Lawyer Depression is Contagious

Catch a depressed mood the way you catch a cold? Not exactly . . . but similar. Can other people really be a source of the rising rate of depression in the United States? The scientific evidence suggests the answer is yes. Our social lives play a huge role in how we think and feel. After all, none of us are immune to the influence of others, for better or worse. How we react to others, and vice-versa, even has a measurable biological impact on our brain chemistry, as our newest brain research shows us. The evidence is rapidly mounting that depression is about much more than just an individual’s “bad chemistry.” Thinking of depression as a brain disease is proving to be too one-dimensional a perspective.

For attorneys, appreciating the social connection to depression is vital if the person is to be viewed – – and responded to – – realistically. Why are attorneys depressed? Go beyond biology as the cause and consider that law is a profession that:
• Often requires engaging in stressful, conflictual relationships.
• Often pressured by important and inflexible deadlines.
• Often is devalued by the general public and even may be misunderstood by friends and family.
• Often brings you into contact with some of the worst aspects of human nature.
• Encourages hazardous self-sacrifice for “the cause.”
• Encourages deceiving others as well as one’s self, a moral compass, in the push for maximizing   billable hours.
• Demands full commitment to making efforts to achieve things one has no control over.
• Encourages rumination, a poor coping mechanism.
• Can sometimes be almost as costly in winning as in losing, increasing uncertainty about what’s best.
• Can be as emotionally high and low as professional sports (“the thrill of victory . . . the agony of defeat.”)

The social aspects of depression have been too long ignored in favor of biological explanations. It would be more helpful to come to terms with the reality that no amount of medication will make potentially depressing situations, like the stressful aspect of practicing law, go away.
The rising rate of depression is not unique to either Americans or lawyers, lending further support to the growing recognition of depression being spread across boarders through social means. Through the studies of cultures, families, and the social lives of depressed people, we have learned a great deal about the social transmission of depression. Negative people can bring us down and good relationships involving an enduring commitment can bring us up. We have also learned how children model their parents in unexpected ways that increase their vulnerability to depression. Thus, in a purely social sense, depression is contagious.

The World Health Organization (WHO) is the international watchdog of health issues around the world. Recently, WHO declared depression the fourth greatest cause of human suffering and disability in the world (behind heart disease, cancer and traffic accidents). The WHO statement tells us how prevalent and how serious depression is right now. Even more troubling, though, is the WHO prediction that by the year 2020 depression will have risen to become the second greatest cause of human disability and suffering. It is a safe prediction for WHO to make, for we already have a half-century worth of data showing that depression has steadily been on the rise for decades.

By focusing on biology alone, as we have done when we talk about chemical imbalances in the brain or calling depression a “disease,” the social dimension has been all but ignored. This allows the social conditions that cause and exacerbate depression in many people’s lives to go unaddressed. Drugs alone cannot address the social factors that underlie depression, a likely reason that drug treatment alone (without additional skill-building) has the highest rate of relapse of any form of intervention. Just as there will never be a pill that can cure our other social issues such as poverty or racisim, there will never be a pill that will cure the depression that is associated with challenging life conditions. This is not to say biology doesn’t matter. It clearly does. But to focus on biology to the exclusion of life’s circumstances, especially the social ones, that lead people in general, and attorneys in particular into depression, is missing a vital target of intervention. Too often, well-intentioned doctors write a prescription for an anti-depressant medication but go no further into treatment. The evidence is growing that this practice is, to put it mildly, less than ideal.

The new understandings about the prominence of social forces in depression require we as mental health professionals to change some of what we do as we try to educate people about depression. The familiar phrasing that suggests “depression is a serious medical illness requiring medication” is an educational approach it that clearly doesn’t work very well. Most of the attorneys who are depressed don’t seek help. For some, it’s because of the stigma of seeking help for an emotional disorder, but for others it’s because they simply don’t think of themselves as “diseased.” They may feel stressed, unhappy, overwhelmed, trapped, or hopeless but they don’t consider themselves “depressed.” In fact, most of the attorneys who suffer depression, still manage to function despite their condition. They show up for work, they give their clients reasonably good legal advice, they get their briefs filed on time, and they participate in family events. But, they are struggling to get through each day. They are what many clinicians refer to as the “walking wounded.”

We can do better than suggest to people they’re diseased and need drug care. Who can do more than continue to push the one-dimensional biological explanation at people for their depression? We can help them understand that depression is caused by many contributing factors of which some are indeed biological, while others are rooted in individual psychology (such as your temperament and style of coping with stress) and social psychology (such as the quality of your relationships and your culturally acquired views). Striving to convince people they’re diseased doesn’t empower them to actively change their lives in meaningful ways. We can teach better relationship skills, better problem-solving skills, better decision-making skills, and better ways to cope with an increasingly complex world. We can teach attorneys-to-be while still in law school how to develop realistic perceptions of life as a lawyer so they won’t get so disillusioned they flee the practice of law so soon after graduating. These are just some of the skills that have not only been shown to reduce depression, but even to prevent it.

Editor’s Note: Michael D. Yapko, Ph.D., is a clinical psychologist and depression expert from Fallbrook, California. He is the author of Depression is Contagious: How the Most Common Mood Disorder is Spreading Around the World and How to Stop It. For more information visit his website at www.yapko.com.

 

 

How Lawyers Can Choose the Right Treatment for Depression

Dr. Irving Kirsch, a professor at The University of Hull, has caused a stir lately with a body of research suggesting that SSRIs, the most common class of antidepressant, are no better than placebos. (Here is a 60-Minutes story about his findings.) Of course, for every SSRI skeptic there are any number of evangelists who swear by the drugs.

Personally, I’m undecided. I’ve seen SSRIs aggravate depression by muting happy emotions and adding unpleasant side-effects, while offering no measurable antidepressant effect. But I have also seen them help. In rare cases, they have been a godsend.

For anyone considering antidepressants, I would humbly suggest that the question, do antidepressants work, is the wrong question. The more relevant and pragmatic question is this: might antidepressants be helpful in my particular case? 

The SSRI debate is useful in general, but it is mostly irrelevant to individual cases. It’s a bit like debating the effectiveness of transmission replacements for cars. Sometimes a new transmission fixes a car, sometimes it doesn’t. It depends on the problem.

If I found a mechanic who insisted on rebuilding every transmission (or who reflexively opposed it) I would find a new mechanic, pronto. I wouldn’t settle for one who failed to define the problem before tearing into my car. Yet that is often what is expected of patients who seek treatment for depression. Describe your symptoms – quickly! – and don’t question my treatment.

It seems to me that our central nervous systems should get at least as much respect as our cars. Of the many times that I have witnessed the failure of an antidepressant, there has been a corresponding misapplication of the drug. The correlation is difficult to ignore.

But don’t take my word for it. There is compelling research suggesting that antidepressants are routinely misused in Western countries. In a rather conservative study, Jureidini and Tonkin (2006) found that many prescriptions (one third or more, depending on the measure and the population) fell outside clinical indications, were given in excessive doses, or were prescribed for far longer than they should have been.

According to another study, only about one-third of patients experience relief after taking an antidepressant for a sufficient period of time (Cascade, Kalali, and Blier, 2007). That’s an exceptionally low number, and I suspect that has more to do with poor diagnosis than the effectiveness of the medication.

Antidepressants may be the first and best option in cases of severe depression. But in mild or moderate cases – which are the vast majority – behavioral interventions work better. Addressing the problems that lie behind depression is often more effective and longer lasting than medication (Dobson et al. 2008).

(Ironically, Jureidini and Tonkin also found that antidepressants are under-prescribed among the seriously depressed who could most benefit from them. They noted that fewer than 25 percent of US, Canadian, and European patients meeting criteria for major depression receive proper medication management.)

Antidepressants appear to be helpful in severe cases but they are probably useless and potentially harmful when they are incorrectly prescribed in less severe cases. I believe that anyone considering SSRIs should first answer these four questions, with the help of a qualified clinician:

  1. How severe is the depression? There are a number of depression inventories to help answer this question. If the symptoms are in the mild to moderate range, SSRIs are probably an inappropriate intervention.
  2. Is the depression most likely a result of circumstances or lifestyle choices that will remain unaffected by medication? If so, pills may blunt moods but they won’t fix the problem.
  3. Have physical problems been ruled out? Depression can be secondary to thyroid problems, low testosterone levels, nutritional deficiencies, sleep difficulties, and other physical problems. SSRIs fix none of these.
  4. Have healthier interventions failed? Making tough decisions about exercise, diet, sleep, alcohol use, and other lifestyle choices should be the first order of business in cases of mild to moderate depression. Physical exercise alone is as effective as any antidepressant in most cases (it is the benign cure-all that SSRIs wish they could be), and cognitive behavioral therapy is an excellent response to circumstances or lifestyle choices that contribute to depression.

SSRIs should only be taken with considerable deliberation and a solid understanding of the problem at hand. Despite their benign image, they are the furthest thing from harmless happy pills. They come with side effects, and there is evidence that they can have serious, long-term effects on the central nervous system. If SSRI’s are the right answer for you, then by all means, use them. But please take the time to properly define the problem first.

I realize that it is an investment of time and money, and I know that depression deprives a person of gung-ho initiative. It might be simpler to skip the process and take the pills, but we only get one brain each. Taking time to define the problem could prevent years of wasted effort and needless suffering.

Dr. Shawn Smith is a psychologist in Denver and the author of The User’s Guide to the Human Mind: Why Our Brains Make Us Unhappy, Anxious, and Neurotic and What We Can Do about It.

 

 

Act now to be a Happy Lawyer Later

Law professors and television writers tell phantasmagorical stories of power and achievement in the legal profession. Big law firm associates haul in big bucks while mentored by legal bigwigs in fancy skyscrapers.  Trial lawyers perform on stage to an admiring audience of jurors. Prosecutors save the city from dangerous criminals and are treated as community super heroes. Don’t be fooled. These are not the stories of lawyer life: the day-to-day work that goes into the paycheck and performance, and it is the lawyer life that determines your happiness. To be happy, focus on being interested, not interesting.

The State of Lawyer (Un) happiness.

Happiness matters, especially if you were born between 1965 and 2000. Your generation is less materialistic than the Baby Boomers who came before you. You value happiness more than money and prestige. You know that to be fulfilled in your heart and mind will lead to a full wallet.

Stories and statistics about drug abuse, alcohol abuse, and depression in the legal field abound.  According to Dan Lukasik, noted expert on lawyers and depression, while 10% of the general population in the U.S. suffers from depression, 20% of lawyers and 40% of law students struggle with depression.  Lawyers have the highest rate of depression when compared to 105 occupations.  Lawyers are also twice as likely to become addicted to alcohol and drugs. As one of the new generation of lawyers, you need to know the numbers and steer clear.

To Be Happy: Know Yourself & Stay Focused

Friends and family may suggest you practice family law because you ooze compassion, be a trial lawyer because you are a captivating speaker, or specialize in tax law because complicated calculations make sense to you. These people mean well, but it doesn’t matter what others think you are good at doing because that may not be what makes you happy.

Studies show that lawyers who help less fortunate clients are the happiest. It is difficult to be happy when you are working 16-hour days while your bazillionnaire client is lying on the white sand of his private island. However, fighting for a client who was abused in a nursing home will remind you of how blessed your own life is. Specialize in elder law, personal injury, immigration, social security, or child advocacy to feel joy and satisfaction from helping those in need.

Studies also show that it is important to study yourself. What is your passion? Is criminal justice fascinating?  Do you get riled up about civil rights? Are you drawn to downtown high-rises and conservative suits or do you gravitate to suburbia and khakis? Do you like having a boss who tells you what to do, or do you enjoy networking and finding your own clients? Know yourself. Pay attention to your passion. What other people think you should do and what other people think is exciting is probably not what will make you happy.

Do not choose your career direction based on money. A 2008 study by Tan N. Nguyen showed that many students enter law school with a passion for public service but few actually serve. Perhaps law school debt or law school curriculum pull students away from their passion. Whatever the cause, stay focused on your passion. Remain open to new discoveries, but be wary of changing course for “practical” reasons.  You will be much happier working in a lower paying position that feeds your passion than hating every minute of your 14 hour, 6 day a week job. You may have more money, but not only will you hate what you do, but you will also have no time to enjoy the things you think the money will buy. Loan repayment assistance programs can help you.

To Be Happy: Ask Yourself

It is easy to be distracted by what others think you should do or by what you think you should be. Tal Ben-Shahar, a Harvard University psychologist suggests the “Three Question Process” to figure out your passions and your path.  Ask yourself (1) What gives me meaning? (2) What gives me pleasure? (3) What are my strengths? Put your answers in a Venn diagram and pay close attention to the intersections.  Keep an open mind. Include everything that answers each question, even if you think it is not job related. Answers such as hiking, shopping, cooking, and guitar are as valid as research, the Constitution, helping the elderly, and the environment. Plan your path based on feeding your passions and you will be a happy lawyer.

Remember, legal jobs look exciting as a trailer, but when you watch the whole movie, the job is sometimes hectic, other times uninteresting, and often unbearably stressful. Choose wisely.

– Guest blog by Judy Zimet, creator of lawstudentally.com 

The Ally Program was created by an educator who mastered law school by applying proven learning strategies. After receiving a B.S. in Education and practicing brain-based, diagnostic, and rehabilitative techniques for over 15 years, Law Student Ally’s creator attended law school. At the outset, her goal was to crack the code – not only to make it easier to obtain the golden ticket (the J.D.) to sit for the bar exam, but also to develop strategies to help students reach their fullest potential. She now offers her approach to others.

“My life’s passions: Education and Advocacy. I combined two strengths to create a stronger force with the goal of empowering future lawyers by helping them achieve their greatest potential. I attended law school with a metacognitive purpose to create a program to achieve my goal. After graduating magna cum laude, number four in the class, serving on law review, landing a summer internship with a world renowned law firm, passing the bar exam, and doing all this in two and a half years, it was time to offer what I know about teaching, learning, and the law to other law students. Thus, LSA was born.” – Judy Z

Judy Zimet is a solo practitioner in Scottsdale, Arizona

 

 

An Interview with Dr. Andrew Weil about Depression

One reason Andrew Weil, M.D., the “father of integrative medicine,” wrote his new book, Spontaneous Happiness, is that the most searched-for term on DrWeil.com is “depression.”

It’s the common cold of modern emotional life. And he thinks we’re thinking about it all wrong. Yes, an imbalance of brain chemicals can trigger depression, but it goes the other way, too: An imbalance of thoughts and habits can change your brain to make depression more likely – – or less likely.

Dr. Weil believes an approach that integrates healthy habits of the body, mind and spirit can play a key role in preventing and alleviating mild to moderate depression. It can foster emotional well-being — and happiness.

Like all of his books, Spontaneous Happiness is a refreshing combination of clarity, science and practical wisdom. But it’s also warm and, indeed, personal: Dr. Weil includes not only anecdotes from people who’ve written to him over the years, but also his own experience in battling mild depression.

What is spontaneous happiness?

I use spontaneous happiness to call attention to the fact that happiness is something that comes from inside. It doesn’t come from getting something you don’t have. You can’t expect to be happy all the time, but you can open yourself up to the possibility of happiness.

A better goal than happiness, actually, is contentment. Contentment is an inner feeling, and it is something that can be cultivated.

Is depression always bad?

I don’t think depression is all bad. Our moods are supposed to vary. We’re supposed to have positive and negative moods. I’m not talking about incapacitating depression. But mild or moderate depression can lead to an inward focus and rumination that may help you solve problems. That’s why depression is often associated with creativity.

Is depression on the rise?

We are witnessing an unprecedented epidemic of depression in this country, mostly mild or moderate. Some may be due to the pharmaceutical industry influence, but maybe only a quarter or so. There’s still a lot of depression to be accounted for. There are many factors: increasing social isolation, disconnection from nature, information overload.

You can’t find cases of severe depression in hunter-gatherer societies. What’s different about them? Almost everything! They eat differently, connect to nature every day and have strong tribal social support. Discontent correlates with affluence — the more people have, the more they are discontent.

Are women more prone to depression than men?

Hormones do play a role. Before puberty, the rate of depression in boys and girls is the same. After puberty, the rates rise [for females]. So, women are more susceptible to depression. That means they should be especially vigilant about their moods, and take this information and put it into practice.

Why is the idea that the mind can affect the body such an important concept?

Changing the way you think and perceive can change the structure and function of the brain. Not to deny brain chemistry, but it’s only one of many factors in depression. Most of psychiatry today only looks at brain chemistry, and so the only solution is drugs. And the drugs don’t even work that well. Physical activity and supplemental fish oil work as well as antidepressant medications.
There are other things you can do, and some are so simple. I was amazed in researching this book how much scientific evidence there is for the power of feeling and expressing gratitude to create lasting changes in mood.

What do you wish primary care physicians would do when someone comes in with mild or moderate depression?

Before reflexively prescribing a drug, I’d like them to look at the person’s lifestyle. Look at all the factors before resorting to medication. Severe depression can be life threatening, and requires medical management, and maybe medication. But even here, I’d like it to be limited to a year, and then [the doctor] should work with the patient to get off the medication and substitute other measures.

You recommend mindfulness for emotional well-being. What is mindfulness?

Mindfulness is the practice of bringing full attention to the present moment. Mindful eating, for example, means eating not in front of the TV or in your car. It means putting the food in your mouth and tasting it. One reason we have an epidemic of obesity is that so much eating is unconscious.

Can mindfulness training be part of the treatment of depression?

Mindfulness is movement that started with the Dalai Lama and collaborations with neuroscientists and Buddhist monks and teachers. They’ve shown that practices like meditation and forgiveness change brain function — and that these practices can be taught.
Mindfulness is now being integrated into cognitive behavioral therapy (CBT). This is very effective for the treatment of depression. It is also very cost efficient and time efficient.

What is the emotional benefit of a “media holiday”?

Addictive listening to and watching news often makes people feel angry, anxious and powerless. It’s not necessary — you can stay informed without it. You can have control over how much you let into your life. Many people tell me that just reducing that input has had major positive benefits on their emotional well-being.

Can silence improve emotional well-being?

Many people aren’t aware how powerful an influence noise is on the nervous system. It really works to cultivate silence.

What do you do every day to foster emotional well-being?
Every day, I try to get physical activity, spend time in nature and get enough good-quality sleep. I follow an anti-inflammatory diet and take fish oil. I meditate and do breathing exercises. And since writing this book, I make notes of things to be grateful for and remember. I also seek out the company of people who are positive. There is very strong evidence that depression is contagious, and so is happiness.

Watch this T.V. Interview where Dr. Weil talks about depression

watch?v=ps3M5DQ-DAY&feature=results_main&playnext=1&list=PL84C5CB591BB45E5F

 


The Swampland: An Interview with Dr. James Hollis about Depression in the Law

Dan:  What is depression?

Jim:   I think first of all we have to differentiate between depressions because it‘s a blanket term which is used to describe many different experiences, different contexts and different internalized experiences of people.  First of all, there is the kind of depression that is driven by biological sources and it is still a mystery as to how that works.  We know it affects a certain number of people in profound ways.   Second, there is reactive depression which is the experience of a person who has suffered loss and as we invest energy in a relationship or a situation and for whatever reason, that other is taken away from us, that energy that was attached to him will invert as depression.  Reactive depression is actually normal.

We would have to figure out where that fine line is and where it might cross over into something that was more than normal.  When we say that a person is grieving too long or it is affecting their lives so profoundly, that’s a judgment call, of course, but we do know people that have been sort of destroyed by reactive depression because they had attached so much of their identity to the other, whatever it might be: a position in life that they lost or a relationship that was important.

But I think none of us can avoid occasional reactive depressions because life is a series of attachments and losses.  Most commonly, when we think about depression, however, we are really looking at a king of intra-psychic phenomenon where we might say there are parts of ourselves that are contending with each other.

If you think lawyers have to deal with outer-litigation, there is inner-litigation going on continuously as we are subject to a lot of interpersonal strife and conflict between values.  For example, there are conflicts of duty and we have an obligation to many competing values within us.  I mean, one of the most obvious duties that we all live with is that you have to earn a living to support yourself and your family and on the other hand, the price of the particular way in which you are doing it is psychologically and perhaps, physically, costly to you.  So already, there is a significant conflict there.  If the ego continues to override that conflict without addressing it, we could expect the symptoms, including the symptoms associated with depression, to show up.

In effect, the good news and the bad news are the same here in the sense that the psyche is not passive, it’s active, it’s continuously expressing its point of view and it is manifesting in our body which is somatic issues in our emotional life,  in our behaviors and of course, in our dream life.  Those expressions of opinion are often something we call “symptoms” in the contemporary mindset and we want to sort of replace symptoms as quickly as possible and that is understandable.  At the same time, the real question is why have they come, what is our own psyche trying to say to us.   Or, put it another way, for what reason is my psyche refusing to cooperate with the agenda that my conscious life has addressed and emerged into?

The withdrawal of energy is often profoundly conflictual within and produces a lot of suffering.  The more I might push myself, the more depressed I might get.  So from a psycho-dynamic standpoint, you would say, well, what really is the value conflict here and how is it that we can learn from the psyche and what we might consider a more appropriate set of choices for you.

Dan:  You know, from what I have seen and from what I have researched, about 10% of the U.S. population suffers from depression.  There have been a couple studies actually about lawyers and law students with depression that show that as many as 40% of law students in America at some point during their 3-year career as law students will deal with depression. Out of the million lawyers in America, about 28% suffer from some type of depression or about a whopping 280,000 lawyers. A recent study on law students is equally troubling: 17% screened positive for depression.

What do you think explains that Jim? What is it about the legal profession that explains an almost tripling of the rate of depression for those in the law?

Jim:   It is hard to generalize.  We would have to look at each individual lawyer on a very personal basis to see what are the factors involved there, but I might say sort of categorically that the legal profession is, by its nature, adversarial and I have known many fine human beings who were lawyers who inwardly suffered when they were in conflictual situations.   I recall one lawyer who I worked with many years ago in another part of the country who was torn by conflict within his family.  He became a lawyer and then he became severely depressed because exactly that kind of conflict that he had suffered so much in his personal life was replicated in his professional life.  He said to me that if I got to trial and failed to settle it, that he was personally a failure.

When I asked him what he meant, you meant, he said, “My whole job is to try to work it out beforehand. Of course, he played that mediatorial role between his parents at some point earlier in his life and so I realized in many ways, his depression was rising from the fact that he was driven into  a role in his family of origin and he identified with that role,  and it sort of rolled over into his adult sense of profession and he chose the law in good faith, but  it was really the unconscious complex that was making the choices for him and to his credit, he was able to look at that and frankly leave the profession and become an educator which is what his real enthusiasm was for.

I would say that first of all, we have to recognize that one is always pitted against someone else in the law. It is seldom a cooperative operation and for some people, they would thrive in that, but for many people, that is a source of great internal stress.   Secondly, many times, lawyers – – like physicians- – are increasingly really prisoners of systems of what appears to be an empowered profession.  It is often one that is highly constricted and constantly scrutinized in having to be reporting all the time to one authority or another, so one can often experience some loss of personal authority and personal autonomy.

Thirdly, with lawyers, there is always this sense in which one has to question, what am I serving really.  Theoretically, the law asks us to serve others with impartiality and everyone deserves a right to a hearing, and these are laudable values, of course.  But, I think often what one can feel is that one is in a compromised position in the first place.  Again, for some people that can cause great internal conflict.  One can even feel that one has in effect, prostituted one’s conscience at times, or one’s talents and that too weighs heavily on lawyers.

But, I would have to say, in each person’s life, we would have to look at what are the factors. There are obviously people who are psychologically appropriate for the various natures of the work.  I know there are many aspects of the law and we would have to try to identify what is the psychology of the person coming into that.  In my profession of psychotherapy, there are many who come from very troubled backgrounds.

They often got identified as children as helpers, mediators, as persons who had to sacrifice their own interests on behalf of stabilizing their environment.  So there is a high rate of depression and stress, burn-out and substance abuse among therapists as well and also the nursing professions and all the professions where you might say is a caregiving function or a service function that one will often find one’s own psychological history exacerbated, intensified and even worsened.

Dan:  I would like to read a brief passage from your wonderful book, “What Matters Most: Living a More Considered Life“.  In there you write:

“The recovery of personal authority is critical to conduct in a reconstruction of the second half of life.    If we are a little more than our adaptations, then we collude with happenstance and remain prisoners of fate.  No matter how sovereign we believe we are, we remain the loneliest of surfs to the tyrannies of whatever remains unconscious”.

I think one of the things that I found interesting, as I read further on in the book, is your notion of psychological adaptions and how they relate to somebody who is suffering from depression.  Can you elaborate on what role adaptations serve with depression?

Jim:   Well the fact that we have survived as individuals and also a species in an often very difficult environment is a function of our capacity of that adaptation. Without the ability to adapt one would be destroyed by the conditions of life. But then, you see, to some degree one’s becoming identified by whatever the environmental factors were that necessitated that adaptation, what happens is through repetition or the fact that these adaptations often occur very early in life, I mean adaptation such as avoidance patterns or the way our engagement with others works out or our compliance adaptations and so forth, these often tend to get replicated a lot and become sort of behavioral systems within each of us.

So that we can fast forward several decades and find ourselves really the creatures of these adaptive patterns: patterns that were once protective, but because they keep getting applied to new situations become constrictive and oblige repetition.

Sigmund Freud noted early that the power of the repetition of compulsion and the power of programming within each of us. The problem of the unconscious, of course, is that we can’t say anything about it definitively and yet these behaviors and their patterns keep falling into the world from us so therefore we would have to admit that they are coming from us and therefore, we have some accountability for it.  

And so, as a therapist, one of the things that we look to discern is what are the patterns that are coming out of this person’s life, from where they might they come and then to make these adaptations more conscious and to see how they get systematized,  and then at some very profound  level, we could see a person who is operating  in a very powerful position outwardly can, in fact, be enslaved  to the messages of decades ago.  What he believes is his free choice is often his protective mechanisms and again, they are there for good reasons, but they completely ignore the fact that the individual has grown up.

He now has a consciousness, he has an empowerment, he has a capacity for resilience that were not present in the life of the child and therefore, there is a kind of unconscious regression every time one of these implicit messages takes over consciousness, so, until we can begin to recognize what are the silent messages to which we are in service, we remain prisoners of history and the very adaptations that were necessary during our childhoods are now constricting agencies.  Working through that and stepping into risk, stepping into an enlargement of vision and honoring the desires within us that wish to be expressed through us into the world.

Sounds simple in the abstract, but in fact people often find is that their most difficult obstacle are their old fear-based adaptations that once were necessary long ago, but today are binding us to a disabling past.

Dan:  Here’s another quote I would like to read from your book, What Matters Most:

“All of us feel shamed by life. All of us consider ourselves failures of some kind, screw ups in something really important to us.  Notice how shame, consciously or unconsciously pulls us away from risk, ratifies our negative sense of worth through self-sabotage or compels us into frenetic efforts of overcompensation or yearning for the validation from others that never comes; how much each of us needs to remember one definition of grace as accepting the fact that we are accepted despite the fact that we are unacceptable”.

It is just a beautiful passage that I think captures so much.  A lot of your writing addresses the issues and problems that all of us must face at mid-life.  Can you talk about that some more? What connection does shame have to do with all of this, with depression suffering and so forth?

Jim:  I would like to respond to two things.  Before we hit mid-life, we often identify with those adaptations that carry us into our lives and create relationships, professions and life patterns.   Then by mid-life, we can typically no-longer ignore the protest that may be coming from within us or in our marriages or in our other behaviors.  It is at that point one might begin to question what is going here really.  “Who am I, apart from my history? Who am I, apart from my roles?”

It can lead to a very interesting conversation which can, in turn, lead to some significant changes and a greater freedom in the second half of life.  But, I think most people feel shame.  Now, the difference between shame and guilt is that with guilt we feel that we are accountable for something we did or failed to do and often that has a powerful effect on people’s lives.  But shame is a feeling that who I am in itself is not sufficient or it is contaminated in some way.

So people can be shamed by the conditions of their birth or the conditions of their family origin or by events that occurred in a person’s life wherein he or she feels that they were insufficient or inadequate.  The kind of generosity or forgiveness or acceptance we would give to another is often very hard to give to ourselves and so typically what we do is we double our work or try to anesthetize our suffering.

But I think shame is an often neglected feature in peoples’ lives and will show up in two primary ways. One is through patterns of avoidance and hiding out from the life we want to live.  The other is grandiosity which is an over-compensation so that one has to continuously try to prove one’s worth to others and that exertion, in the end, leads to greater and greater sense of frustration and emptiness.

Since we are often not conscious of any of this, whatever accomplishments are there are never enough.  It can drive a person higher and higher and higher in his or her efforts to demonstrate personal worth as a treatment plan for guilt.  That person remains very much hooked by that which invariably leads to excess and then leads to consequences which again feeds the shame cycle again.    I think one of the hardest things in life, in addition to recovering personal authority, is learning self-forgiveness and self-acceptance. These are not easy things because they must include honest accountability for choices made, choices not made and for consequences that are choices produced.

Dan:  Jim, would it be fair to say many successful people or those who strive for success, in some way continually over-compensate in their lives and careers?  And when they, in some sense fail to meet these unconscious goals of success, however well or fully defined, they feel shame? It seems to me that this is a reality for a lot of lawyers who are engaged in a very competitive, win-loss type of career.  And they often do not have a place to go to work that through.

Jim:   That’s right.  I think most folks have seen the film, Citizen Kane. That whole story basically was a portrait based on the life of overcompensation; a power-driven person who is still compensating for the conditions of poverty and shame of his childhood.   If one could have unlocked that secret early, his path in life might have been less destructive and less driven by demons, so to speak.

Frankly, that’s the role of therapy. I believe therapy is such an important means by which one can have a conversation with oneself.  Too often, people associate therapy with some grand pathology.  But I think if we explore it rather as a kind of encounter with one’s deepest self, that one will begin to realize that I myself am a mystery, I am a complexity, I am a richness of which I know only a small portion from a conscious standpoint.  It is not about self-absorption or narcissism.

Quite the contrary, it is a humble dialog with a therapist. And then one becomes, frankly, less dangerous to the world. We become a more available partner, spouse, parent, and colleague and I think can begin to zero in on what really does matter to us, what choices we are making.

Dan:  One of the things I took away from your book is the idea that most of us, on an unconscious level, believe that life is a problem to be solved rather than mysteries to be lived.

I think that this insight has helped alleviate a lot of my depression and others I know.  With depression, there’s so much ruminative thinking.  We get caught in this vicious circle of trying to solve depression.  Or, in a greater context, larger issues such as, “Why was I born into a family with an alcoholic father?  Or, “Why am I such a screw-up?” We try to answer these negative questions over and over again.  But these are questions with no true answers.

Jim:   I think that we need to realize that suffering depressions – – and I put that in the plural- – is actually a normal human experience and highly functioning people and capable people often have what I would call “pockets of depression” and yet are not governed by it.

These pockets of depression have to do with real losses they have experienced in their lives or the experience of internal conflicts.  The human condition itself involves suffering and we always have to ask a question, “Is the way in which I am experiencing my suffering and my conflict, is it leading me to a larger life or is it leading me to a smaller life?”  “Does it enlarge me or does it diminish me?”

And I think we usually know the answer to that question.  The flight from suffering leads to an inauthentic life, to a superficial life.  So, I think it’s important to recognize that in the course of our journey, we will, from time to time, visit what I call “The Swampland of the Soul”. And in every swampland, there is a task and if we can identify that task and address it, it can lead us out of victimhood and into a large consciousness.

One of them is depression.  So again, we have to remember that the word means “to press down”.  So, we must ask ourselves, “What is being pressed down?” “What energy, what value, what agenda, what desire is being pressed down and are we the unwitting agencies of that oppression or is it something that has happened to us along the way with which we identified and what life wishes to be served? And in many cases, people, by just asking these questions, will be led to a larger life, a change, if not a change of direction or course in life, a change in some of the attitudes with which they address daily life.

James Hollis, Ph.D. was born in Springfield, Illinois. He graduated with an A.B. from Manchester College in 1962 and with a Ph.D. from Drew University in 1967. He taught the Humanities 26 years in various colleges and universities before retraining as a Jungian analyst at the Jung Institute of Zurich, Switzerland (1977-82). He is a licensed Jungian analyst in private practice in Houston, Texas, where he served as Executive Director of the Jung Educational Center of Houston from 1997-2008. He is a retired Senior Training Analyst for the Inter-Regional Society of Jungian Analysts, was the first Director of Training of the Philadelphia Jung Institute, and is vice president emeritus of the Philemon Foundation, which is dedicated to the publication of the complete works of Jung. In addition to the book “Living a More Considered Life: What Matters Most,” he is the author of “Finding Meaning in the Second Half of Life: How to Finally, Really Grow Up“.

 

An Interview with Will Meyerhofer About Depression in the Legal Profession

Will Meyerhofer, JD LCSW, is an author and a psychotherapist in private practice in NYC.  He holds degrees from Harvard, NYU School of Law and The Hunter College School of Social Work.  Following law school, he worked as an associate at the BigLaw firm of Sullivan & Cromwell in New York City before becoming a therapist. He is also the creator of the website and blog The Peoples’ Therapist.  I spoke with Will about what depression is, how it forms and why so many lawyers are afflicted by it.

Dan:  As someone who has suffered from depression and treats people for depression, what is depression and how does it develop?

Will:  When Freud was asked why he went into neurology, and medicine, the career which developed, for him, into psychoanalysis, he said he was inspired by Charles Darwin’s astonishing breakthrough with the theory of evolution.  Freud was an admirer of Darwin.  That’s relevant, because evolution, I believe, plays an important role in depression.  Depression is an evolutionary adaptation of humankind gone wrong.

It’s a bit like Sickle Cell Anemia, which is actually an adaptation in our blood intended to prevent Malaria.  Unfortunately, that adaptation can also go too far and result in a harmful blood disorder.

Human beings have an enormously long childhood – the period of dependency following birth.  That is chiefly due to our single most important adaptation – large brains, which at full size, would never fit through the birth canal.  So we are born with a partially developed brain, about a third of its full size.  As a result, our brains require a strikingly long period following birth– at least compared to most other higher species – to develop and mature.  During that time, we’re utterly helpless.  Many species are born, brush themselves off, and a couple of hours or days later, they are up and running around – just think of horses birthing foals.  That’s not true for people.  Humans take 10-14 years before they’re in any shape to take care of themselves.  Our brains don’t even reach their full size until we’re about 6 years old.

Dan:  What does this long period of childhood have to do with depression?

Will:  We humans experience a very long period in our lives in which we demand and require enormous amounts of care in order to survive.  Otherwise we’d die.  Little children comprehend that situation on a cellular level.  If you walk away from a little child – make it clear that you are planning to abandon him for any length of time – that little child is going to absolutely flip; he is going to scream so loudly it will peel the paint off the walls.  That’s because he knows he could die if he is abandoned.  A child will always experience solitude as abandonment.  To put it bluntly – the role of a human child is to please.  It’s more intense for humans than for other life forms, because we require a lot more care and for a much longer period of time.  Reptiles lay eggs and disappear.  They might even feed on their own young and not think much of it.  But mammals need care – milk from the mother.  And of all the mammals, humans need the most care – years and years of it.  So humans spend many years learning to please.  We grow up with this directive to please – and blame ourselves if we fail at that task.  It gets coded into our brains and becomes a trained behavior, an instinct.  Keep in mind, the threat of death is real.  Historically, as a species, humans display high rates of infanticide.  This phenomenon exists in many species.  Birds often cull their young, and throw hatchlings out of the nest if there is insufficient food.  But with humans, because we require so much care in our early years, if things are bad, it would not be uncommon to take a child who is disfavored – perhaps an illegitimate or disabled or otherwise undesirable child – and leave it out in the woods to die or simply abandon it as a street urchin.  It is incumbent upon every human child to please so he can receive care and survive.

Ok, so how does this apply to depression?  Under stress, humans regress – they fall back instinctively into old, unconscious behaviors acquired during childhood.  In our case, that means falling back into the childhood pattern of locating the fault within –  feeling that you’ve failed to please, and that if you’re not pleasing, you are going to die.  So, when you are under stress and things aren’t going well for you, you blame yourself – it must be your fault.  Instead of acting like an adult, and getting angry and thinking – I’m not being treated well, I have a right to get angry and advocate for myself, or take care of myself, if no one else is going to do it – instead of that healthy, adult functioning, it’s the old regression, to “I’ve failed.  It’s my fault.  I’ll die because I’ve failed to please.”

An adult – unlike a child – does not have to experience solitude as abandonment.  You can say I am an adult.  I am independent.  I can take care of myself.  Not only that, I can choose an environment that’s healthy for me and I can reassure myself.  I can self-sooth, I can self-parent.  I can say to myself, hey you are a good person, come on.  You choose who you are going to be each day. You are proud of who you are. You make that determination.  You make that judgment whether you are worthy of being valued and receiving care each day.  And you can tell yourself, Hey cheer up, you are going to get through this.  You’re going to surround yourself with people who value you because that’s what you deserve and you are going to take care of yourself.  And you can feel angry if you’re not receiving the care you deserve.  That – in a nutshell – is how you address depression.  You snap out of the regression to behaving like a dependent child and become an adult, a parent for your own child.

Dan: What signs do you look for to diagnose depression?

Will:  There are two major indicators for depression that give it away each and every time.

First, I see an absence of appropriate anger.  A child does not get angry when the parent fails to provide him with suitable care – the child sees himself as helpless.  You can’t get angry at someone if you need them desperately, the way a child needs a parent.  It’s not where the hell are you, I need a feeding, my diaper needs to be changed.   Instead, the child’s in absolute panic and thinking I’m bad, I’m bad, I’ve failed here, I have failed to please – now they’ll leave me to die.  That is the first characteristic of depression – absence of appropriate anger.  If I ask a depressed client “Are you angry right now?” I’ll always hear the same answer.  It will be always be some variation of “I’m only angry at myself.”  The rest of that statement would be “. . . because I’ve failed to please and can’t survive on my own.”

The Second indicator of depression is a dismantling of a person’s self-esteem apparatus. There’s no sense of pride in yourself or a sense of value in who you are and what you do. You think I failed, I hate being me.  A depressed person will insist, over and over again –I’m only angry at myself.  I don’t like who I am.”  That’s because the depressed person’s fantasy is to escape into someone else – someone who will please, and therefore be worthy of care – and survival.

Dan:  The absence of appropriate anger and a dismantled self-esteem.  I think those are two things that people on the street and even lawyers would associate with lawyers. We expect them to be tough and strong.  We expect them to have high self-esteem and take pride in what they do. In your experience, why is the exact opposite true for lawyers struggling with depression?

Will:  At a law firm, you are reduced to a child-like helplessness.  You have no right to speak your mind, to self-advocate – to stand up to authority.  Instead, you go helpless, and try to please.  Any anger, if it is acknowledged to any degree, is tightly bottled.  You can’t show it.  The environment at law firms is uptight, rigid and extremely constrained.  You can’t say to the partner – “Oh, for heaven sake, it’s Friday – why are you bothering me with this?”  You say – “Yes, sir.  I’ll do it right away.”  If the partner – who is clearly exploiting you to make money – announces you are going to be working all weekend, you say “Absolutely, no problem.”   You do not put up any kind of a fight.  Lawyers, especially young lawyers, imagine themselves as helpless as young children in the law firm environment – utterly dependent on the partners, utterly incapable of advocating for themselves, or providing themselves with the care they need on their own.  They permit themselves to be abused in an extremely toxic, exploitative environment – they often don’t even seem to realize they’re being abused.  They’re too busy attempting to please their abusers.

Dan:  Will, you treat a lot of lawyers with depression.  Is depression in some way different for lawyers?  Are there different causes for their depression?

Will:  If I were to design an environment specifically to create depression, I would design a law firm.  The reason is that lawyers are pleasers.  A lawyer tends to be the kid with the best grades in the class – a generalist whose primary skill is getting good grades – pleasing teachers.   If you are really good at math, you become a mathematician or a scientist.  If you are particularly skilled on the violin, you become a musician.  But if you get an “A” in everything, then your only skill set is getting good grades – and to monetize that skill set, you wind up heading to law school.  That’s pretty much how I did it.  I got into Harvard and then went on to NYU Law.  I wasn’t spectacular at any one thing – I was a generalist.   I was also the teacher’s pet.  I was an excellent student – but what is an excellent student?  It’s someone who gives the teachers what they want. Bill Gates, Mark Zuckerberg, they dropped out of Harvard, they weren’t good students – because they – and others like them – were geniuses, and entrepreneurs, not good students.  Lots of geniuses drop out of college – it’s a common feature they share.  They’re not pleasers. Einstein struggled to complete the academic rigamarole required to get a teaching post – he was too busy re-inventing physics.

Lawyers tend to be good students.  A genius or an entrepreneur – an individualist – says I’m going to do it my own way and the hell with you.  Screw Harvard. I don’t need it.   This is in contrast to lawyer, the pleaser – the type of person who says I’m going to compete viciously with my peers and get straight A’s at Harvard and then go to a top law school and compete some more to get more straight A’s and then get a job at a top law firm and keep on competing.  What happens to a pleaser when you get to these top firms? You do what you are told.  And you compete.  That’s a very typical lawyer behavior – you are essentially pleasing partners who are replacements for your parents and teachers, what therapists call the idealized parent object, the primary object – the person you’re programmed to please.  And you are killing off your peers – the other children who compete for parental attention and care.

Dan:  Big firms then have collections of pleasers and demanding partners.  What does that do to the psyche of a lawyer?

Will:  A law firm takes all these pleasers, herds all these kids who have always gotten A’s, and concentrates them in one giant feeding lot.  So you have an entire law firm stocked with pleasers, and no one to please!  There are no more teachersThe partners are the closest thing to a parent-object, and they’re overgrown pleasers themselves.   It ends up with everyone competing with everyone else and everyone feeling like they’re failing.  Throwing people under the bus is not a management technique except in a law firm.   Anyone who’s ever worked in big law firms will tell you that folks get thrown under the bus every day at those places.  It’s the antithesis of good management.   That’s because they’re all competing – no one is stepping back and getting pleased, and saying – hey, you’re doing a terrific job!  Good management is a requirement for happiness at a workplace.  Everyone seems to realize that but lawyers.  Employees need to feel supported, appreciated and motivated.  They’ll do better work if they believe they’re good at what they do.  Employees need to feel like they want to come in everyday because they like their workplace.  Every time you walk in, you need to feel like Yeah, I know everybody here, my boss knows me, he respects me, he thanks me for my work.  A good manager understands this – it isn’t rocket science.  A fundamental management principle is that a review process needs to be supportive.  There should be about 90% praise, and the constructive suggestions should be just that – constructive and suggestions.  You don’t get anything remotely resembling that in a law firm because everyone is busy instinctively competing with each other like little baby animals trying to kill off the other baby animals as though they might die if someone else succeeds.  Management technique, at a big law firm, amounts to throwing someone else under a bus, and thinking you feel better afterwards – like, somehow you’re now in a safer position.  It’s madness.

Dan:  Please tell us about your two books.

Will:  My first book, Life is a Brief Opportunity for Joy, actually started out as notes for  young therapists.  I was doing trainings for volunteer counselors at a hospital and I kept repeating the same things over and over to them, explaining anxiety and depression.  So I started with these notes and realized there was a book there that I could use with my clients.  That’s one way to look at therapy – as educating your clients – training them, really, to be therapists themselves, to the extent that they gain an understanding of emotions and how they work.

The first part of the book is about gaining awareness and understanding how anxiety and depression work. The second part tackles applying that knowledge to your life as you live it.

It’s interesting, how I came up with the title.  I wrote this phrase, somewhere around the middle of the book – “Life is a brief opportunity for joy.”  It was a literary agent, later on, who read the book and spotted it and said, that’s your title Will.  It seemed to sum up the entire book.  Let’s face it:  We are all heading to the same place – oblivion – a hole in the ground.  It’s a brief trip and it goes by quickly. Our mission is to be joyous. Life is a gift – it really is.

Many many lawyers make themselves incredibly unhappy. I think sometimes it’s as if they’re determined to make themselves miserable.  And depression is, at its heart, a self- punitive behavior.  You are doing this to yourself.  You are beating yourself up. You are being a bad parent to your inner child, by abandoning him to panic and attack himself for failing to please.

Dan:  So when someone struggles with depression as an adult, they’re basically repeating the maladaptive patterns they learned in childhood – – but this time they’re doing it to themselves.

Will:  Pretty much.  You’re not pleasing others, so you blame yourself for that failure.  You place the fault within and dismantle your self-esteem.  That’s what I did.  Instead of saying to myself maybe I don’t belong here, I kidded myself I did belong there.  The truth is, I never belonged in the legal profession.  I went because of the money and to try to please my mother in some misguided way.  I was a writer and a young therapist, at heart.   I would have become a therapist if my parents had done a better job handling my coming out as a gay man.  I  would have gone into mental health right away because I was fascinated by it.  But my parents hated that I was gay and sent me to a psychiatrist to be “cured.”  That scared me away from mental health, and in the end I wanted to make my parents happy and provide them all the money and the status to compensate for being gay.  I didn’t even understand what law was. I just went into it blindly thinking well, okay, status and money.

Dan:  Now, tell us about the second book and why you wrote it?

Will:  Well, the second book has a silly title, Way Worse than Being a Dentist: The Lawyer’s Quest for Meaning.  I have a literary agent friend who always seems to come up with my titles and she came up with this one, too.  We were kidding over coffee and I said, well basically, if you’re not smart enough to get into medical school, you have two choices.  You can aim a little lower and go to dental school or you can become a lawyer.  Weirdly enough, I’ve had people write me who read the book and said “You know, I went into dentistry and I am glad I did.”  Or, “I went law and damn I should have gone into dentistry.

So that was the idea – you should have been a dentist.  There are people who bash dentists and talk about their high rate of suicide or depression.  In actuality, I think that’s a myth.  The dentists I know are fascinated by it and doing a lot of good for people.  I have a bunch of dentist friends.

But anyway, I came up with this silly title and the book was based on a bunch of columns I wrote for Above the Law, along with additional materials that were either too personal or too honest or too long or too – something – to get included in the original published columns.  Every time I wrote a column, I thought of more I wanted to say and I realized I was starting to exorcise my own demons from that very traumatic experience of trying to be a lawyer years before. I dedicated the book to the partners of Sullivan and Cromwell, just for a laugh.  The back photo, if you really look at it, is my firm’s facebook photo from my very first day at Sullivan. They took my photo in a suit and tie – I was terrified, but trying to look confident and successful.

Dan:  Give us just a few thoughts or ideas about how lawyers can recover from depression.

Will:  First of all:  Remember who you are.  I had a friend at the firm, years ago, a brilliant guy. He went to Yale Law School and then onto Sullivan and Cromwell.  I remember him looking at me one day as if he were saying the most forbidden thing he could ever admit: “Will I just don’t think I’m very good at this.”  And I remember thinking, God, that’s how I feel.  This guy was so accomplished and I thought, My God, they have really torn him down. He has forgotten who he is. I told him “Look at your record. You were a Yale undergrad and then Yale Law” and on and on; top of his class in everything and I said “How did they do this to you?”

How do you remember who you are?  There are a couple of things that can help to snap you out of depressive thinking.

One, remember that you are not always right, but you are not always wrong either.  It might not be your fault when things don’t go right at work.  Depressed people tend to put the entire fault on themselves.  Everything is their fault, they failed and they feel they have no right to anger. I always tell my clients “Look, you have the right to have anger, even if you’re just angry that it’s raining outside.  Get angry about something.”  It’s about dignity.  The inherit dignity of being an adult and possessing a right to your own opinion, a right to your anger.

A child doesn’t really get angry.  He gets scared and terrified.  But an adult can say, hey, maybe this isn’t the right environment for me.  I remember someone at Sullivan & Cromwell, at some point, very sadistically telling me, “Maybe you’re not cut out for this place.” At the time I was desperate. I went to my office and wept because I had to be cut out for it. I had to succeed.  Then I realized maybe I am not cut out for this.   And I remember laughing and then I thought Oh my God, there is a way out. I don’t have to please.  I can please myself.  I can remember who I actually am.

I pose this question all the time to my lawyer clients:  Who are you really, inside?  They say “Well, come to think of it, I was an English major, I loved reading, I loved computer games and I always wanted to go bicycling,” or whatever.   It starts to come back and they remember who they are:  “You know, I love to bake cupcakes and I love to go hiking. I’m mad about punk music from the 70’s.”  Whatever floats their boat – their very individual, quirky, personal boat.  And then a person starts to come back to who they really are, to their true self.  That’s the beginning of the end of depression – simply remembering who you are, giving yourself the dignity to be you – not trying to care for yourself by pleasing others, but doing it directly – by caring for yourself, in the way you need to be cared for, the way the child inside you – who celebrates life and drinks deep of joy – needs to be cared for.  That’s how you beat depression.

 

Lawyers and Anxiety — The Fault of the Person, the field or law school?

I have a friend named Matt. He was one of the most popular students at my high school. A bit of a nerd, he was excellent at basketball, good enough at football, and not too bad with the ladies. He and our group of mutual friends would go out regularly, getting into shenanigans and living it up like young people are supposed to live.

As we got older, not much changed. While our shenanigans matured, we were still a group of outgoing companions that found ways to make life more enjoyable while still remaining as responsible as possible. We were the ideal – outgoing people with adult lives who continued to enjoy each other’s company.

Then Matt got into law school.

During law school he suffered from some general life stresses. His mother was diagnosed with cancer, and he and his girlfriend had their ups and downs. It was hard on him, certainly, but his mother was getting treatment and he and his girlfriend were still together, so it seems like something the average emotionally healthy person would cope with.

But he couldn’t because law school didn’t allow him to. His first year was brutal, without even the smallest break for some type of school/life balance. He was placed into a law student group in which he spent the vast majority of his time. He had no social life, he had no free time, and he certainly didn’t have the opportunity to cope with the stress he was experiencing in his personal life.

Not long after that he became a different person. He became socially withdrawn, “flaky,” and took to drinking. He was past the age when most people suffer from major personality changes and yet there he was, becoming a different person right in front of me, with very little I could do as most of his time was still spent on his law degree.

Learning to Cope in Law School

There’s an excellent article on this website about the personality of lawyers. In it, the author found that lawyers tended to be more naturally pessimistic, and that the practice itself often contributed to their depression and anxiety.

But I submit that law schools are also creating students that haven’t had an opportunity to learn to cope with the stresses of both the job and life. Many of them appear to be cutting their students off from the outside world – and even from fellow law students – and breeding young lawyers that haven’t had an opportunity to take a breath for several years.

Once they graduate, many of these students will be defending hardened criminals, helping companies dodge taxes, or even burying their faces in paperwork as they try to help companies and individuals avoid prosecution or take advantage of legal loopholes. Some of them will win their cases. Others will lose, often. It’s a lot of high stress work.

And yet few of these students will have had an opportunity to relax or cope since their first year of law school. These high stress students are being thrown into high stress careers, and the one payoff (money) isn’t enough to make up for what they’re being forced to experience.

The career is to blame for a lot of this stress. It’s a career that is prone to numerous failures, and one that expects a great deal of anyone that chooses to pursue it. But the universities that are training these students are also to blame. They’re preventing their students from coping with their daily life, only to throw them into a career with greater stress and no coping strategies.

Law schools need to start taking mental health into far greater consideration with all of their programs. The intensity of each program is believed to be valuable to training future leaders in the field of law, but if 20% of those lawyers are suffering from severe anxiety and depression, these programs have failed, as all they’ve created is another individual suffering from stress in their life. This needs to change.

About the Author: Ryan Rivera is an author and speaker on anxiety and depression, and often meets with lawyers whose jobs are the leadingcause of anxiety. He has more information on anxiety and depression at www.calmclinic.com.

 

Spirituality and Depression: A Talk with Dr. Hamdy El-Rayes

I had the opportunity to interview Dr. Hamdy El-Rayes about his new book, Mental Wellness: A Spiritual Journey. In his book, he explores the connection between spirituality and depression and how the lack of spirituality can be a cause of depression.  Dr. Hamdy grew up in Egypt in the Muslim faith and experienced depression as a young man.  He found a spiritual healer in the Sufi Muslim tradition who helped him recover, but found that his depression returned when he came to North America. 

Dan:          Can you tell us about your background?

Hamdy:     I have a MBA and Ph.D. in Electrical Engineering and currently live in British Columbia in Canada. I also teach at the British Columbia Institute of Technology and work in upper management there.  I became interested in the subject of depression because I have suffered from depression and anxiety.  I found that there was no help out there that could help me heal with spirituality and that’s when I decided to take my own future in my hands and decided to use my skills and research background to find a way out.   That is what led me into this work.  That is what led me to write a book, Mental Wellness: A Spiritual Journey, on depression and found the H.R. Mental Wellness Center here.

Dan:           How old were you when you first experienced depression?

Hamdy:     It started at a very young age. My first time was when I was 14 years old.  I then recovered and managed to find my own way through a spiritual teacher and I kind of brought spirituality into my life. I didn’t struggle with any depression again until I came here to Canada.  I found that the North American lifestyle takes you away from yourself and you lose your sense in the process of living a life here. That’s what happened to me.

Dan:           Can you elaborate on that?  What is it about our culture that creates and sustains depression?

Hamdy:      We live in a very fast-paced culture.  We are driven from the time we wake up until the time we go to bed.  We don’t have time to interact with ourselves.  We don’t have time to reflect on our life with all the technology around us to keep us moving at a fast pace – cell phones, computers, IPAD’s and you-name-it devices. Today we are distant from a sense of spirituality in our lives.  This drift really began about a century ago with the theories of Sigmund Freud.  He had an enormous influence on the university culture in Europe, the United States and the educated people of his time.  His influence and those of his protégés continue to this day. He considered religion, the more formal and institutional practice of religion, as a kind of mental disorder.

Dan:            That is a very interesting.  I think when we talk about depression in contemporary culture in the west, we often talk about treating depression with medication and psychotherapy because that is what the psychiatric and psychological establishment tells us to do.  But there is not much discussion about spirituality and how spirituality can help somebody recover from depression, let alone suggest that its absence in our lives can be a cause of depression.   

Hamdy:      Yes, it became like a taboo.  For most of the psychiatrists in the U.S., spirituality is not thought of as a solution to depression because it is not based on science and biology about how the brain work

Dan:          I agree that many in the west think of depression solely as a medical issue, as a disease, and when people think of it as a disease, they say, “ Well it’s like heart disease or diabetes.”  If it is just a medical disease, people probably don’t think that spirituality, and the lack of it, has to do with their depression.  You have a new book out, Mental Wellness: A Spiritual Journey.  In it, you say that spirituality has a lot to do with depression and healing from it.

Hamdy:     It is not really my personal opinion.  It is based on work done in past 20-25 years where doctors started recognizing that there is a powerful relationship between health and religion.   There are about 95 articles and research reports about the impact of spirituality on various physical and mental illnesses.  As we know, spirituality helps people with addiction, healing from various physical illnesses like diabetes, arthritis, heart problems.  It even helps cope with cancer. 

Dan:           Can you talk more about how a lack of spirituality contributes to depression?

Hamdy:      In developing our character, there are some qualities we develop when we bring spirituality into our lives.  This character development changes our way of thinking and when you change your way of thinking you change your perception of the world.  How we perceive the world plays an important role in depression.

Dan:          Can you give us an example of one character quality that you are talking about in terms of development in your spiritual tradition and it may relate to depression?

Hamdy:     Well I’ll give you something very close to us all: love. The capacity to love is something we can develop in ourselves and grow by practicing our spirituality.  One of the main things people struggle with is the lack of love in their life.  So often, they didn’t learn how to love themselves. And if you don’t know how to love yourself, it is tough to know how to love other people.  Most of the people who suffer from depression have something from their childhood that set the stage for depression in adult life, whether they were abused or didn’t learn to love themselves or others at home.

Dan:          Was that the case for you?

Hamdy:     I wasn’t very healthy as a child.  I was given the leeway of doing things that maybe other kids in the family were not allowed to in my culture.  I was given a little bit of freedom to be me and that may be the best thing that I got from my family although it was for a reason.

Dan:          What country were you born in Hamdy?

Hamdy:     Egypt. 

Dan:           When you spoke earlier about spirituality and your childhood spirituality, were you raised in the Muslim faith?

Hamdy:     Yes.  I was raised as a Muslim in a conservative family where religion was very important.  I was kind of rebel and was given the freedom not to go to the Mosque because I really didn’t like it.  I didn’t like it because I found that many people who went to Mosque were not as my mother told me:  all good people, very kind, very caring and all those things. I didn’t see it in the people who went there.  So I said no, I don’t want to be there.  So I was allowed not to go.   Although my father, I remember, he was kind of ashamed.  He was embarrassed that his son was the only kid that didn’t go to the Mosque.   Everyone else went to the Friday prayers.  My friends would meet in the morning before prayers and then go to the Mosque.   I was the only kid who went home.    My father got to the point where he would say “Hamdy, I will give you something.  I will give you money every time you go to Mosque”.   The sum of money he offered would be like the equivalent of $50.00 today.   To a child, $50.00 is a huge amount of money!   I told him no, I don’t want money.  That’s why I got depressed and started talking to this spiritual teacher. He was a wonderful man. 

Dan:          Was he a Muslim as well?

Hamdy:     Yes, he was a Sufi.   He was a very spiritual man and every discussion you had with him was very deep.

Dan:          How is a Sufi Muslim different than just a regular Muslim?  What is it about Sufism that’s different? 

Hamdy:     Sufism is the mystical part of the Muslim religion.  A Sufi is a person who is focused on the depths of developing themselves.   They don’t attach to the rituals as much as in being.   Religions are wonderful.  I have studied Judaism and Christianity and you know they have the same foundations. When it comes to practice, we most of us tend to focus on the rituals and forget where the rituals where supposed to lead us, how they were supposed to transform us in our daily life experiences.

Dan:        I am a very liberal Catholic, a religion that has many rituals.  We can also get caught up in the rituals to such an extent that we go through the motions with rituals and neglect the practice of our spirituality.  It doesn’t transform us in some positive way.  I read a book by Brother David Steindl-Rast who wrote that there is the belief in God and the trust in God.  There are many beliefs, but only one trust in God.  Belief comes from the mind and trust from the heart.  In my tradition, I trust in Jesus as a “Person”.  I have a personal relationship with Him and I try to practice and nurture that every day.  In doing so, I feel more aligned with my true self.

Hamdy:     In my book, the most important part of spirituality is to come to know yourself and develop your character.  Developing your spiritual skills becomes easy as you practice and becomes like second nature to you.  Rituals when not combined with true spirituality will not help us to know ourselves.

Dan:           Can you tell me, why did you write this book?

Hamdy:     I wrote it because  I had developed  this program for myself to help me heal and I had outstanding results, I couldn’t even dream of getting the results I got.  So I decided to offer this to people on my own.  I set up a charity and I started offering this program to people in the community.

Dan:           For those of our readers who are interested in your book and would like to know basically what it’s about, can you give us just a brief synopsis or an idea of what kind of things your book addresses?

Hamdy:     I start with really trying to kind of correct the erroneous conclusions about life that we formed in childhood and carried into our adult lives. The past we are moving in today leads to depression and anxiety and other mental illnesses.    That is the essence of the book.  So we start with learning how to manage stress to get us to a place where we can function well in our daily lives.  That is the most important step.  Then I talk about, in the introduction, how the American community has distanced us from spirituality which is an integral part of our human experience. Our life is incomplete without incorporating spirituality in our life.

Dan:           And I think that sense of spirituality, I think one of the key elements of it, at least in my own experience, is a sense of community and a sense of belonging.  A lot of people find that experience absent in modern society.  Do you feel that way too?

Hamdy:      Absolutely, it is part of the process because if you look into how we develop ourselves, when we develop our spiritual skills, in every skill, it has as a part of it community and how we relate to our community.  So that is an important thing. 

Dan:           When there is an absence of that relationship to community, I guess we could think of it as a form of stress; we don’t feel the support, we don’t feel the positive energy of other people and we are kind of left alone to battle in the world.  We become estranged from humanity and alienated.

Hamdy:     You know we are social beings and if we don’t have the community that we are a part of, we are lacking something and that can be a kind of contributing factor to our depression.

Dan:            Did you find that in your own experiences of depression that you had difficulty managing stress?

Hamdy:      Yes. You know, the problem with stress is that there are smaller stresses along the way and stress is cumulative. So we have small stresses and we don’t manage this stress which is cumulative and affects us in a very significant way whether physically or mentally without us noticing because we kind of become numb to the impact of stress and we don’t see its cumulative effect, unfortunately, until we are burned out or we are suffering from a major mental or physical illness.

Dan:          In your book, do you have some recommendations for how we should approach healing from depression.  Can you share with our readers’ one or two?

Hamdy:     Number one is learning how to manage your daily life, how to relax with meditation and living mindfully.   It not just to practice meditation, it is to bring it into your life in every activity you do in your life right now.  Living mindfully is a very important thing and if you live mindfully, you are not distracted with things that happened in the past or concerns about things that may happen in the future.

Dan:          I agree with you and I think meditation is important.  I guess it might be fair to say, the opposite of mindfulness is mindlessness which I guess, while we are in depression, it is kind of a mindless state where we are confused, disorientated, disconnected.  Was that your experience?

Hamdy:     Absolutely, and in the process, we get more distant from ourselves.  We are really unaware of how we feel physically or emotionally until we get a wake-up call that is depression or having a mental or physical illness. 

Dan:       The culture really contributes to that. You said earliest we are driven from the moment we get up and we override our symptoms or signs that we are in trouble; maybe we are suffering from depression or heart disease or other problems.

Hamdy:     One other thing is when you start practicing your spiritual skills, you kind of are more oriented to become yourself.   One of the main reasons for our depression is conditioning from our families and fast-paced culture that allows us to become distant from our essential  self.     It is important for us to recover this true self.  In recovering our true self, you live in harmony with the world around you; you are not in conflict anymore.

Dan:           Yes, that makes a lot of sense to me.  Thanks for your time Hamdy. It was a great talking to you.

How Stress Can Shape a Life

The psychologist Richard O’Connor believes that we tell ourselves stories about our lives to control stress. Stress has a way of becoming a chronic condition. It wears down your body and damages your brain, especially when combined with depression.

Yet stress is a killer we often crave like a drug. We create stories that help us make sense of an unbalanced life.

Stories of Challenge

In my work, I often felt I wasn’t doing much if I weren’t insanely “busy,” meaning stressed out completely. As much as I swore to cut back and lead a more balanced life, I could never do that for long.

Unless I felt the edge of stress, I thought I was drifting and had little motivation. I didn’t think of it as stress. It was the excitement of challenge.

Like a lot of us, the people I considered the heroes of our culture and workplace could handle more stress than anyone. They could take the heat, drive themselves ceaselessly and thrive on the challenge of super-achievement.

Take this story that made the front page of the local paper where I used to live. An attorney was driving to work on a snowy day and saw a car ahead of him slide off the freeway, hit a rock, and crash-land on its side. He stopped, rushed to the scene, pried open a jammed door and pulled out the dazed driver.

Just then another car plowed into them and sent the lawyer flying into a ditch. He got up, brushed off the snow, stayed with everyone until help arrived, then drove to work where he had a great day in a high-stakes case. Wow, what a guy! The super-achiever who jumps into the challenge and feeds on the energy of each wild situation without a moment’s rest.

There’s an important story-line here. It’s the heroic control of stress. It becomes a challenge, a test of strength and endurance. It’s a story that hides the biological damage under praise and success.

Stories of Loss

The rest of us tell humbler stories about living with stress. We try to control it through schedules and medication, lists of priorities and days of relaxation. The tools usually don’t work because the world won’t let up its constant pressure to do more.

Stress is one of the connectors between the social world and our intensely private experience of depression. I’ve read a lot about the effects of broad social and cultural changes on our inner lives, but most of that is far too general to relate to what I feel right now in my little corner of the world.

OK, we’ve lost the old bonds of community and extended family, we’re on our own in a storm of information. We face the confusion of choice, confusion over identity, rootlessness – all that may be true. But it’s the immediacy of stress that helped me make the connection, not with big social changes, but with more immediate crises.

Stress hits us through tension and the fear that we can’t handle the most threatening problems. There isn’t enough money to pay debts. I could lose my job any day. We could lose our home to the bank because we can’t make mortgage payments. I’m sick – or my partner or my children are sick – and the health costs are staggering.

The fear of loss is always there – more and more loss until disaster hits or until we settle into a pattern of living in a diminished way. We’re trapped in a world of pressures that have pushed us down. Trying to get up is a constant struggle.

That’s the way the social dimension has combined with biology and my inner life. The constant stress has deepened depression.

Spiraling Down, Spiraling Up

The story I tell myself in depression is that all these dimensions of my life have proven too much for me. I’m not good enough to handle them. I’ve never been good enough. I’m stressed all the more by memories of failure – threats I’ve run from, challenges I couldn’t meet, self-destructive actions.

The person I am, I’m certain, continues to lose control to the pressures of living.

But when I’m not depressed, everything looks different. I feel I can live the story of victory over challenges. Stress is a stimulant, one I need to stay motivated, to live at the top of my game. I’m even afraid that if I lose the tension and excitement of constantly pushing myself, I’ll start to drift into emptiness again.

There’s always an imbalance, tipping me into a spiral. One spiral takes me deeper into depression until it spins itself out. From the bottom of the whirling storm, I start to spiral upward on the other side.

In both modes, the stress is a powerful force: stress from the world and stress from inside.

Awareness of the Story

These days I feel as close to balance between the spirals of excitement and depression as I’ve ever been. I believe I have a better chance now to sustain this balance because I’ve worked at learning skills to keep me going.

I think we all have the capacity to observe ourselves in action. Usually, I used the ability to detach from experience enough to tell myself the story of how I’m living.

That’s the basic tool. Today it’s known as mindfulness – the ability to see your life as your living it and accept its changing flow without being controlled by it. Then we have to work with that awareness to retell our stories.

I know everyone doesn’t live this way, but does it make sense as one explanation? It rings true for me. How about you?

Visit John’s award-winning website Storied Mind.

This article is reprinted with permission of the author and is copyrighted.

 

 

 

 

 

 

Life as a 1L can be Depressing

Katie has been married to her law student husband for almost four years. She has grown into a more compassionate and well-rounded Certified Health Education Specialist and Mental Health First Aid provider from her experiences with her husband’s mental health issues, and enjoys sharing information with others about health and wellness. Her husband is currently searching for a job. As such, Katie has only given her first name.

Last year, my husband became a first-year law student at a state school with an excellent reputation. After several years of waffling between pursuing medicine, law, military, and scientific research careers, he opted for law and was admitted to a number of schools, accepting his best offer. We relocated so that he could attend, moving from the sunny Southwest to the frigid winters of the Mid-Atlantic. He was excited at first, eager to begin a new chapter of his life and enthusiastic to embark on a learning journey; he loves to read and study politics,
economics, business, and law, and felt that this endeavor would help him fulfill his potential both personally and professionally.

Shortly into the first year, I noticed my usually calm husband – laid-back almost to a fault – was frequently stressed. He worried constantly about understanding the material, completing his assignments, competing for grades, getting an internship, and even being able to get a job upon graduating. Although this may seem natural for law students (1L’s in particular), it was a marked change in his personality that lasted for weeks on end, almost to the point of keeping him from being able to study, write, or prepare for his classes.

His friendly nature struggled with the intense sense of competition among the other students, and he was unable to form many friendships, leaving him feeling isolated and lonely. Furthermore, the mounting pressure to perform dominated his thoughts, paralyzing him and making him reach a point of hopelessness; he felt that even his best wasn’t good enough, and that there was no
point in continuing if he couldn’t get a good job at the end of it all.

The Loving, but Ignorant, Spouse

I tried to play the supportive spouse. To me, it seemed likely that many other students felt the same way as him but managed to focus more on the task at hand, not tying every tiny detail to future results. It even angered me that despite all the sacrifices we had both made for him to be able to return to school, he was risking it all because he refused to focus on anything but his potential for failure. I told him time and again that I was absolutely positive he would do just fine, that I wasn’t worried about his ability to succeed and get an excellent job, that his understanding of the material would mean more for his career than a grade on his transcript, and that his best efforts would surely serve him well. But my encouragement didn’t help.

In the past, my husband was an avid athlete. He still holds a state record for his high school swimming times, he trained himself to run a half marathon every weekend, and he completed the entire P90-X workout course. This all stopped when we moved and he started school, principally due to his lack of time. He snuck in a few workouts at the beginning of his first semester, but quickly traded exercise for sleep whenever he had a spare minute. His ambitious early morning study sessions from the start of the semester had disappeared by fall break, andas the sun went down earlier every night, so did he. He began sleeping as much as he possibly could – at times even falling asleep while studying or sleeping and skipping studying altogether. My usually upbeat, happy husband started making off-the-cuff remarks about how worthless he was and how stupid he felt, even tossing out an occasional comment about shooting himself so I wouldn’t have to repay his school loans, followed by swift assurances that he was “just kidding.”

Getting Serious About Depression

Even though I am a trained public health professional and a Certified Health Education Specialists, the signs flew right by me. I just assumed he was having difficulty adjusting to life in a new state, unhappy about having to make new friends and commit considerable effort to his degree. I missed the signs of depression that were staring me in the face every single day. To make matters worse, three visits he made to the student health center for check-ups and care for his asthma found nothing of concern.

I am ashamed to admit that several months passed wherein I did absolutely nothing, I suppose in a state of self-denial. I couldn’t convince myself that he was not right, not healthy, that something was seriously wrong despite the symptoms I tried to tiptoe around on a regular basis. A kindly older neighbor was good enough to give me a kick in the pants to help my husband get the help he needed.

“What’s wrong with him?” she asked – no beating around the bush. “He’s changed – he used to be so bright and smiley, and now he just seems…unhealthy and sad. A sad, defeated man.”

I was dumbfounded, utterly shocked and hurt by what was the clear truth. My husband was suffering, he was miserable and I had neglected him. I tearfully squeezed her hand and marched straight home to make an appointment with a counselor for him. He went the following week and, after a series of visits, tests, and consultations, was diagnosed with major depression. I was heartbroken and embarrassed at my failure to notice his cries for help earlier in the year, but I was relieved that he would be getting the help he needed.

Living With – and Healing From – Depression

I am happy to report that with exercise therapy and regular talk therapy, he has been able to manage his depression without medication, although he still has some terribly painful bad days. We are starting to see what we hope is the light at the end of the tunnel for him. He is still pursuing his degree, and although he won’t be at the top of his class when he graduates, he has come to realize that a life-long career is built on more than where you fall on the grading curve. He has rediscovered his passion for running, and his sunny disposition is again bringing joy to both of our lives.

I wanted to share this story with any lawyers and law students potentially suffering from depressive symptoms to let you know that sometimes the people who most want to help you are not totally aware of what is going on in your head. Whether you think your behavior makes your pain obvious or you think you are hiding your emotions successfully, your loved ones are probably waiting for a wake-up call to push them into action. Be open with them about your pain, anxiety, and especially any suicidal thoughts. Sometimes a few words about how serious your troubles are may be the impetus for positive change – having a helpful friend to walk the long and difficult road with you can make it easier for you to get the help you need in a timely and effective manner.

For me, it took an old lady with a keen skill for observation to spur me into helping my husband get the treatment he needed; if you don’t think old Mrs. Wilson down the street will be doing the same for you, have a conversation with someone today about what you are experiencing, and let them know you don’t want to keep feeling that way. Help is available. You can get it, and a friend or family member will be happy to assist. Don’t wait – lawyers and law students are in unique positions to help others, and life is too short to spend time battling a mental disorder that steals your talents from you and the world. So go on, tell someone, and start feeling better soon.

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