small children.

Walking home, we would walk by a neighbor’s house and swear that we’d seen Edgar Allen Poe looking out the window at the full moon.

A Paranormal Force

Ghosts don’t strike us as happy beings, unless it’s Casper The Friendly Ghost. They frighten us, haunt us. Depression has been referred to as a vile creature, an entity of sorts in our popular imagination. You have to look no further that the National Book Award winner, “The Noonday Demon: An Atlas of Depression” by Andrew Solomon. When I had depression years ago, I was told by a friend he understood that I had to “fight my demons.” As if I were the little girl possessed by Satan in The Exorcist. But he didn’t understand, really.

Depression is like a paranormal force, not something inside of our brains, but something outside of it. In a way, depression is a world inhabited by ghoulish ghosts that haunt us. They sporadically interrupt our lives and won’t leave us alone.

Ghosts are always people that have passed away. Often, these ghosts are haunting others because they’re not at peace. Maybe because they left something unsolved in this world. Or, maybe, because we have not let them go.

The Ghosts of Our Childhood

I think this is a crucial aspect of depression: the trouble letting go, the problem of forgiveness of those who have wronged us in the past.

Depression is a pressing down of sadness. A strategy doomed to failure if ever there was one. While many think of it as only as disease born solely of genetics, its archeological origins seem to have begun in the ghosts of our childhoods.

Researchers now know that many with adult-onset depression have had troubled childhoods of neglect or abuse. The nervous system is spooked by trauma and/or neglect which changes our neurochemistry and even the structure of the brain.  Ghosts take up residence in the attics of the brain where they lounge around sipping tea cups of neurochemicals that we all need to feel happy. But just as importantly, trauma creates a well of sadness, terrible loss and wounding of the spirit that lives on with us into our adult lives.

Children who come out of such childhoods often spend a lot of their adult lives feeling like a part of them is missing.  It’s a leak in their soul which can’t be plugged.

Elizabeth Wurztel, in her best-selling book, Prozac Diary, describes the difference between sadness and the zombie-like state major depression can create:

“That’s the thing I want to make clear about depression: It’s got nothing at all to do with life. In the course of life, there is sadness and pain and sorrow, all of which, in their right time and season, are normal—unpleasant, but normal. Depression is an altogether different zone because it involves a complete absence: absence of affect, absence of feeling, absence of response, absence of interest. The pain you feel in the course of a major clinical depression is an attempt on nature’s part (nature, after all, abhors a vacuum) to fill up the empty space. But for all intents and purposes, the deeply depressed are just the walking, waking dead.”

Psychologists can act as mediums at seances, seeking to welcome the dead into our presence so we can have it out with them and heal. We can finally let their voices go and live a life that is uniquely defined by the choices we make rather than the ones’ thrust upon us.

Psychiatrists strike me as more like Ghostbuster’s with ray guns of medication designed to blast the depression out of us.

In her book, Unholy Ghosts: Writers Write on Depression, Nell Casey has assembled various writers who write about their experiences with depression. The theme running through many of the writings is the dark, blank state of depression where the pain of it is actually the absence of feeling. One psychologist wrote that the opposite of depression isn’t happiness, it’s vitality. It’s the capacity to experience the full colorful palette of emotions that make up a normal human life.

For those who’ve experienced depression, they often run from it because they themselves fear becoming unholy ghosts.

But it’s ultimately in turning and facing the ghosts of depression that these phantoms lose the capacity to scare us, to truncate our emotional vibrancy. We can learn to see them for what they are: voices that aren’t true. Voices that can be left for dead.

Turning 50

Because time itself is like a spiral, something special happens on your birthday each year: The same energy that God invested in you at birth is present once again – Rabbi Menachem Mendel Schneerson

I just turned 50 a month ago.

My beautiful wife threw a birthday party for me at my in-laws beach house on the shores of Lake Erie, about fifteen miles from my fair city of Buffalo, New York, also known by locals as The City of No Illusions, the origins of which remain unknown to me.

You get a real sense of your age when all the tunes cranked out by the live band at your birthday gala are all from the sixties and seventies. No Lady GaGa tracks at this hoopla, but lots of gag gifts for the old geezer.

There’s Something About the Number

There is something momentous about turning 50. We all crunch numbers, don’t we. Those who have joined the 50 club seek a sort of mathematical revelation about its meaning: A half-century of 200 changes of the seasons, 600 full moons that have passed through the night skies from my boyhood until now.

It’s been two years since I’ve blogged about my 30th High School Return.  As I drove to that event, it was like a time tunnel back to my younger self as Bachman Turner Overdrive wailed “Taking Care of Business” as I barreled down Route 78, my thinning hair flying with the breeze kicking in through my car’s window.

My dad died at age fifty-six, about six year older than I am now.  That was over 30 years ago.  I wonder what he thought about turning 50.  I will never know.

Obama, George Clooney, Boy George and Eddie Murphy all heard the fifty gun salute this year.  Fame does not delay the passing of the years, though good makeup may.

The acclaimed poet, Billy Collins, on the occasion of his 50th Birthday, wrote:

But I keep picturing the number, round and daunting:

I drop a fifty-dollar bill on a crowed street,

I carry a fifty-pound bag of wet sand on my shoulders.

I see fifty yearlings leaping a fence in the field.

I fan the five decades before me like a poker hand.

Taking Stock

We all look backwards at 50 through the rearview mirror. We take stock of the climb from diapers to degrees, from backpacks to briefcases, from youthful meanderings to mid-life muddling.

We all remember our parents at this ripe age. They seemed so old, didn’t they? We look at ourselves in the mirror and, seemingly overnight, we have become . . . well . . . old.

My hair recedes like the waves going back out to sea, my joints crack and my energy flags around 9:30 at night. Warm milk? Not necessary as my AARP (I just got my unsolicited card in the mail) brain softly whispers to me, “Goodnight Dan”.

Life has brought plenty of trouble, pain and suffering to all of us by 50; curve balls, losses and betrayals of all types. In the balance, it’s also graced us with unadulterated joy, irony, whimsy, mischief and love. We are all challenged to learn from the negative and practice gratitude for the many blessing that have been bestowed on us and those we care about it.

I savor the words of Dag Hammarskjold, former Secretary General of the United Nations, from his book Markings, “For all that has been – Thanks. For all that shall be – Yes.”

There is a grace that comes at 50 that I didn’t have at 30 or 40; a sense of being at home in my own skin. My bones, like the roots of a mature tree in an old-growth forest, have sunk deep into the rich, brown soil. Like all people, I’ve weathered many storms. While I know that there are sure to be more to come, I have faith that I’ll still be standing after they’ve pass, that the barometric pressure will rise and that I’ll be walking in the sun again.

We hope by age 50 that we’ve becoming wiser. That in taking stock of our lives at the three-quarter turn of the track, we are able to distill something essential about how to live a good life.

True Grit

I think there’s some grit that comes at the half-century mark. We have less tolerance of others’ bullshit and, hopefully, our own. Having lived long enough, we know the truth even if we can’t articulate it. I admire people who can tell the truth with wit, irony, humility and a sense of decency. They don’t belittle others, nor are they arrogant or closed-minded about contrarian views. I always walk away from such people enlightened by such people and marvel that in speaking their own truth they give permission for others to speak theirs as well.

Maybe few of us tell the truth all the time. So don’t be so hard on yourself. But bites and pieces of it well chewed, like my grandmother’s sweet potato pie, make for good digestion.

Garrision Keillor, of A Prairie Home Companion fame, wrote in Things to Do When You Turn 50:

“Start telling the truth. In small doses at first and then gradually build up to one out of three, a decent batting average. When you’re young, you’re scared, you’re trying to wend your way through the trees and not get shot at, you’re trying to stay on the warm side of the various big cheeses in your life, you’re wanting to be the good guy who everybody loves, not the jerk with the big mouth. But when you hit 50, you’re entering a new passage of life in which you can say what you really think.”

The Speed of Time

We all look forward to events on the horizons of our lives. For a guy like me that just turned 50, it’s retirement sometime in the not so distant future and a day when I won’t be father to a 12 year old daughter, but to a twenty-something woman walking down the aisle with her sixty-something dad.

As you head into the fifty-something territory, others of the same age spontaneously lament and wax that time is moving more quickly the older you get. This conversation can take place with perfect strangers at Starbucks.  I sense that it might be okay to have this middle-aged banter with someone because I can usually tell their approximate age by looking at them: thinning hair, a slightly craggy face and the look in their eyes that they’ve known just how tough life can be.

There is a recognition of our finitude, that time is precious, that we don’t have forever to take running leaps towards our dreams.

Steve Jobs, the founder of Apple Computers, spoke to a Stanford graduating class as their commencement speaker in 2005.

Shortly before then, he has been diagnosed, treated and recovered from pancreatic cancer, a cancer that would take his life some six years later. Not mincing words, he told the class that we will all die. This wasn’t meant to be morbid, he told them. But a recognition that time is precious and not to be squandered.  Our mortality gives us the motivation to find out what we love to do and do it.

Americans often associate this with finding a job they love. No doubt a noble endeavor. Yet most people do not find a job they love and often toil at average paying jobs that bring only a modicum of happiness, if any at all. But they labor on supporting themselves and their families seeking refuge in the solace of forests, a great book, a ball game and in making their spouse and children happy.

Much wisdom can be culled from our years of living to 50. We learn to see what’s really important and what is, by comparison, trivial at best. More than anything, I know this much is true: the decency and dignity with which we carry ourselves everyday trumps everything else that happens to us.

We All Have Choices

We all have choices and we need to be reminded of this over and over. Life will spare no one suffering. Some of us by mid-life will have suffered grievously: the loss of a spouse or loved one to cancer, the undeserved loss of a job and means to support oneself or, as I’ve written at some length before, episodes of depression.

But in my life time, I’ve learned that suffering does not have the final say. That we do have a large say about what suffering means to us and our relationship to it.

Brother David Steindl-Rast, writes in his book, Deeper than Words:

“Our human dignity hinges on the right use of freedom. The converse is the abuse of freedom. Fearing that, should we then want freedom to be eliminated so as to get rid of suffering? No freedom, no love; no love, no meaning; the worst possible suffering: meaningless. The only way off this dead-end road lies in the opposite direction love can give meaning even to suffering – and so overcome it.”

Yes, our life, if it is to have true meaning, is finally to be used to love and serve others. For when we pass, we will not be remembered in others’ hearts so much for our accomplishments, but for the love we have given and shared with others. You can bet on that.

The Triumph of the Human Spirit – Folks Dealing with Depression

A hero is an ordinary person who finds the strength to persevere and endure in spite of overwhelming obstacles – Christopher Reeve.

I want to tell others about all the remarkable people I’ve known who’ve struggled with depression.  While they’re not paladins that ride into medieval battle swinging swords atop snorting mares, they fight a different kind of battle.  And one no less heroic.

Many of the best people I’ve been privileged to know struggle with depression every day.  While they don’t have shiny medals pinned on their lapels, there is an unmistakable strength in them – even if they don’t see it.  I know it’s real because I see and feel it – just like when I am in a grove of giant and majestic pines during a walk in the forest that must withstand the fury of a winter’s storm in January.

A Hero Steps Forward

Take Bob Antonioni. Bob’s story appeared in Esperanza magazine’s regular column, “Everyday Heroes”.  He had a budding political career in the Massachusetts State Senate and a law practice. Despite holding such a public position, Bob took the courageous step to disclose that he suffered from clinical depression in the hope of letting others know it was okay – there wasn’t anything to be ashamed of:

“Telling his story has become another tool to chip away at stigma. Yet he remembers his trepidation when he disclosed the truth in a November 2003 interview with a local newspaper.
‘I had misgivings,’ he admits, ‘but I guess I didn’t give people enough credit. All I heard were thank yous —the complete opposite of what I expected.’ In fact, Antonioni was re-elected twice after that. He retired from public office in 2009 to have more time for himself and his family, but continues to practice law and pursue his advocacy work.”

To me, it says something wonderful about the human spirit that against such a formidable foe as depression, people keep fighting to get better. And many triumph. Just like Bob.

The Black Dog

A few weeks ago in Canada’s Globe and Mail newspaper, there was a great piece, Ill to Power.  The article was about Winston Churchill’s life-long battle with depression written by the author of the new book, A First-rate Madness.  Here, he describes Churchill’s struggles:

“There is no doubt that he had severe periods of depression; he was open about it – calling it, following Samuel Johnson, his ‘Black Dog.’ Apparently his most severe bout of depression came in 1910, when he was, at about age 35, Home Secretary. Later in his life, he told his doctor, ‘For two or three years the light faded from the picture. I sat in the House of Commons, but black depression settled on me.’ He had thoughts of killing himself. ‘I don’t like standing near the edge of the platform when an express train is passing through’.”

Like Churchill, Abraham Lincoln struggled with major bouts of depression.  In the book Lincoln’s Melancholy: How Depression Fueled a President to Greatness, Lincoln writes about a cloud over him that every bit matches Churchill’s darkness:

“I am now the most miserable man living.  If what I feel were felt by the whole human race, there would not be one cheerful face left on earth”.

Lincoln, who many say was one of this country’s greatest heroes, apparently did not feel like one all the time.

Hard to Feel Like a Hero

Most people depression — in some fundamental sense –feel broken.  This conclusion is fueled by the depression itself – both biological (sleep, appetite, energy levels) and psychological (e.g. “Nobody really cares about me”, “I stink at my job” or “My depression will never end”).  But this brokenness isn’t just an “inside job” – crummy stuff they tell themselves about themselves.  Other people or events in a depressive’s daily orbit serve-up damaging assessments and innuendos about a depressed person’s behavior or personhood.

Others may tell them that they are letting them down at the office or not contributing enough to family responsibilities – yes, loved ones can get fed up with the depressed person’s withdrawal from the family, the inability to do chores he/she used to do and the depressed person’s sourpuss.  Or, they deny the immensity of the suffering of the depressive by minimizing it:  “Don’t worry, things will get better.  You’re just in a slump.” 

We sense that their agenda isn’t so much about helping us get better, as it is about them their needs.  Why else would we feel so much crappier and lonely after such exchanges?  It isn’t as if their needs aren’t important, but shouldn’t our mental health be at least as important?

Then there is the cultural stigma – a cloud of ignorance, fear and misunderstanding – surrounding depression.  American culture tends to see depression as a moral or personal weakness; the “just-get-over-it” rants of a society that likes simplistic answers to complicated problems.  Dr. Richard O’Connor, in his book Undoing Depression, captures some the irony of how our society sees depression as different from – or maybe not as real as — other forms of illness:

“Where’s the big national foundation leading the battle against depression?  Where is the Jerry Lewis Telethon and the Annual Run for Depression? Little black ribbons for everyone to wear?  The obvious answer is the stigma associated with the disease. Too much of the public still views depression as a weakness or character flaw, and thinks we should pull ourselves up by our bootstraps. 

And all the hype about new antidepressant medications has only made things worse by suggesting that recovery is simply a matter of taking a pill.  Too many people with depression take the same attitude; we are ashamed of and embarrassed by having depression.  This is the cruelest part of the disease: we blame ourselves for being weak or lacking character instead of accepting that we have an illness, instead of realizing that our self-blame is a symptom of the disease.  And feeling that way, we don’t step forward and challenge unthinking people who reinforce those negative stereotypes.  So we stay hidden away, feeling miserable and yourselves for ourselves for our own misery”.

Renaming One’s Walk through Depression as Heroic

Why can’t we re-imagine our self-image in relationship to our depression in a more positive light?  Why can’t we think of our battles with depression as, in fact, heroic?  Instead of counting all of times that depression has gotten the better of us and knocked us to our knees, how about giving ourselves credit for all of the times that we have triumphed over depression (perhaps even in the simplest ways); the times that we have risen to the occasion in spite of our melancholy and the moments that we have looked depression in the eye and said, “no more.”  Make no mistake about it that takes gumption – lots of it!  And I’ve witnessed scores of people say “that’s enough.”  While talking back to depression isn’t a panacea, it may be a healtier way for us to cope rather than succumb to it.

Viewing yourself as a hero is a constructive and healing experience for people with depression.  It doesn’t deny that we struggle with it sometimes, but it more importantly doesn’t deny the power we actually do have over it and the courage it takes to deal with it to the best of our ability each day.

In his article “The Continuing Stigma of Depression” psychologist Jonathan Rottenberg writes about the stigma for those who have recovered from depression:

“My hunch is that the disease/defect model of depression, is unwittingly contributing to the ongoing stigma of depression.  Through the lens of the disease model, the legions of the formerly depressed are a “broken” people who need lifelong assistance.  I would like to see a more revolutionary public education approach, with campaigns that emphasize the unique strengths that are required to endure depression. Even if a person is helped by drugs or therapy, grappling with a severe depression requires enormous courage.  In many ways, a person who has emerged from the grip of depression has just passed the most severe of trials in the human experience.  If we acknowledge that surviving depression requires a special toughness, we will not see formerly depressed people as a broken legion, but as a resource who can teach us all something about overcoming adversity”. 

Things to Consider

 – Maybe we fall down 30 times a day, or maybe it’s just a stumble, but we have to regain our balance and get up.  As the old Zen saying goes, “fall down seven times — get up eight.”  That, my friends, is heroic. Just remember that when you fall and get up – YOU are that hero.

– We must remember that when we are in a depression, it isn’t easy to feel like a hero — just think of Honest Abe. But the depression will pass. So don’t be too hard on yourself if you don’t feel heroic all the time.

– We should not condemn ourselves when we are down, but pick ourselves up and remember that we are, truly, remarkable people. 

As writer Andrew Berstein once wrote:  “A hero has faced it all: he/she need not be undefeated, but he/she must be undaunted.”

 

The Suicide of a Lawyer with Depression — Ken’s Story

This is a guest blog by Cincinnati, Ohio attorney Tabitha M. Hochscheid, Esq., a partner at the law firm of Cohen, Todd, Kite & Stanford, LLC.  In this moving tribute, she writes about her law partner and dear friend Ken Jameson who committed suicide in May of 2011 after a battle with depression.

How well do we know those with whom we spend our work days with?  Is it possible to practice with someone and be there friend for years yet, not truly know that they are suffering from the depths of depression?  Being around other attorneys can give us the camaraderie and support we need to grow and build our practice.  But, often times, people keep their emotional health a secret and suffer from depression in silence.  By the time their colleagues realize what is going on, it can be too late to do anything about it. My partner and friend Ken Jameson was one of the people.  This is his story. 

Ken Jameson was, by outward appearances, successful, well liked, a loving husband and father, a friend to everyone and a dependable partner.  In fact, Ken was perhaps the epitome of the well liked, client centered and dedicated lawyer many of us envision when we think of how lawyers should behave. On the inside, however, Ken was struggling with the depression which eventually took his life.

I first met Ken in the summer of 2007 for breakfast to discuss my interest in joining Cohen, Todd, Kite and Stanford, LLC.  Ken was so easy to talk to and we instantly bonded because he too had left a small firm to find a place to grow and build his practice at Cohen, Todd, Kite & Stanford, LLC.   After I joined the firm in January 2008, Ken was always available to help and support me and we grew into friends, as well as, colleagues.

Like so many attorneys, Ken built a practice by creating a network of referrals, by giving his clients personal service and building long term relationships.  He was an attorney who facilitated resolutions and provided estate plans for people of all income levels.  Ken enjoyed his work.  After joining the firm himself in 2006, his practice thrived.  He became a trusted member of the firm and was on the management committee.   Ken shared is life outside of the office with his wife and best friend of 35 years, Betsy, and three adult children of whom he was most proud.

Ken was a universally well liked person.  He conducted himself professionally in such a way that he never seemed to have conflicts with others.  Ken cared about his firm family, he always checked in on people if they were sick or if he knew you were under stress.  He was active member in his Church.  Ken took care of his physical health by walking 5 miles a day, attending Pilates classes twice a week and maintaining a healthy diet.  By all outward appearances, Ken had success in his work, a happy home life and seemed content.

However, Ken had underlying mental health issues.  Like many attorneys he had trouble sleeping well.  Sleep is something that eludes most attorneys from time to time, but his type of sleep loss was chronic.   He would fall asleep and wake up in just a few hours and not be able to go back to sleep.  As long as I knew Ken, he had this issue.  He tried relaxation techniques to help him sleep better, he read books about stress management and attempted to delegate work to others.  Ultimately, Ken was a self confessed perfectionist and as such, had an inner critic who told him he had to be at work all the time.

Most lawyers struggle with the challenges of building a law practice, client demands and finding out how to have precious downtime.  Ken was doing all the right things, but he still wasn’t able to sleep.  In March of this year, he took time out of the office due to exhaustion.  He went to see his family doctor and was prescribed something for sleep.   He tried to come back to the office part time within a few weeks but was unable to sustain a schedule.   Ken represented to those of us at work that he was exhausted and initially did not tell others what was really going on.

In late April, he left the office again.  This time it was lack of sleep and a pinched a nerve in his back.   With this new medical issue, his depression worsened.  He spent sometime in the hospital to adjust to new medications and was scheduled for back surgery.  At this point, Ken began expressing worry about the office and felt as if he was letting the firm down.  Finally, Ken had back surgery for the pinched nerve in the middle of May.  After the surgery, Ken seemed to be doing better; everyone thought his return to the office was imminent.

Ken never returned to the office.  On Sunday, May 22, 2011, I received a call from our office manager.    She informed me that Ken’s depression had worsened and that he had taken his own life that morning.  As the next few days unfolded, details began to surface.  Ken underwent surgery on his back and in the days following the procedure, had checked in with people at the office and had seemed like his old self.  Ken also visited his mother and called his best friend.  All the while, Ken meticulously planned how to take his own life.

No one can answer the question of what was going through his head or why he was in such despair that he took his life.  The next five days were difficult at the office.  People were in a state of shock and disbelief.  His office door has remained open since Monday, May 23, 2011.   A memorial was held the Saturday following his death and it was standing room only.   Ken clearly touched the lives of thousands and his life was remembered in eulogies by his friends, his sister and his wife.  It was touching to see so many people who loved him, but the confusion as to what occurred actually increased for many.

Do you ever really know the people we practice law with?  Everyone at the office felt they had a personal relationship with Ken.  But, did anyone of us really know what was happening.  It is easy now to look back and see the signs of Ken’s illness (sleep deprivation, self criticism, feeling of letting others down, a search for answers and inability to allow others to help) and to wonder what if anything could have changed the outcome.  Time, however, does not give us this luxury and these questions will never be answered.  The best that can be done is to acknowledge that Ken’s illness, depression, can be deadly. 

It seems that our profession gives little in return for years of hard labor.  Learning a way to balance the demands of the business of being a lawyer with the need for downtime is essential to one’s mental and physical health.  Ken’s depression is an all too real downside of the practice of law.  His suicide is a tragedy to his family, our law firm and to the legal community.  He was one of the “good” guys and the profession needs more people like him.

For those of us left behind we struggle for understanding and to carry on in spite of the sadness we each feel.  Inevitably when speaking with others we are confronted with the questions of why?  Most people will ask the normal questions – were there money problems, did he have marital problems or health issues.  The answer to these questions is no and then people just cannot fathom why Ken chose to end his life.   I know in my heart that, as the minister said during his memorial, that Ken felt he was “fixing” the situation.  Ken was a fixer and this was his only choice left.

I’ll always miss Ken Jameson.  The courage and commitment he showed to his clients, his family and those of us in business with him is something I admire.   However, his suffering in silence has left me and his other colleagues with regrets as to what we could have done to help.  In the end, however, Ken could not give himself permission to be less than perfect and eventually, felt those in his life were better off without him.  It is truly a sad ending to a beautiful life that could have been prevented.  My hope in sharing Ken’s story is that there will be greater recognition of depression and the despair that can accompany and that it will help someone struggling with these issues.  As for Ken, I hope he has found the peace that life did not provide.

Editors note — If you or someone you know suffers from depression and may have thought about suicide, visit the website of the national organization The American Association of Suicidology which contains great information, resources and how to get help. Lawyers can also contact  Lawyer Assistance Programs in their legal community.  To locate a program near you, visit the ABA’s Commission on Lawyer Assistance Programs website.

Paying Attention to Our Depression

Depression isn’t just an illness.  It’s a messenger.

In his book, Unstuck, James Gordon, M.D., writes:

“Depression is not a disease, the end point of a pathological process.  It is a sign that our lives are out of balance, that we’re stuck.  It’s a wake-up call and the start of a journey that can help us become whole and happy, a journey that can change and transform our lives.  Healing depression and overcoming unhappiness mean dealing more effectively with stress; recovering physical and psychological balance; reclaiming parts of ourselves that we’ve ignored or suppressed: and appreciating the wholeness that has somehow slipped away from us, or that we have never really known”.

If we would but listen, we might find that our depression is trying to tell us something; important insights about our lives and the ways we live it that might be keeping us mired in a soupy gloom.

We often don’t heed our inner wisdom, but keep going full-speed ahead in the wrong direction anyway. Richard O’Connor, Ph.D. observed, “Depression is a vicious circle and we keep doing these destructive patterns because “we don’t how to do anything else.”

When we think of depression only as an illness, we oversimplify its causes and remedies.  No doubt, it has profound effects on our brains and bodies.  Surely, it runs in families and likely has a genetic component. But if it were only that, a blue pill would solve the problem.  And it doesn’t.

The pain of depression may be an impetus for sufferers to live a more authentic life.  Often people who suffer from depression are living from a wounded place within themselves.  Along the way, they learned that they weren’t “good” enough or were “bad people”.  As a consequence, they learned to hide their true needs and wants and live an inauthentic life; a life that may not work, but they don’t know how to change.

In this vein, folks can come to think of depression as some sort of punishment:  a recompense of some unknown sins from an undefined past.  Or, maybe the very real wrongs they may have committed are magnified, as they are prone to be in the mind of a depressive, by the process of generalization: a known cognitive trick of depression where we take a negative incident (e.g. “I lost this case”) and turn it into “Why am I such a failure?”

Depression doesn’t just happen to anyone. Rather, it is the accumulation of a lifetime of varying degrees of psychic pain suffered during a lifetime, often starting in early childhood.  In our early years, many learned that it was dangerous to live from a space of our true selves because of a parent who was an alcoholic, abusive or in some way emotional abusive or absent.

Ellen McGrath, Ph.D., writes:

“Scientists know that traumatic experiences such as child abuse and neglect change the chemistry and even the structure of the brain.  They sensitize the stress response system so that those who are abused become overly responsive to environmental pressures.  They shape wiring patterns in the brain and reset the sensitivity level of the machinery.   Eventually, even small degrees of stress provoke an outpouring of stress hormones, and these hormones in turn act directly on multiple sites to produce the behavioral symptoms of depression. They push the brain’s fear center into overdrive, churning out negative emotions that steer the depression’s severity and add a twist of anxiety”.

Our parents, acting out of their own wounded souls, unconsciously played out their unresolved pain with us during our childhood.  They did so because of their distorted way of seeing the world; a place that they found threatening, its problems unsolvable and against them at every turn.  This hardened them and led them to fail in life’s most important vocation: the nurturance of their own children.

I recall my mom saying to me as a child, “Well, what are you going to do?”  While one could say this was the innocuous lament of a middle-aged mother of 5 kids, later in life I learned it was mom’s worldview that there weren’t really solutions to life’s fundamental problems, that we are, at our core, helpless in the face of life’s thorny challenges. 

My mom suffered from undiagnosed and untreated depression for most of her life.  I now see how this passive, victimized way of seeing the world took root in my psyche as a young man.  And how hard I had to work to overcome it over the years; how I had to struggle to listen less to the inner voice and critic of my parents and incline my ears toward my true self which was always there waiting to be heard.

In Listening to Depression, psychologist, Lara Honos-Webb writes that depression is trying to tell us something: that we are on the wrong track in life.  In this sense, depression can be a teacher if we would only listen to it.

How can we come to see depression as a teacher?  Honos-Webb writes:

“Depression can be seen as a break-down in the service of offering the person an opportunity for a break-through.  In this way, depression can be a corrective feedback to a life with little reflection.  We only reflect on those things that break down in life.  For example, if life is going along smoothly you won’t spend time thinking about the meaning of life.  We tend to think deeply about life when something is not working.  When we identify a problem, we begin to reflect on what caused the problem and how to fix the problem.  If you are disconnected from your deepest feelings and impulses you may still manage to get through life without realizing it.”

I admit that it’s hard to see depression’s value when in the thick of it, the swamp through which we slog with little relief.  But there’s much to be said for seeing depression not just as a disease, but as a messenger that our lives need to change for us to heal.

 

 

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