Guest Articles

Can Creativity Help You Heal From Depression? An Interview With Carrie Barron, M.D.

Dan: Why did you write The Creativity Cure?

Carrie: I felt that the solutions out there for people with anxiety and depression were partial solutions, incomplete remedies. The way we live now causes stress for many people – the pace, the lack of rest or leisure, the relentless striving. Our technological, cerebrally focused culture has taken us out of our bodies and ourselves.  Addiction to devices causes an imbalance and a malaise. When you are tied to a device 24-7 you may not be experiencing the fullness of all 5 senses, the things that make you feel energized.  The primal satisfaction of making things and using the hands are slowly slipping away from us. For wellbeing, we have to make a conscious effort to maintain them. When my patients make and fix things, they feel better.  Research shows that manual effort and creativity are antidotes for malaise. The Creativity Cure was written to help people find another way.

Dan: I deal with lawyers with depression and other professionals that are on their phones and computers a lot. What kinds of things would you recommend that they do with their hands for physical?

Carrie:  It’s about getting out of your head.  There are many cerebrally oriented people, but “ I think therefore I am” (Descartes) may not be the answer in the current culture.  It is really becoming I think therefore I’m not. Too much thinking at the exclusion of physical and manual activity can make us depressed.  Physicality, creativity and using your hands – – cooking or washing cars or crafting, painting walls or using watercolors — honor anatomical intent.  Long ago manual action in everyday life was necessary for physical survival. Now we need these actions for psychological survival.

The need to create is primal. Paint a wooden board or do Legos with your child.  Do that thing you were always drawn and do it clumsily, imperfectly. You don’t have to have any experience as an artist or a maker of things.  You don’t have to have a fine result. You can just explore, begin and build. The beauty is in the inner experience.  Research has shown that meaningful hand use decreases depression.

Dan: In your book, write about the unconscious mind. What do you mean by that?

Carrie: The unconscious mind, the deepest most hidden layer of our mind  houses our ,  primal self, our instincts, our intuitions and our truth.  The unconscious is a treasure trove of clues about our natural self, our unique self.   We can get in touch with the deepest layer of our mind via dreams and seemingly random thoughts. Noting where our minds naturally drift helps us learn about where we need to be and what we need to do. The unconscious is a very powerful resource.

Dan: What is our unconscious trying to tell us for people who suffer with anxiety and depression?

Carrie:  Depression can have many different causes: biological, situational, genetic or hormonal. It can also be the result of trauma.  Self-knowledge and insight  – knowing what resides in your unconscious mind – helps with depression because as the saying goes, the truth sets us free.  Talking to a pastor or a mental health professional can elucidate information that moves you forward. Understanding yourself: who you really are, what your instincts are or what you are actually upset about is key for positive change. Sometimes you think your concern is one thing and your deeper self tells you that it is another. Following unconscious clues helps you live more truthfully and happily.

Dan: You mentioned “clues” from the unconscious. Can people that are dealing with anxiety and depression unearth these clues themselves? If a person did receive such clues, how would a person know, without talking to a therapist, know what to make of these clues?

Carrie: Writing is helpful. Keep a journal.  Take walks, try yoga, breathe, self-reflect, fiddle with paint, doodle, just let.  Important material bubbles up when your mind slows down. Be curious and wonder, “Who am I that I love that, what does this leaning say about me, how can I this passion be part of my regular life?” Paying attention to the feeling that accompanies certain thoughts can help you. Certain involvements can make you unhappy but they are habitual so you just keep on. Acknowledging your true inner responses enables you to change.  Breaking through denial is key.

Dan: In my work helping lawyers with burnout, anxiety and depression, many of them that seem to contact me are middle-aged. Do you find that a lot of the people, the clients you see are coming to you in midlife?

Carrie:  Yes, and midlife can be the best time of life. Loss and disruption, while initially causing depression or anxiety, can lead to positive inner transformation. If we learn to seek pleasure, solace or a feeling of elevation from friendships, family, creativity, and tending to those we love, we are empowered. If you are dependent on an outside institution for your self-esteem, you are less in control of your life and more vulnerable. Define yourself; don’t let it come from the outside.

Dan: I’d like to follow up on a point you make in your book when you talk about people not being in contact with their physical bodies and a visceral since of being alive.  I spoke recently with Richard O’Connor, a psychologist in New York City who wrote the book Undoing Depression. He said that depression really wasn’t really about the emotion of sadness – – but about the absence of all emotion. Is that something that you see with the depressed patients you treat?

Carrie: I think it was Andrew Solomon, author of The Noonday Demon: An Atlas of Depression, who offered that beautiful juxtaposition: the opposite of depression is vitality  – – not happiness. That really captures it.

Dan: In your book you make a distinction. You indicated that The Creativity Cure is a good fit for people with mild to moderate depression anxiety, but maybe not major depression. Why?

Carrie: For those who suffer from major depression and feel that their depression is well managed, The Creativity Cure is a great option for finding more vitality.   Those who at baseline have mild to moderate depression and find that meds do not help enough can discover ways to unleash creativity and happiness in the book. It takes some motivation, but once you get going, you will have more energy and a greater number of happy moments.

Dan: What percentage of your patients would you say depression plays a role in their maladies for which they’re seeing you?

Carrie: Eighty percent.

Dan:  Wow – -that many. And to actually put The Creativity Cure into effect, how long do you generally work with somebody to get to the point where they can do it on their own?

Carrie: We start right away by finding out as much as we can about who that person is and what makes him or her feel alive.  We think about what is working and what is not, why certain choices were made and ways to redirect the self. Through the Five Part Prescription: Insight, Movement, Mind Rest, Using Your Own Two Hands and Mind Shift people can uncover their true leanings and find more vigor, inspiration, passion. For positive change, integrate the methods into your lifestyle over several weeks. Little steps! True change is all about a little at a time and building.

Dan: In your career as therapist, have you treated lawyers with depression?

Carrie: Yes, yes.

Dan: Have you found anything about their life style that contributes to their depression?

Carrie: I think its three things for lawyers, especially those in high-pressure positions. My client Marnie comes to mind.  She is a 28 year-old lawyer who has to give up her personal life at the drop of a hat when she is needed. It is tough.  Number one, she is often exhausted because 17 -hour days are not uncommon. Number two, there is a lack of autonomy because this 17 -hour day can be thrust upon her at anytime and continue for weeks. Marnie, professional, committed and with good attitude, has to be available in the moment, late nights, on weekends.

But, compliance takes a toll.  It makes her depressed to be in the office and not see sunlight. Not being in control of her time is hard. Even if the work is interesting, she has to give up other important involvements.  Marnie feels lonely and isolated because she has little opportunity to be with old friends or to develop new ones.  We are working on ways she can maintain friendships, even in text message or email shoot-outs if an in- the- flesh visit must be delayed.

Number three is that living in your head all the time, no matter how brilliant you are, is not healthy. Smart as a whip with facts and numbers, Marnie garners much more pleasure from aesthetics. She likes design but has not felt free enough to develop this interest. Colors, shapes, proportions  – thinking about these things makes her happy. It is a sensual, visual way of moving through the world.  A big part of the treatment is making her interest in design part of her ongoing life.

I think lawyers in general are really smart people who are great at using their minds. They have been reinforced for this all their lives, but for a richer, higher, happier state, many of these cerebral people need to get out of their heads and start using their hands. Go into a creative world. Balance mind, hands and body.

Dan: I have given many talks around the country on the topic of lawyer and one of the things I like to say is that lawyers have the most active fantasy lives of most professionals I’ve ever spoke to, where they dream of doing something else than lawyering. Can those be clues that would fit in with The Creativity Cure?

Carrie:  Fantasizing is a sign of mental health. It’s a good thing.  Learning about your inclinations through daydreams might lead you to change your life in a big way or make it better in small ways. Tiny steps allow for big changes because they foster consistency and this builds a new self in a solid way.  If you’re interested in learning how to make beautiful cupcakes you can do that for an hour on the weekend.  Play guitar, write poems, tend tomatoes in a vegetable garden and do it for a few minutes a day. Start small and make it part of you. Keep dreaming and keep doing. Contentment is about maintaining an identity that integrates your creative self.

Carrie Barron, M.D., is a psychiatrist and psychoanalyst in New York City, an adjunct psychiatrist at Columbian-Presbyternian and author of the recently published book, “The Creativity Cure“.  Please check her insight blog at www.creativitycure.com.

 

Helpful Repetitive Thinking in Depression

In a previous blog, I noted that rumination – repeated dwelling on feelings, problems, and difficulties – is an important process maintaining depression. I also discussed the finding that repetitive thinking about upsetting events and unresolved problems is a normal and natural response – and that sometimes it can be helpful. For example, focusing on our difficulties can help us to come to terms with them and to solve problems. These contrasting effects of repetitive thinking led to the key questions of what factors determine whether repetitive thinking is helpful or unhelpful, and how does such thinking go wrong in depression?

These questions have been the primary focus of my research over the last 15 years and we are beginning to get some preliminary answers. This research is summarized in a research paper I published in Psychological Bulletin (2008).

First, it appears that the content and focus of the repetitive thinking is important. If you keep thinking about something positive, it is likely to make you feel better, whereas if you keep dwelling on something negative it will make you feel worse. In a nice meta-analysis of the field, Mor and Winquist (2002) found that attention to negative aspects of the self was strongly related to increased levels of negative mood, whereas attention to positive aspects of the self was related to lower levels of negative mood. The act of repetitively thinking about anything acts as a form of mental rehearsal for the content of inner speech, strengthening and elaborating the mental representations, making them easier to come to mind in future. It also tends to polarize and exaggerate thinking, making it more extreme. So, repetitive focus tends to exacerbate the current state and mood – if you are in a sad mood with negative thoughts, and you dwell on them, the mood will get worse, and the thinking will get more negative. Thus, repetitive thought acts as an amplifier of thoughts and feelings.

Second, the style of the repetitive thinking is equally important. It is possible to focus on negative information in helpful or unhelpful ways.

Imagine that you are faced with an upsetting and saddening event such as the unwanted end of an intimate relationship. The break-down of a relationship will be experienced as negative by nearly everyone and will likely lead one to dwell on its demise. However, there are quite distinct ways of dwelling on it.

One understandable way to dwell on this split is to think about why it happened, what it means, what caused it, and its implications for the future. In this style of processing the break-up, you would be focused on the causes, meanings, and implications of what happened. This way of thinking tends to move away from the specific details and contexts of what happened and to more general abstractions, which capture the key gist of the event and what this event might share with past events and with other situations in the future. Hence, this style of thinking is called abstract processing. Typical questions might include “Why did this happen? What does it mean about me? What does it mean about the future?” An extensive social psychology literature indicates that such “why?” questions tend to make thinking more abstract and to distance individuals from the specifics of situations.

This abstract style of processing negative events is typical of depressive rumination and anxious worry. You can see how if you are feeling down and have low self-esteem, focusing on yourself and thinking about a break-up in this abstract way could be unhelpful, because asking these questions about causes, meanings, and implications is likely to lead to negative self-blaming conclusions, e.g., “It is my fault”. Moreover, because abstract processing tends to broaden out across situations, such thinking will pull in past memories of rejection and loss (e.g., “This keeps happening to me”), and may lead to general conclusions about the future, such as “I will never have a lasting relationship”, all of which worsen mood and exacerbate depression.

In contrast, you could repetitively reflect on the break-up by focusing on exactly how it happened, replaying in detail the events that led up to the split and the final few meetings and conversations with your ex, noting in detail what happened. In this style of processing the break-up, you would be focused on the specific details, the sequence and the circumstance of how the relationship came to an end. This way of thinking focuses on the context (when, where, how, what, who) of what happened and how it happened and stays close to your actual concrete experience of the end of the relationship, rather than thinking about its meaning. Hence, this style of thinking is called concrete processing. Typical questions might include “How did this happen? What did I do? What did my ex do? How did I feel? How did this unfold over time?”

A series of experiments in my lab, replicated in other labs, have found that, when faced with problems or upsetting events, adopting a concrete style of processing is more helpful than an abstract style of processing. For example, when asked to generate solutions to interpersonal difficulties such as an argument with a partner or a disagreement with your boss, we found that prompting currently depressed patients, formerly depressed patients and never depressed controls with either no questions, abstract “Why?” questions, or concrete “How?” questions, influenced the quality of solutions generated. Replicating other findings, patients with depression were worse at solving social problems than recovered depressed patients and non-depressed individuals when left to their own devices. However, when prompted to ask concrete questions, patients with depression were as good at solving problems as the other two groups, suggesting that these “How?” questions ameliorated this difficulty. Further, asking abstract “Why?” questions worsened problem-solving in people who were formerly depressed, suggesting that these questions activated their previous difficulties. We believe that concrete processing is more helpful for problem-solving because it makes an individual aware of the specific circumstances and behaviors that occurred in a situation, suggesting possible alternatives to resolve the situation.

In another study, we found that training students to think about the meanings and implications of emotional events for 30 minutes caused them to feel worse to a subsequent stressful anagram task than students who practiced thinking about the concrete details of emotional events. Thus, relative to concrete processing abstract processing increases the negative emotional response to difficulties. Similar effects have been found when studying how quickly people recover from previous upsetting events, with a concrete style of thinking about past sad or traumatic events proving to be more helpful.

Taken together, this research suggests that repetitive thinking about the self, negative feelings and problems in an abstract style will be particularly problematic, driving depression and anxiety. Further, it suggests that shifting to a more concrete way of thinking about difficulties could be helpful for people with depression. Building on this hypothesis, we have investigated whether training people with depression to become more concrete and specific can itself help to reduce depression. This will be the subject of another blog.

Ed Watkins, Ph.D. is a clinical psychologist.

 

Separating Sadness From Depression

Sad movies are popular. People read sad novels and get in touch with the feeling. However, in our daily lives, sadness is a bittersweet memory of what once was.

This normal and natural emotion accompanies a loss of something or someone you value. It can be brief. It can linger. Sadness can reappear on the date of a loss, from looking at a picture, a situation, a passing thought—practically anything that you associate with the loss that holds meaning for you.

It is because we form attachments with people, with animals, and with ideals and places, that sadness carries through our lives. The size of the loss doesn’t matter. A child who experiences the loss of a goldfish weeps at a loss that others might find trivial. It’s not trivial. This loss is as real as any other is.

Losses come in different ways at different times. The loss of a tradition can evoke sadness. You may miss and feel sad when your children grow to adulthood and leave home to live on their own. The death of a close friend may leave you with a lingering feeling of loss. All sad. All inevitable.

When my childhood friend Al’s teen-aged daughter died, I saw my six-foot-five, 350-pound friend collapse in sadness and despair. He asked, “How will I ever get through this?” There was no answer. There was only time. I supported him as best I could. I wrote a poem in her memory. I wished I could have done more.

Within the year of his daughter’s death, Al died from cancer. I felt a great loss. Sadness still awakens within me when I think of happier times. When I visit his grave, I bury an old coin in the ground. Silly? Perhaps. Al loved to collect old coins. There is nothing wrong with feeling sentimental.

Sadness is a tribute. If there were no meaning to our relationships, there would be no sad feelings. There are sad times because there were once happy times, cherished times, and valued attachments.

Sadness reminds us that we are human. It is part of our biology and our heritage. If you accept that reality, you may find that you don’t go through phases of denial, anger, and resignation following a major loss. You may avoid depression. Acceptance of sadness is enough. Meanwhile, write poetry. Organize a march to raise money for a cause. Paint. Walk. Solve a problem.

Loss. Sadness. Time to grieve. Time to heal. Time. Time. Time. It can go so slowly. There is acceptance. There is allowance. There is working through the process of loss. However, in situations where the loss came from a tragedy that is followed by depressive thinking and depression, it can take considerable time and work to come to grips with the experience.

Bob’s fiancée, Jane, died hours before their wedding. It was a tragic automobile accident. Bob felt numbed and grief stricken. Three years after this tragic event, Bob continued to feel great guilt and depression. He told himself, “If only I had phoned Jane before she left, she would have gone through the intersection at another time.” He told himself, “I can’t live without her.” He believed, “I will never find anyone like Jane.” A cloud of hopelessness covered his life, and his depressed mood was both deep and painful.

Bob stopped doing what he once enjoyed. An avid tennis player, Bob let his racquet gather dust. There were no more dinners with his friends. As he drew within himself, he withdrew from his family. Previously a successful accountant, Bob quit. Thereafter, he mostly did odd jobs, such as buffing automobiles.

Bob felt overwhelmed by the details of daily living. His mood was despondent. He awakened in the middle of the night with a frightening image of the accident that took Jane’s life. He compounded his profound sadness with defeatism, pessimism, and self-loathing.

As he learned to defuse the negativity in his thoughts, and to accept his lack of control over Jane’s tragic death, Bob’s inner turmoil softened to sadness. Months later, he resumed his accounting career. At the time of this writing, he is happily married with three children. His family is a source of great joy. Has he forgotten about Jane? Jane lives on as a cherished memory.

Loss is inevitable. Sadness is inevitable. But, depression is not inevitable. Sadness, you accept. You deal with depression.

When sadness changes to depressive darkness, it’s time to look for a flashlight.

By Bill Knauss, Ph.D.

Depression & Procrastination

Most people who are depressed have a hard time being productive. Work—and here I mean everything from paid employment to child-rearing and housekeeping to the kinds of “work” we assign ourselves, like reading a good book or planting a garden—is a chore to the depressed. It drains us, leaves us feeling as bad as before, physically worn out and emotionally depleted, instead of proud of ourselves and invigorated. Other people with depression seem to work very hard all the time, but there is little payoff for their efforts. As with so much of depression, there is a real chicken-or-egg question—is work so difficult because we’re depressed, or are we depressed in part because we can’t accomplish anything? And as with so many chicken-or-egg situations, we face a false dichotomy: the truth is, poor work habits and depression reinforce each other.

Depressed people tend to be great procrastinators. Procrastination means putting off for a later time what “should” be done now. The “should” may come from without, as with the teenager who dawdles over homework, or from within, as with me planting my garden. When it comes from without, it’s easy to see the rebelliousness that procrastination expresses. When it comes from within, it’s hard to see immediately what purpose procrastination serves—but it may serve many.

procrastination-meterProcrastinators have some big false assumptions about how work works. They assume that really productive people are always in a positive, energetic frame of mind that lets them jump right into piles of paper and quickly do what needs to be done, only emerging when the task is accomplished. On the contrary, motivation follows action instead of the other way around. When we make ourselves face the task ahead of us, it usually isn’t as bad as we think, and we begin to feel good about the progress we start making. Work comes first, and then comes the positive frame of mind. Closely allied to this misunderstanding about motivation is the idea that things should be easy. Depressed people assume that people who are good at work skills always feel confident and easily attain their goals; because they themselves don’t feel this way, they assume that they will never be successful. But again, most people who are really successful assume that there are going to be hard times, frustrations, and setbacks along the way. Knowing this in advance, they don’t get thrown for a loop and descend into self-blame whenever there’s a problem. If we wait until we feel completely prepared and feeling really motivated, we’ll spend a lot of our lives waiting. See my page on developing greater will power.

Procrastination can also help protect the depressed person’s precarious self-esteem. We can always tell ourselves we would have done it better if. . . . The paradigm is the college term paper rushed together in a furious all-nighter. The student protects himself from the risk of exposing his best work by never having the time to do it right. This allows him to protect his fantasied sense of himself as special and uniquely gifted. Procrastination is also a result of the depressed person’s tendency toward perfectionism, a crippling problem. Research has shown that the more perfectionistic a depressed person is, the worse his chances of recovery. Trying so hard to make every single little piece of a project perfect, we doom ourselves to disappointment and frustration.

broad_chain_closeup_c_wikimedia_org_There is a simple, useful process psychologists call chaining, or making one event depend on another event’s being accomplished first. You can make chains that help you get a lot of work done. I want to go play Tomb Raider on my computer, but I’m going to let that be my reward for first going through the outdated magazines. As I go through the pile, I find there’s one I really must renew my subscription to. Now I have to do that as well before I play Tomb Raider. Renewing that subscription reminds me that I have a stack of unpaid bills nagging at me. Maybe I can’t get the bills all paid, but I can take twenty minutes to get them organized and make a commitment to myself to pay them tomorrow. Now I can go play my computer game feeling a little less overwhelmed by events and a little more deserving of some time to goof off. As you get used to this practice, your chains can get longer and longer without getting burdensome.

Finally, there’s also the Irish way of overcoming procrastination. Confronted with a wall too high to climb, the Irishman throws his hat over it. Now he must find a way over the wall. If I have to paint a room, I’ll likely get the paint and start the first coat as soon as I can, disrupting the whole household in the process. That way I’m fully committed, and have to finish quickly.

Controlling procrastination is more like controlling eating or exercise than smoking or drinking; it’s impossible to never procrastinate. For one thing, often it’s not clear which of two is the most important activity. Study for the exam right now, or eat dinner and then study? Or eat dinner, take out the garbage, walk the dog, call a friend, check Facebook, and then study? But procrastination is a habit that can gradually be replaced by the habit of not putting things off.

Rita Emmett, in The Procrastinator’s Handbook, gives us Emmett’s Law: “The dread of doing a task uses up more time and energy than doing the task itself.” Here’s O’Connor’s corollary: “It’s amazing what you can accomplish when you finally get down to work.” So my first advice for overcoming procrastination is to glue your seat to the chair, ignore distractions, and work for five minutes. Then you can take a short break if you feel it’s necessary, but put in another five minutes after your break. The procrastinating impulse in your mindless self won’t respond to logical argument, but it may respond to a narrowing of focus. You’ll get in a groove, start feeling productive, and the impulse to procrastinate further will dwindle. If it doesn’t work today, try again tomorrow.

A second piece of advice: while you’re sitting glued to your chair, you’re not allowed to do anything other than the task you’re there for, no matter what attractive distraction might come to mind. You don’t have to work on your primary task, but you can’t do anything else. This can be torture, but it’s great mental discipline. You’ll quickly see how easily distracted you are, but you’re forced to develop the will power to withstand temptation. Eventually, you’ll get something constructive done.

Hold yourself to precommitments. No television (Internet, email) until I’ve worked for a half hour. If I get X done, I’ll reward myself with pizza tonight; otherwise it’s peanut butter. Be sure to keep these commitments reasonable and don’t set yourself up to fail. If you practice and get consistent at this, you can start to up the ante.

Business Finish LineProcrastinators don’t reward themselves for finishing. A drink with friends, a special dessert—things that normal people might do to celebrate an accomplishment—these things don’t occur to procrastinators (partly because they’re never satisfied with their results). But it’s important to practice these rituals because, in our minds, the pleasure that comes with the reward comes to be associated with doing a job well. In this way, work itself becomes more satisfying.

Clutter is highly associated with procrastination. Each of those extraneous items on your desk, workspace, or computer desktop is a distraction, a reminder of something else to do. Mental clutter works the same way; if you have a set of nagging chores, just making a list will help you focus on the present. The list will contain the nagging. Every time we are distracted, we lose efficiency. You can reduce your procrastination greatly by eliminating distracting cues.

Of course, personal computers and wireless communication have created many more temptations to procrastinate—games, Facebook updates, checking on the news. Tweets, cell phone calls, and instant messages constantly break our concentration. If we really want to focus on something, we have to remove temptation and prevent interruptions. If you work on your computer, turn off your Internet browser and make it difficult to get back on. Put the phone on silent. Multitasking is a myth.

By Richard O’Connor, Ph.D.

Dr. O’Connor is a therapist and best-selling author of the book Undoing Depression: What Therapy Can’t Teach You and Medication Can’t Give You.

 

Eight Keys to Life Hardiness and Resiliency: Helpful Reminders during Challenging Times

Helen Keller once wrote: “Character cannot be developed in ease and quiet. Only through experience of trial and suffering can the soul be strengthened, vision cleared, ambition inspired and success achieved.” As we navigate through challenging times toward a better future, it’s useful to visit some tried and true ideas regarding life hardiness and resiliency. This is not meant to be an exhaustive list, but rather a reminder of some existential ideas we sometimes set aside as we tend to the hectic details of daily life. If you find this article helpful, share it with those whom you care about who are in need. There’s power in good will reverberated.

1. The power of perspective

Life is not always easy. We all know that. How we choose the way we think, feel, and act in relation to life’s challenges can often make the difference between hope versus despair, optimism versus frustration, and victory versus defeat. With every challenging situation we encounter, ask questions such as “What is the lesson here?”, “How can I learn from this experience?”, “What is most important now?”, and “If I think outside the box, what are some better answers?” The higher the quality of questions we ask, the better the quality of answers we will receive. Ask constructive questions based on learning and priorities, and we can gain the proper perspective to help us tackle the situation at hand.

“I am not discouraged, because every wrong attempt discarded is another step forward.”

– Thomas A. Edison

2. Don’t focus on the mud

We should learn from the past, but not be stuck in it. Sometimes life circumstances and personal setbacks can haunt and prevent us from seeing our true potential and recognizing new opportunities. What has already happened we cannot change, but what is yet to happen we can shape and influence. At times the first step is simply to break from the past and declare that it is you, not your history, who’s in charge. Ask empowering questions such as “What matters to me now?”, “How can I make a difference in this situation?”, and “What’s the next step for my best interest and well-being?” Every moment we’re alive we can make new choices that help us move on and step toward a better future. If we pay attention to only mud on the ground after a storm, we won’t notice that the sky above us has already cleared. Goethe reminds us: “Nothing is worth more than this day.” Don’t focus on the mud. Make better choices today and move on.

3. All you have to do is ask…the right individuals

In life we sometimes may feel like we’re walking alone, but we don’t have to be as long as we’re honest with ourselves, and ask for help when needed. You can find strength and support through a “board of advisors” you create. These are your “go-to” people when you’re in need of sound advice, a new perspective, a certain expertise, or simply an empathetic ear. Members of the board can include individuals you know whose opinions you respect and character you trust. Your personal B.O.A. can also include your role models from past and present, historical or fictional. Ask, for example: “What would (role model A) say about my situation?”, or “What would (role model B) do if she were in my shoes?” Asking for help is not the same as complaining. Habitual complainers dwell on what’s wrong. Successful people assume responsibility for finding the support they need to solve the problem.

 “Normal people have problems. The smart ones get help.”

– Daniel Amen

4. Thrive on your strengths while exploring new potential

We each have certain dispositions in which we naturally excel. Some of us are great with people, others are handy with tools, yet others thrive on information. A mismatch between what you’re naturally good at and your work in life is wasted potential. There are a myriad of assessment tools available that can help you determine your natural strengths, as well as your areas of greatest potential.

“When you follow your bliss… doors will open where you would not have thought there would be doors, and where there wouldn’t be a door for anyone else.”

– Joseph Campbell

5. Keep the fun and enjoyment

Van Wilder from the movie of the same name said: “You shouldn’t take life too seriously. You’ll never get out alive.” No matter how difficult the circumstances, resolve to keep the fun and enjoyment in your life. Make a point to take a “mini-vacation” everyday; be it walking in the park, exercising, hugging a loved one, or taking a nice, hot bath. The more challenging and stressful life is, the more important it is to take good care of yourself so you can relax your body, ease your mind, and rejuvenate your spirit. After recharging your batteries, you may see the same situation in a different, more positive light.

6. Keep your options open

There are many paths to opportunity, success, and happiness. We can begin by asking ourselves what true success and happiness means and looks like to us, and let our answers show the way. When one path seems to be at a dead end, look another way and see what new openings may be waiting just around the corner. Options can come from consulting the aforementioned board of advisors, thinking outside the box, daring to dream, doing something different, or simply letting go of a habit or condition that has clearly outlived its usefulness. We’re never stuck unless we have blinders on. Keep your options open.

“We must dare to think ‘unthinkable’ thoughts. We must learn to explore all the options and possibilities that confront us in a complex and rapidly changing world.”

– James W. Fulbright

7. Keep the faith

There are many ways to keep your faith alive: Faith in yourself, faith in your place in this world, and faith in answers the Universe has in store for you. Go to places and engage in activities that give you the greatest feeling of inner peace. When you give yourself this gift on a regular basis, what psychologists call the Higher Self emerges, as insights, inspiration, and a sense of deep knowing spring forth from the depth of your soul.

The following quote by Anne Frank is just one example: “The best remedy for those who are afraid, lonely, or unhappy is to go outside, somewhere where they can be quiet, alone with the heavens, nature, and God. Because only then does one feel that all is as it should be and that God wishes to see people happy, amidst the simple beauty of nature.”

As you immerse yourself in peace, ask: “What if what I’m going through is a blessing in disguise? What greater meaning exists for me now?” Put forth these and any other constructive questions that come straight from your heart. Don’t try to figure out the answers during these moments, but rather “empty your mind” and let the solutions come to you. The answers may come at that moment or later: sometimes when the time is right; sometimes when you least expect them. All you have to do is hold the questions and pay attention.

Keep the faith. Find your peace within, and the answers will come!

8. Resolve to never, ever give up

I once heard a courageous person say that there are no losers in life, except for those who give up on themselves. If you’re still alive and breathing, your purpose in this life time is not yet fulfilled. The great adventure is in discovering what that purpose is, and to live it until your last breath. If you’re reading this article, you’re probably being pulled by an inner calling to do more. That calling is your adventure waiting to happen. What are you waiting for? And what are you willing to do now?

“Abraham Lincoln lost eight elections, failed twice in business and suffered a nervous breakdown before he became the president of the United States.”

– Wall Street Journal

“If you don’t have the capacity to change yourself and your own attitudes, then nothing around you can be changed.”

– Anwar Sadat

“The marvelous richness of human experience would lose something of rewarding joy if there were no limitations to overcome. The hilltop hour would not be half so wonderful if there were no dark valleys to traverse.”

– Helen Keller

By Preston Ni, M.S.B.A.

Can Depression Be Good For You?

Most people think of depression as a mental disorder, that is, a biological illness of the brain. Here I argue that the concept of depression as a mental disorder has been unhelpfully overextended to include all manner of human suffering, and, more controversially, that ‘depression’ can even be good for us—an idea that I first visited in my book The Meaning of Madness.

Let us begin by thinking very broadly about the concept of depression. There are important geographical variations in the prevalence of depression, and these can in large part be accounted for by socio-cultural rather than biological factors. In traditional societies human distress is more likely to be seen as an indicator of the need to address important life problems rather than as a mental disorder requiring professional treatment, and for this reason the diagnosis of depression is correspondingly less common. Some linguistic communities do not have a word or even a concept to talk or think about ‘depression’, and many people from traditional societies with what may be construed as depression present instead with physical complaints such as fatigue, headache, or chest pain. Punjabi women who have recently immigrated to the UK and given birth find it baffling that a health visitor should pop round to ask them if they are depressed. Not only had they never considered the possibility that giving birth could be anything other than a joyous event, but they do not even have a word with which to translate the concept of ‘depression’ into Punjabi.

In modern societies such as the UK and the USA, people talk about depression more readily and more easily. As a result, they are more likely to interpret their distress in terms of depression, and also more likely to seek out a diagnosis of the illness. At the same time, groups with vested interests such as pharmaceutical companies and mental health experts promote the notion of saccharine happiness as a natural, default state, and of human distress as a mental disorder. The concept of depression as a mental disorder may be useful for the more severe and intractable cases treated by hospital psychiatrists, but probably not for the majority of cases, which, for the most part, are mild and short-lived and easily interpreted in terms of life circumstances, human nature, or the human condition.

Another (non-mutually exclusive) explanation for the important geographical variations in the prevalence of depression may lie in the nature of modern societies, which have become increasingly individualistic and divorced from traditional values. For many people living in our society, life can seem both suffocating and far removed, lonely even and especially among the multitudes, and not only meaningless but absurd. By encoding their distress in terms of a mental disorder, our society may be subtly implying that the problem lies not with itself but with them, fragile and failing individuals that they are. Of course, many people prefer to buy into this reductive, physicalist explanation than, presumably, to confront their existential angst. But thinking of unhappiness in terms of an illness or chemical imbalance can be counterproductive, as it can prevent us from identifying and addressing the important psychological or life problems that are at the root of our distress.

All this is not to say that the concept of depression as a mental disorder is bogus, but only that the diagnosis of depression has been over-extended to include far more than just depression the mental disorder. If, like the majority of medical conditions, depression could be defined and diagnosed according to its aetiology or pathology—that is, according to its physical cause or effect—such a state of affairs could not have arisen. Unfortunately, depression cannot as yet be defined according to its aetiology or pathology, but only according to its clinical manifestations and symptoms. Given this, a physician cannot base a diagnosis of depression on any objective criterion such as a blood test or a brain scan, but only on his subjective interpretation of the nature and severity of the patient’s symptoms; if some of these symptoms appear to tally with the diagnostic criteria for depression, then, bingo, the physician is able to justify a diagnosis of depression.

One important problem here is that the definition of ‘depression’ is circular: the concept of depression is defined according to the symptoms of depression, which are in turn defined according to the concept of depression. For this reason, it is impossible to be certain that the concept of depression maps onto any distinct disease entity, particularly since a diagnosis of depression can apply to anything from mild depression to depressive psychosis and depressive stupor, and overlap with several other categories of mental disorder including dysthymia, adjustment disorders, and anxiety disorders. One of the consequences of our ‘menu of symptoms‘ approach to diagnosing depression is that two people with absolutely no symptoms in common (not even depressed mood) can both end up with the same unitary diagnosis of depression. For this reason especially, the concept of depression as a mental disorder has been charged with being little more than a socially constructed dustbin for all manner of human suffering.

Let us grant, as the orthodoxy has it, that every person inherits a certain complement of genes that make him more or less vulnerable to entering a state that could be diagnosed as depression (and let us also refer to this state as ‘the depressive position’ to include the entire continuum of clinical depression and other states of depressed mood). A person enters the depressive position if the amount of stress that he or she comes under is greater than the amount of stress that he or she can tolerate, given the complement of genes that he or she has inherited. Genes for potentially debilitating disorders gradually pass out of a population over time because affected people have, on average, fewer children or fewer healthy children than non-affected people. The fact that this has not happened for clinical depression suggests that the genes responsible are being maintained despite their potentially debilitating effects on a significant proportion of the population, and thus that they are conferring an important adaptive advantage.

There are other instances of genes that both predispose to an illness and confer an important adaptive advantage. In sickle cell disease, for example, red blood cells assume a rigid sickle shape that restricts their passage through tiny blood vessels. This leads to a number of serious physical complications and, in traditional or historical societies, to a radically shortened life expectancy. At the same time, carrying just one allele of the sickle cell gene (‘sickle cell trait’) makes it impossible for malarial parasites to reproduce in red blood cells, and thereby confers immunity to malaria. The fact that the gene for sickle cell disease is particularly common in populations from malarial regions suggests that, at least in evolutionary terms, a debilitating illness in the few can be a price worth paying for an important adaptive advantage in the many.

What important adaptive advantage could the depressive position be conferring? Just as physical pain has evolved to signal injury and to prevent further injury, so the depressive position may have evolved to remove us from distressing, damaging, or futile situations. The time and space and solitude that the adoption of the depressive position affords prevents us from making rash decisions, enables us to see the bigger picture, and – in the context of being a social animal – to reassess our social relationships, think about those who are significant to us, and relate to them more meaningfully and with greater compassion. In other words, the depressive position may have evolved as a signal that something is seriously wrong and needs working through and changing or, at least, processing and understanding. Sometimes we can become so immersed in the humdrum of our everyday lives that we no longer have time to think and feel about ourselves, and so lose sight of our bigger picture. The adoption of the depressive position can force us to cast off the Polyannish optimism and rose-tinted spectacles that shield us from reality, stand back at a distance, re-evaluate and prioritise our needs, and formulate a modest but realistic plan for fulfilling them.

Although the adoption of the depressive position can serve such a mundane purpose, it can also enable us to develop a more refined perspective and deeper understanding of ourselves, of our lives, and of life in general. From an existential standpoint, the adoption of the depressive position obliges us to become aware of our mortality and freedom, and challenges us to exercise the latter within the framework of the former. By meeting this difficult challenge, we are able to break out of the mould that has been imposed upon us, discover who we truly are, and, in so doing, begin to give deep meaning to our lives. Many of the most creative and insightful people in society suffer or suffered from depression or a state that may have been diagnosed as depression. They include the politicians Winston Churchill and Abraham Lincoln; the poets Charles Baudelaire, Elizabeth Bishop, Hart Crane, Emily Dickinson, Sylvia Plath, and Rainer Maria Rilke; the thinkers Michel Foucault, William James, John Stuart Mill, Isaac Newton, Friedrich Nietzsche, and Arthur Schopenhauer; and the writers Charles Dickens, William Faulkner, Graham Greene, Leo Tolstoy, Evelyn Waugh, and Tennessee Williams, and many, many others. To quote Marcel Proust, who himself suffered from depression, ‘Happiness is good for the body, but it is grief which develops the strengths of the mind.’

You see, people in the depressive position are often stigmatised as ‘failures’ or ‘losers’. Of course, nothing could be further from the truth. If these people are in the depressive position, it is most probably because they have tried too hard or taken on too much, so hard and so much that they have made themselves ‘ill with depression’. In other words, if these people are in the depressive position, it is because their world was simply not good enough for them. They wanted more, they wanted better, and they wanted different, not just for themselves, but for all those around them. So if they are failures or losers, this is only because they set the bar far too high. They could have swept everything under the carpet and pretended, as many people do, that all is for the best in the best of possible worlds. But unlike many people, they had the honesty and the strength to admit that something was amiss, that something was not quite right. So rather than being failures or losers, they are just the opposite: they are ambitious, they are truthful, and they are courageous. And that is precisely why they got ‘ill’.

To make them believe that they are suffering from some chemical imbalance in the brain and that their recovery depends solely or even mostly on popping pills is to do them a great disfavour: it is to deny them the precious opportunity not only to identify and address important life problems, but also to develop a deeper and more refined appreciation of themselves and of the world around them—and therefore to deny them the opportunity to fulfil their highest potential as human beings.

Neel Burton, M.D.

Growing Pains: Young Lawyers and Ignoring Depression

I won’t mince words about this: depression is a real illness, and it really, really stinks.   That may be an obvious point for anyone drawn to read this, but obvious as it may be, it is worth repeating aloud occasionally for people like me who learned it the hard way.

To the extent that the depression literature addresses its prevalence within our profession, most of it seems to be directed to, or at least about, our more veteran practitioners: the shareholders and shareholder-aged lawyers among us who have been honing their craft for a decade or more.  But depression is not an ageist beast.  To the contrary, it is indiscriminately opportunistic and content to sprout quietly from a tiny seed, and young lawyers should not be afraid, as I was, to acknowledge this.

You see, we young lawyers are eager to hit the ground running in our careers.  We have typically been successful at everything else we have done in life, and don’t for a second think that our journey through this profession will be any different.  Already Type-A overachievers to begin with in many cases, our desire to succeed these days is heightened by the fact that, especially for young “BigLaw” associates, we know there is a long line of potential replacements waiting in the wings.  Contrary to many of our veteran colleagues, the only legal market we have ever known is that of the Great Recession, where the supply of new lawyers far outpaces the demand for their services.

So we put our heads down and work because that is what we have always done, and because want to be as good at our careers as we have been at everything else in our lives.  However, for many of my peers (lawyers who have been out of law school for six years or less), our burning desire to succeed from Day One, coupled with the modern legal services landscape, is creating a potentially expensive psychological cocktail.

Nine weeks ago, at the ripe age of twenty-eight and nearly four years out of law school, I was diagnosed with depression after failing to heed the warning signs that festered unattended to for over a year.  I was stunned by the news.  How could this have snuck up on me?

I had always prided myself on being even keeled and thoughtful, someone who always had a good feel on his internal pulse.  I had done well in law school, too.  I graduated near the top of my class, was the editor-in-chief of the law review, worked as a research assistant, and had two law review articles to my credit.  During my 3L year, just after
Lehman Brothers collapsed and the hiring market started to spiral into the abyss, I got a state court appellate clerkship with a great judge (who happened to be an even better person, and has been one of my best sources of support these days).  I was smart, worked hard, and generally checked off all the boxes budding young lawyers were supposed to.

As my clerkship term was winding down in early 2011, I received an offer to join an Am-Law Top 10 law firm, the biggest and best in town.  It was an opportunity of a lifetime, and I happily accepted.  Sometime thereafter is when things started to fall apart.  During the 2011 holidays, it struck me just how much I had been grinding at the firm.  I was still getting my feet wet to some degree, but my overwhelming desire to please and be perfect meant that I was seeing my wife for barely two hours a day during the week, and going weeks if not months at a time without seeing any other family or friends.  I was working so hard, and yet the billable hours weren’t reflecting it.  “Suck it up,” I thought, “you’re a young lawyer paying your dues.  All of your peers are in the same boat and you’re lucky to be paying them here!”

And so it trudged on, constantly tweaking my schedule and searching for any edge to achieve that magical balance between the ideal young associate and fulfilled human being.  For the better part of a year, I suppressed any feelings that didn’t sync with my war chant:  “You’re blessed.  People would gladly trade places with you.  Represent yourself, your family, your law school!”

As time wore on, I began to lose the control I had always had over my life.  A classic overachiever, I had always striven to be the consummate All-American Kid, juggling an apparently impossible plate of demands, goals, and desires with aplomb.  For the first time in my life, the internal and external pressures I was feeling were making it difficult for me to juggle, and as the balls hit the ground I felt myself sinking into a pit of deep frustration.  The frustration turned to anger, which turned to sadness, and ultimately the pervasive emptiness that is depression’s hallmark.

It seems obvious now in hindsight, but I was missing, misreading, and just flat-out dismissing so many of my symptoms.  When the crushing fatigue and inability to concentrate on even simple tasks overwhelmed me, I scolded myself for being lazy.  When I started gaining weight and stopped enjoying the active outdoor lifestyle I’d carried on with my wife since we were in high school, I chalked it up as a cost of working in our profession at a high level.  And when personal emptiness and numbness enveloped me, I told myself I was being unappreciative of my many blessings.

I had been programmed for so long to relentlessly push myself toward my next goal that I shoved aside what my own body was trying to tell me.  All the while I was continuing to pull on my proverbial suit of armor, making sure that my colleagues and the rest of the outside world – even my wife and parents – believed I was doing just fine.  I even took on additional extra-curricular activities at the firm, hoping that my increased engagement beyond the day-to-day work would nudge me from my melancholy.

But I was slowly dying behind that armor.  And when I started to realize that what I was feeling wasn’t normal, the paralysis hardened.  I felt like I had been buckled into a stock car and sent around the track a few times at ninety miles per hour.  On the one hand, I knew that to drive the car properly I had to commit to a greater velocity, at the cost of the world outside the car becoming blurrier and me feeling less in control of the race.  On the other hand, I couldn’t bring myself to pull the car over and get out, and even if I thought that were an option, I didn’t know how I would do it.  After all, I was driving a bloody stock car around a racetrack!  Very few people get to drive what I was driving before my thirtieth birthday, and I really wanted to be successful at it.

By the time November 2012 rolled around, however, I had become so terrified of making mistakes, so worried to ask for help for fear of being perceived as incompetent or weak, that I had almost completely withdrawn from any real engagement in my professional life. Just the act of physically plucking a case file off the shelf became a monumental task, and I had even become afraid to engage in conversations with coworkers for fear that the cracks in my foundation would show through.  Entire days would go by without me speaking to anyone at the office, and I often wondered how I would be able to continue this for another twenty years.  On some days it was all I could do to keep from collapsing in the hallway on my way to the restroom.

I finally realized that I needed to take a step back and address what had become a raging forest fire when I was called into my department head’s office on a Friday evening for a meeting with all of the department’s shareholders.  I recall feeling my head go light, my hands go numb, and my chest go tight when my boss said that this would not be a pleasant conversation, and I remember my “calm armor” defense mechanism kicking in as I silently listened to what he had to say.

My depression had essentially become so pervasive that it had started to affect my work.  Of course, nobody else in the room knew what the root cause was.  When I was asked to take the weekend off to think about whether this was really what I wanted to do with my career, I instinctively tried to respond that of course it was, but what came out instead was an embarrassing, blabbering mess, the details of which I (thankfully) cannot recall.  Even as my body was smoldering inside, I was clinging to whatever I could to keep from waving the white flag.

It was not until the following Tuesday morning that I finally mustered the courage to tell my boss that I had not been healthy for a long time, and needed to take a leave of absence to address my medical issues.  To his credit, he was very supportive and encouraged me to go home and start healing right away.

Today I am less than three weeks away from my return-to-work date, and I frankly still don’t know whether I can climb back into that stock car.  What I do know is that I have learned a hard lesson early in life and early in my career, and I can only hope that my experience can help other young lawyers staring at a similar battle to find the courage to address their depression sooner and more effectively than I did.  As the old proverb goes, the best time to plant a tree was twenty years ago.  The second best time is now.

Anonymous

 

A Trial Attorney’s Dirty Little Secret: Depression

Once upon a time, I was a trial attorney at a personal injury defense firm. I was good at it.  I always pushed hard; always did the best job possible.  I won a good share of cases, and, of course, lost a few as well.  I was valued highly enough to be made a partner shortly after joining the firm.

But I had a dirty little secret.  I had bipolar disorder, which was well-controlled through a close partnership with a good psychiatrist.  Still, in my mind, if word ever got out, my employers would see me as weak, a liability.  To a degree, I understood.  If the insurance companies that paid the bills learned that one of the firm’s trial attorneys had such a condition, their mandate would be clear: if you want our business, get rid of him. That is what I assumed.

Throughout my career, colleagues would make offhanded remarks about someone “not taking his medication.” I would grit my teeth and ignore it.

Instead, I was able to construct an alter-ego, the “happy warrior.”  I had a smile on my face and a sardonic remark ready on cue. But I went about my daily business feeling like a secret agent in a Cold War spy movie.  If my cover was ever blown, I was certain that my career would be at an end.

Over time, maintaining this secret identity while dealing with the usual strains of trial practice gave rise to a growing depression.  Yet I still performed at a high level and still got results.

Although I had a close friend at the firm, another partner, he would deflect when I tried to talk to him about my depression, so I stopped.  I began to worry that others at the firm might know about me.

Fear and the sense of isolation only fed upon themselves in a continuous cycle.  I finally experienced a severe episode of depression that led to a period of disability.  When I told my boss what was going on, he expressed genuine surprise that I was suffering from depression at all.

When I returned to work, I felt better, but I remained wary.  Instead of engaging in a conversation about what had happened, we all acted as though nothing had occurred.  The computer was rebooted, and business continued on as usual.  I went back undercover, and no one seemed to mind.

Simply due to scheduling conflicts and adjournments, it was some time before I tried another case.  I admit that I was a little nervous, but I was having no trouble handling my case load.  I was puzzled when my boss came into my office one afternoon as I was preparing for the trial.  He asked me if I felt good to go.  He had never done that before.  I said, “yes,” because I felt perfectly up to the task.  I never asked myself, “If he is worried about my performance, why is he even letting me try the case?”

At trial, the insurance company sent an adjuster to audit the proceedings, a routine procedure.  I knew him well, and he had an excellent grasp of the case, even though he had not been involved before trial.  We had constant discussions about what was going on, and we seemed to be in sync.  Suddenly, the insurance company pulled my old friend off the case and replaced him with a mid-level manager who consistently praised my performance.

The case went to verdict, and the jury awarded somewhat less than what the insurance company had offered settle for.  To preclude the possibility of an appeal, the insurance company threw in a few more dollars.  Case closed, on to the next one.  To me, that was a pretty good result.

Was I in for a big surprise.

Shortly after the trial, year-end reviews were scheduled.  I was getting ready for another trial, and I was very excited about it, so I wasn’t really paying attention to what was going on in the office.  Other attorneys were getting their reviews – important because raises would be discussed – but I was never called in.

Ultimately, my case settled after much hard work on all sides, and the usual time for reviews was long past.  I did start to worry then.  I even made a remark to my secretary about it.

The call finally came.  When I stepped into the conference room and saw every equity partner in the firm waiting for me, I knew.  The spy had been caught, but what would happen?

My boss said that they waited to speak with me because they did not want to put pressure on me while I was preparing for another trial.  He asked me if I felt capable of trying cases.  I paused, and then broke under the years of strain.  I wept, and answered, “No.”  Whether that “No” was true then or true now or was ever true, it was the most humiliating moment of a 20-year career.

My boss started to dissect my prior trial, telling me that the insurance company’s representative was reporting that I was doing a bad job.  He even told me that the supervisor at the insurance company knew that I had depression.  After the expected awkward silence, another partner suggested that “we find a creative solution” to keep me at the firm.  I made some suggestions over the next few months.  No replies were forthcoming.  I was quietly being swept out the door.  It wasn’t hard to get the message. I found another job, and moved on.

The whole experience seemed to confirm everything I feared about being a lawyer with depression.  Currently, I am not practicing, and am seeking other opportunities.

But if the story ends there, what is the point?  Can I offer my account as a teaching opportunity?  At the very heart of the tale lies the sad truth that we, as lawyers, trained to be superlative communicators, can utterly fail to make each other understood when it comes to depression.  Should I have been more candid about my condition?  My employers never told me what concerns they had or what they knew.  Could all of us have been proactive for our mutual benefit, especially after I returned to work?  I believe that there had been an opportunity to open a constructive dialogue, but my fear told me to keep my mouth shut.  I cannot speak for my former employers, although I highly doubt that they held any malice.  I doubt that they thought much about it at all, until some critical pressure was brought to bear, whether from within or outside of the firm.  Unfortunately, by the time everyone was talking, my job at a firm I loved was gone.

I miss working there.  I still have close friends there.  I see them when I can, which is not often enough.  Just recently, I ran into my secretary, and we briefly chatted about my plans for the future.  And then she said something that cut me to the quick: “You were a good lawyer.”

— Anonymous Guest Blog

When Life Loses Its Meaning: The Heavy Price of Acheivement

“If you have ever seen a building that has been burned out, you know it’s a devastating sight. What had once been a throbbing, vital structure is now deserted. Where there had once been activity, there are now only crumbling reminders of energy and life. Some bricks or concrete may be left; some outline of windows. Indeed, the outer shell may seem almost intact. Only if you venture inside will you be struck by the full force of the desolation.”

This is the opening of the 1980 book, Burn-Out: The High Cost of Achievement, written by Dr. Herbert Freudenberger, the first person to describe the syndrome known as burnout. Dr. Freudenberger explained his use of the metaphor by noting that people who burnout under the stress of living in a demanding world are very much like a burned out building. Although on the outside they may look the same, “their inner resources are consumed as if by fire, leaving a great emptiness inside.”Bottom of Form

The discovery of burnout in the 1970s came during an era of great social and personal stress. It was a time of government corruption (Watergate), war protests (Vietnam), stagflation, soaring divorce rates, oil shortages, and an unstable job market where long hours and stressful work environments were the norm. The chronic stress of this era caused many people, especially those who were “accomplishers and doers,” to lose their enthusiasm.

Dr. Freudenberger noticed that while most of his high-achieving clients had once pursued life with vigor, excitement, and optimism, over time their passion had been dulled, in some cases killed by what he called “a demon born of the society and times we live in;” times exemplified by swift changes and the “depersonalization” of neighborhoods, school and work environments. They began to feel disengaged, disenchanted, and uninvolved, even when surrounded by family and friends. They began to view their jobs as draining and unrewarding. For many, life seemed to have lost its meaning.

Sound familiar? It should. Today’s world is remarkably similar. War, economic woes, distrust of the government, soaring unemployment, seemingly endless work days, and stressful jobs-all of these things are taking a heavy toll on the minds and bodies of our best and our brightest, leading to chronic fatigue, disillusionment, discontentment, and disengagement.  In short . . .  burnout.

So I thought I’d share with you some pearls of wisdom from the man who discovered the condition known as burnout. Although the insights and advice Dr. Freudenberger offered to victims of burnout were published over 30 years ago, they bear repeating because they are no less true today than they were 30 years ago.

“In a word, slowly. No matter how suddenly it seems to erupt, Burn-Out is a chronic condition; something a person has been working toward over a period of weeks, months, even years.” (p. 13)

The Type of Person Most Likely to Burnout

“The people who fall prey to [burnout] are, for the most part, decent individuals who have striven hard to reach a goal. Their schedules are busy, and whatever the project or job, they can be counted on to do more than their share. They’re usually the leaders among us who have never been able to admit limitations. They’re burning out because they’ve pushed themselves too hard for too long.” (pp. 11-12)

The Symptoms Common to Burnout

Exhaustion: usually the first distress signal of distress in burnout victims

Detachment: Dr. Freudenberger explains that when burned out people feel let down by people and situations (which inevitably happens), there’s a strong temptation to think, ‘I don’t care, it wasn’t important anyway,'” which leads to detachment.

Boredom and Cynicism: what was once exciting now feels draining, and “You begin to question the value of activities and friendships, even of life itself. You become skeptical of people’s motives and blasé about causes.”

Impatience and Heightened Irritability: as burnout worsens and it becomes harder and harder to accomplish tasks, impatience grows and spills over into irritability with everyone around.

A Sense of Omnipotence: Dr. Freudenberger notes that sentiments such as “No one else can do it. Only I can” are expressions of an unhealthy ego. He says, “Be assured–somebody else can do it. Maybe not the same way you’d have done it or with the same degree of excellence, but it may be a situation that doesn’t require excellence.”

A Suspicion of Being Unappreciated: burned out individuals often become upset over what they see as a lack of appreciation of all they do, and they become increasingly bitter and angry.

Paranoia: when people feel put-upon and mistreated, as burned out people often do, they become increasingly suspicious of their environment and the people around them.

Disorientation: feeling a growing separation from one’s environment

Psychosomatic Complaints: Dr. Freudenberger says that “Headaches, colds that linger, backaches–all these are signs that something is wrong, and it’s usually something the person doesn’t want to look at.”

Depression: In contrast to depression unrelated to burnout, Dr. Freudenberger notes that burnout depression is “usually temporary, specific, and localized, pertaining more or less to one area of life.”

Denial of Feelings: “Since we know that people who are subject to Burn-Out are the carers among us, it doesn’t make sense to assume that one day, for no particular reason, the caring simply stopped …. Far more logical is the assumption that the caring has been shut off for a very good reason–and shut off by the person himself.” (pp. 67-68)

What Burnout Looks Like to Others

“A person who is burning out is not, on the surface, a very sympathetic figure. He or she may be cranky, critical, angry, rigid, resistant to suggestions, and given to behavior patterns that turn people off. Unless we’re able to probe beneath the surface and see that the person is really suffering, our tendency will be to turn away.” (p. 11)

The Excessive Demands High-achievers Place on Themselves

“As we pile layer on layer, the weight bows us under. We begin to make excessive demands on ourselves, all the time draining ourselves of energy. To compensate for the weakness, the burning out we feel, we develop rigidity. Things must be just so … to maintain our position, we must constantly excel. Unfortunately, the harder we try, the more we impair our efficiency. About the only thing we succeed in doing is burning ourselves out more.” (pp. 5-6)

Taking a Good, Hard Look Inside

“Since being out of touch with, or shutting off, large parts of yourself is a primary contributor to Burn-Out, your greatest protection against it is self-awareness.” (p. 27)

Keeping Perspective

“… never lose sight of the fact that you, as a human being, are more important than the task, no matter how crucial the task may be.” (p. 158)

Keeping a Sense of Humor

“Remember, if you want to avoid Burn-Out, heavy is out; light is in. Any time you can laugh at something, you reduce its importance, even if that something is yourself.” (p. 179)

The Paradoxes of Society

“At the same time our society dangles the impossible dream in front of us, it sets the stage for Burn-Out by eroding tradition, banishing our support systems, barricading minority groups, and dissolving relationships. It sends out mixed messages to all our emerging groups. Women, gays, Hispanics, blacks-we tell them all they are entitled to the same rights and privileges as the rest of the population; then we take our children and move to the suburbs. We advertise ourselves as “equal-opportunity employers;” then we offer unequal pay for equal jobs. To someone buying the promise and setting up expectations based on it, the contradiction between the myth and the reality is devastating. Not the least reason why Burn-Out is on the rise today is that our society abounds in paradoxes like these.” (p. 198)

Dr. Freudenberger offers three basic ingredients for overcoming burnout:

Self-Awareness: He says to ask yourself, “Are you in charge of your life? Or has it taken charge of you? By fostering this kind of awareness, you will eventually get in touch with the real you that you have become so estranged from, and some of your detachment will vanish.” (p. 205)

Slow Down, You Move Too Fast:  Don’t try to be everywhere at one time. Breathe.

Kindness: Dr. Freudenberger recommends getting out an old family photo album. He explains, “Old photographs teach us a lot, especially about kindness … when you sit down with your album, look at that child you were from the vantage point of who you are now …. And remember, that little kid hasn’t vanished from the earth.” He reminds us that the child in us is alive and well somewhere inside and that we can help that child emerge by being kind to ourselves, accepting who we are, and exploring where we want to go.

Changing: The more well-rounded our lives are, the more protected we are from burnout. He recommends, “If you’ve stopped trying new activities, make a conscious effort to start again. Dig up your old adventurous spirit and get it going. Try jogging or skating or swimming or tennis or dancing, but try something.”

Finally, Dr. Freudenberger offers encouragement: “In every fire,” he says, “there are glowing embers. You can use them to rekindle the spark.”

And that’s true. Burnout is not a terminal condition. But it’s also not a condition that gets better by being ignored. So take an honest look at your life. Reassess your goals in terms of their intrinsic worth and update them as needed. A choice you made early on in life may not be the best choice for you right now.

Also, look at your relationships as objectively as possible. What are you bringing to your relationships, good and bad? And explore what your relationships are giving to and taking from you.

Look at your work. Does it consume you? Do you have a life apart from your job, or is your life your job? And is that what you really want?

Finally, what’s the state of your social life? Do you have one? Is there something you’ve always wanted to do, but never took the time to do it? Why not?

When I was writing my book, High Octane Women: How Superachievers Can Avoid Burnout, a friend sent me what I considered a very powerful quote, so powerful that I ended my book with it. Written anonymously, I believe it should serve as an important reminder that life is more than just a job or a marriage or the zealous pursuit of any singular goal.

First, I was dying to finish high school and start college.

And then I was dying to finish college and start working.

Then I was dying to marry and have children.

And then I was dying for my children to grow old enough so I could go back to work.

And then I was dying to retire.

And now I’m dying . . .

And suddenly I realized I forgot to live.

Achievement and success are important, but are they worth sacrificing everything for?

By Sherrie Bourg Carter, Psy.D.

 

Happiness is How You Are, Not How You Feel

Aristotle said, “Happiness is the meaning and the purpose of life, the whole aim and end of human existence.” For him and most of his contemporaries, happiness referred not to an emotion but the long-term pattern of action, the sum of which was your moral character. It is the habits of virtue that are acquired over years of exercising the appropriate virtues.

A person doesn’t feel happy as much as happiness is a general state of being. Viewing happiness as something in the world as opposed to an individual feeling is not the way we usually understand the term.

The modern orientation is dominated by individual psychology. But something of the older understanding of happiness as essentially relational still exists in a secondary meaning. For example, we continue to refer to “good times,” or a particular era in a country, or to a happy period in a person’s life. This refers not to feeling happy per se—the kind of happiness that brings a smile to our face—but to a condition that arises in a larger context of actions, conditions, and behavior. To live well is to be good. A happy life is a good life, on this account, and a good life is a virtuous life.

“Happiness is the highest good,” Aristotle wrote. And happiness is realized through the practice of virtue. Happiness casts its gaze outward and is obtainable through the cultivation of moral habits.

The story of beautiful Narcissus is the cautionary tale. He drowns in his own reflection because in his love of himself there is no room for others. For Aristotle, friendship is central to human well-being. Human flourishing isn’t possible without it.

“Friends enhance our ability to think and to act,” Aristotle wrote. This isn’t just any way of thinking or acting but consists of good judgment and virtuous behavior. Friends hold us up to our better selves, directing us toward the good.

You need friends to do good and without them you are likely to fail. It is a failure to be virtuous, and without virtue you can’t be happy. Narcissus drowns because in his self-love there is no one to bring him to develop his moral character.

According to Aristotle, it isn’t good luck or fortune that determines whether you will be happy, although he acknowledges the importance of possessing certain goods as making the attaining of a good life more likely. Friendship, wealth, and power all contribute to a good life.

Conversely, happiness is endangered if you are severely lacking in certain advantages—for example, if you are extremely ugly or disfigured, or have lost children or good friends through death. Tragedy and misfortune hinder human flourishing. This is the impetus behind eliminating social injustices and addressing basic human needs—to open up life’s possibilities even to those beset by bad luck.

Today, I think Aristotle would have added the disadvantage of clinical depression, for, as we now know, this is a bio-chemical illness that is beyond the power of the mind to control through a change of attitude or behavior. Other forms of mental illnesses fall into this category. These are medical issues, not philosophical ones. In addition, I think he would have understood how the subordination of women was contrary to the good life. Parity in terms of power between men and women is necessary for the over-all happiness in society.

Basic needs of nutrition and shelter are necessary for a good life, as is access to knowledge. Good fortune and happenstance play a role in happiness but typically luck isn’t a determining factor. As the work of psychologist Martin E. P. Seligman demonstrates, factors such as money and health account for less than 20 percent of the variance in life satisfaction.

People rise above material circumstances by developing their moral character so that you act virtuously despite the limitations. It is possible to have the disposition to be good most of the time despite the lack of material support.

By Arthur Dobrin, D.S.W.

 

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