Patrick Krill, a lawyer turned mental health counselor and consultant to law firms about lawyer mental health issues tries to answer the question: “A predicate to all of this, however, is the need to determine if you are actually depressed. Maybe you just hate your job, end of story. Moving on to a different practice or firm could be the change you need. Or, maybe you have an underlying medical condition that is masquerading as or causing a depressed feeling.” Read the rest of his blog here.
Today’s guest is Dr. Carrie Barron, a board-certified psychiatrist/psychoanalyst on the clinical faculty of the Columbia College of Physicians and Surgeons who also has a private practice in New York City. She has published in peer-reviewed journals, won several academic awards, and presented original works related to creativity and self-expression at national meetings of the American Psychoanalytic Association. Along with her husband, Alton Barron, M.D., a hand and shoulder surgeon, she co-authored the book, The Creativity Cure: How to Build Happiness with Your Own Two Hands.
Why is depression such a problem in our culture?
I think the level of stress has gone up enormously because we have so much to do and we’re on twenty-four hours a day. So I think because of technology, which offers us so many great things, but gives us much to do. I think that’s part of it. I also think, especially for children, we’re in a striving, ambitious, be productive all the time mentality – for children and adults. We need to play, we need to hangout, we need to have spontaneous time. I think spontaneous thought does a lot for alleviating depression and anxiety.
We have so many different words in our culture for unpleasant experiences. We might say things like, “I’m sad,” “I’m burnt-out,” “I’m stressed-out,” or “I’m depressed.” But what is the difference in your mind, as a clinician, between sadness, say, and depression?
Sadness is a normal emotion. We don’t have to treat everything and be afraid of sadness. We don’t have to pathologize everything. There is a range. I mean, life can be very hard and it’s appropriate not only to have it, but let yourself have it. Sometimes it is actually moving towards the authentic feeling, rather than running away from it, that actually makes it go away. You first have to experience it, and then when you understand it, and you’re in it, it runs its course. Now, this is separate from a true major depression where you can’t get up in the morning. That’s another story. But sadness is a normal part of life.
In your clinical practice, how often would you say depression has played a role in why people have come to see you?
I think it plays a role often. The categories that we have in the DSM-5, I think they’re useful so that clinicians can communicate with others. But nobody is fully described by a category or diagnosis. There’s a lot of overlap. When people are depressed, they’re also often anxious and also stressed, and sometimes it’s more one than the other. But depression does come up a lot for people and it’s very painful. I think not being able to get up in the morning, not feeling like doing anything, not being able to enjoy the sunny day or the view of the water, or whatever else people are getting into, it makes you feel very separate and alone when you are depressed and other people around you are not. So it has, kind of, a trickle-down effect, too.
Why did you write the book, The Creativity Cure? I found it such an interesting book, a fascinating read. You wrote it with your husband who is a surgeon. Can you tell our audience why you wrote it?
There are two things. I talk about this now, I didn’t talk about this in the book, when I was a kid, I had some problems. I was depressed. I was anxious. We weren’t taking meds at that time. There was some chaos in my world. I really had to find a way to survive. When I look back on it now, all those things that I recommend in my book are things I was doing, or trying to do, like using my hands. I would cook a lot. I would take long walks. Then, later in my practice, maybe ten years ago, patients were saying, “You know, I went home and I fixed my sink and I became euphoric! I felt great!” I started to realize that meaningful hand use has a lot to do with happiness. And yet, because so much of what we do now is accomplished with a click on a device, we’re deprived of the process. And process, being deeply immersed in making, or making music, brings with it the possibility for euphoria, and satisfaction, and feeling good about living. So creativity is really about a way to have an optimal life. How you define creativity is another matter.
What’s going on in the body, in particular, the brain when someone is struggling with depression? And how does creative action interact with that?
I think a lot of studies have been done, and serotonin and neurotransmitters, there’s a depleted state, and that we need to boost it up with medication or activities that do the same. Vigorous exercise can create the same biological state that antidepressants can. I want to qualify this and say that one must see their physician and make an informed decision, but certainly exercise can help a lot. Also, meaningful hand use has been shown to boost mood. Dr. Kelly Lambert wrote a book, Lifting Depression: A Neuroscientist’s Hands-On Approach to Activating Your Brain’s Healing Power, and she was the one who talked a lot about how purposeful hand use can affect brain chemistry and make people feel happier.
What would be some examples of using your hands? When we think of creativity, many people might think of painting, for example. They might say to themselves, “Well, I’m not a good painter,” or “I don’t play an instrument.” But creativity isn’t really limited to that. Can you expand on that?
Sure. I am so glad you asked that. I think this is the crucial question. And I think you hit the nail on the head. A lot of people say, “I’m not creative.” Well, first of all, I think we’re all born creative. It’s a matter of finding what you can do. It can be applied to business. You can be amazing. You could be a genius at figuring out what the team needs to be. That’s very creative. You could be an amazing cook. You could have a tremendous talent for decorating. Gardening, the design of a garden. It doesn’t have to be on a professional level. It’s really a matter of figuring out what you can get into. You may find that if you put some time into mastering a skill that you find a certain pleasure and freedom with it. That could be something like painting, but it doesn’t have to be. Knitting, crafting, it could even be fixing things. All of that involves meaningful hand use.
There are many definitions of creativity. My definition of it is allowing most natural self to emerge to make a positive contribution. It’s allowing you a freedom, a spontaneity in the way that you live, a feeling of safety that allows you to do that so you’ll throw out an idea, you’ll say something funny in conversation, so that you are just yourself and it works. That’s really optimal living.
You talked earlier about when you were younger and growing up having some difficult childhood experiences and learning some creative coping skills. Myself, when I think about this, I had a very difficult childhood as well with an alcoholic, abusive father. Over time, I didn’t have what I would now think of as depression as a young adult. It developed more at midlife when I turned forty. It seems that there’s a lot of research that suggests that when people in their childhoods have difficult experiences, either emotional abuse, or physical abuse, or deprivation, there’s some kind of linkup with adult-onset depression. Have you found you found that in your experience?
Yea, I think so. I think because in certain ways when you’re in your twenties and your thirties and you’re striving, and you’re distracted and you have a strong goal, that, in and of itself, that kind of commitment to a goal or emotion can stave off certain aspects of your memory or your inner life and it might get triggered in your forties. Maybe when you have a little bit more time to contemplate or think back. I will say that there are certainly ways, I just like to not be falsely optimistic, but be really optimistic and really encourage people to understand that there are ways to look into your particular history, your particular form of depression, and work with it to get to a much better place at any age.
In your book, you talk specifically about not only being creatively engaged, but the use of one’s hands, a physical activity, and how that somehow connects to creativity, no matter your history, or the causes of your depression. This seems to work for just about anybody with depression or unhappiness. Would you say that’s the case?
I do. I think it’s mild or moderate depression. I think if you have a very severe depression, you might need some medical intervention or an intense therapy. But what I like to say is that if you develop a creative habit, it’s very useful to fall back on it when you are depressed. You may not be able to master a new habit when you’re severely depressed, but if you’re mild to moderate, and you work on your knitting, or you work on your painting, or you go into the kitchen and you are inventive about your cooking, it really can shift mood, but not if you’re in a very crippled state. In a crippled state, you need to get to, sort of, a better place, and then use the creativity after that.
You’re living in New York City, but you’re soon to be on the move. Tell us a little bit about that.
I’m very excited because I am going to be moving to Austin, Texas soon. I’m going to be involved in, and working with the great people to try to develop a creativity/wellness program together. I’m not sure exactly, I haven’t submitted a proposal to them about human flourishing and aspects of human flourishing, but from my research, I outline 10 principles that are based on scientific research, but also on ancient philosophies that really help people with optimal living. Most of those are, actually, linked to creativity and linked to better health. So I’m really excited to get to work with people there.
You actually have a website. Where can our podcast listeners and readers find you?
At carriebarronmd.com and we have a pretty active Facebook page has a wide following. People make lots of comments and have lots of pretty interesting things to say on that. So that might be a place to look. And I do have an active Psychology Today blog. I try to keep it lighter for Facebook, kind of short for my website. On Psychology Today, I try to deal with deeper, more complicated issues, but try to be useful.
Carrie, it’s been a real pleasure speaking with you today on this very important topic of depression and what we can do about it with creativity. And we look forward to following your future work. I hope everybody follows Carrie on her website and reads her blogs. This is Dan Lukasik from Lawyers with Depression. Join us next week for another interesting interview.
The ABA Journal report that Big firms have long been reticent to openly address addiction and other mental-health problems, despite research showing lawyers face higher rates of substance abuse, depression, and suicide than the wider population,” the article says. “Law firm leaders say the need to keep up appearances in a competitive industry has contributed to the resistance. That attitude, however, is slowly changing. Read the article.
From Esperanza magazine, blogger Margaret Lanning writes, “Lack of motivation is probably the most difficult part of depression I continue to wrestle with. Trying to figure out how to get up and get moving is extremely challenging. It can make or break a day. When I feel apathetic, my senseless thought cycle starts with the notion that I need to choose to do something (clean the kitchen). Then comes immediate resistance (I don’t want to clean the kitchen), then the guilt trip (good mothers clean kitchens so the family can be healthy), then the compromise (I can have a bite of chocolate if I clean the kitchen), then the shut-down (but I still don’t want to clean, and I’ll probably eat the whole chocolate bar), then the self-punishment (I am a bad person because I’m still sitting here).” Read the blog.
From LA Magazine. Advocates are hailing ketamine therapy and its attendant hallucinations as the ultimate brain hack. Prominent doctors and even the stodgy National Institute of Mental Health have championed the treatment as a powerful weapon in the battle against depression, one that could potentially prevent people from taking their own lives. Read the article.
From Forbes magazine. As most people who have dealt with depression know, good treatments are hard to come by—but they do exist. Part of the issue is that a given treatment may work for one person and not the other, and it may take several tries before the right therapy, or a combination of therapies, is arrived upon. Here are some of the methods that have been shown to work, and are worth considering. As always, finding a therapist you trust and connect with is often the first step to figuring out which route to take. Read the article here.
During my depression, my world narrowed. I just didn’t want to go anywhere. My life was lived inside coffee shops, on the couch watching television, sitting in my office with the door closed. There was something deadening about this. In hindsight, I guess I felt that doing something else wouldn’t make a difference anyway.
I have learned over the years that nature is a powerful antidote to depression. Being in nature does make a difference. Maybe it’s because there is such power in nature. It’s always in motion, isn’t it? There isn’t any clinical depression in nature. Humans evolved from the natural world, not from concrete and office towers. One study found that a walk in a park or countryside reduced depression whereas walking in a shopping center or urban setting increased depression. This summer, I am going to reconnect with nature by taking my daughter on nature walks. During these times, I just want to let my incessant conversation with my depression go and let nature speak to me.
Ten percent of those diagnosed with seasonal affective disorder suffer symptoms at the brightest time of the year. The summer’s brutal heat, bright light, and long days can affect a person’s circadian rhythm and contribute to depression for the opposite reasons that winter conditions do. If you’re a Summer Hater, or just notice that your mood is affected negatively by the heat, here are some summer depression busters that may help you better tolerate these months — maybe even enjoy the
Once upon a time, I was a trial attorney at a personal injury defense firm. I was good at it. I always pushed hard; always did the best job possible. I won a good share of cases, and, of course, lost a few as well. I was valued highly enough to be made a partner shortly after joining the firm.
But I had a dirty little secret. I had bipolar disorder, which was well-controlled through a close partnership with a good psychiatrist. Still, in my mind, if word ever got out, my employers would see me as weak, a liability. To a degree, I understood. If the insurance companies that paid the bills learned that one of the firm’s trial attorneys had such a condition, their mandate would be clear: if you want our business, get rid of him. That is what I assumed.
Throughout my career, colleagues would make offhanded remarks about someone “not taking his medication.” I would grit my teeth and ignore it.
Instead, I was able to construct an alter-ego, the “happy warrior.” I had a smile on my face and a sardonic remark ready on cue. But I went about my daily business feeling like a secret agent in a Cold War spy movie. If my cover was ever blown, I was certain that my career would be at an end.
Over time, maintaining this secret identity while dealing with the usual strains of trial practice gave rise to a growing depression. Yet I still performed at a high level and still got results.
Although I had a close friend at the firm, another partner, he would deflect when I tried to talk to him about my depression, so I stopped. I began to worry that others at the firm might know about me.
Fear and the sense of isolation only fed upon themselves in a continuous cycle. I finally experienced a severe episode of depression that led to a period of disability. When I told my boss what was going on, he expressed genuine surprise that I was suffering from depression at all.
When I returned to work, I felt better, but I remained wary. Instead of engaging in a conversation about what had happened, we all acted as though nothing had occurred. The computer was rebooted, and business continued on as usual. I went back undercover, and no one seemed to mind.
Simply due to scheduling conflicts and adjournments, it was some time before I tried another case. I admit that I was a little nervous, but I was having no trouble handling my case load. I was puzzled when my boss came into my office one afternoon as I was preparing for the trial. He asked me if I felt good to go. He had never done that before. I said, “yes,” because I felt perfectly up to the task. I never asked myself, “If he is worried about my performance, why is he even letting me try the case?”
At trial, the insurance company sent an adjuster to audit the proceedings, a routine procedure. I knew him well, and he had an excellent grasp of the case, even though he had not been involved before trial. We had constant discussions about what was going on, and we seemed to be in sync. Suddenly, the insurance company pulled my old friend off the case and replaced him with a mid-level manager who consistently praised my performance.
The case went to verdict, and the jury awarded somewhat less than what the insurance company had offered settle for. To preclude the possibility of an appeal, the insurance company threw in a few more dollars. Case closed, on to the next one. To me, that was a pretty good result.
Was I in for a big surprise.
Shortly after the trial, year-end reviews were scheduled. I was getting ready for another trial, and I was very excited about it, so I wasn’t really paying attention to what was going on in the office. Other attorneys were getting their reviews – important because raises would be discussed – but I was never called in.
Ultimately, my case settled after much hard work on all sides, and the usual time for reviews was long past. I did start to worry then. I even made a remark to my secretary about it.
The call finally came. When I stepped into the conference room and saw every equity partner in the firm waiting for me, I knew. The spy had been caught, but what would happen?
My boss said that they waited to speak with me because they did not want to put pressure on me while I was preparing for another trial. He asked me if I felt capable of trying cases. I paused and then broke under the years of strain. I wept, and answered, “No.” Whether that “No” was true then or true now or was ever true, it was the most humiliating moment of a 20-year career.
My boss started to dissect my prior trial, telling me that the insurance company’s representative was reporting that I was doing a bad job. He even told me that the supervisor at the insurance company knew that I had depression. After the expected awkward silence, another partner suggested that “we find a creative solution” to keep me at the firm. I made some suggestions over the next few months. No replies were forthcoming. I was quietly being swept out the door. It wasn’t hard to get the message. I found another job and moved on.
The whole experience seemed to confirm everything I feared about being a lawyer with depression. Currently, I am not practicing, and am seeking other opportunities.
But if the story ends there, what is the point? Can I offer my account as a teaching opportunity? At the very heart of the tale lies the sad truth that we, as lawyers, trained to be superlative communicators, can utterly fail to make each other understood when it comes to depression. Should I have been more candid about my condition? My employers never told me what concerns they had or what they knew. Could all of us have been proactive for our mutual benefit, especially after I returned to work? I believe that there had been an opportunity to open a constructive dialogue, but my fear told me to keep my mouth shut. I cannot speak for my former employers, although I highly doubt that they held any malice. I doubt that they thought much about it at all until some critical pressure was brought to bear, whether from within or outside of the firm. Unfortunately, by the time everyone was talking, my job at a firm I loved was gone.
I miss working there. I still have close friends there. I see them when I can, which is not often enough. Just recently, I ran into my secretary, and we briefly chatted about my plans for the future. And then she said something that cut me to the quick: “You were a good lawyer.”
— Anonymous guest blog
“If you look deeply into the palm of your hand, you will see your parents and all generations of your ancestors. All of them are alive in the moment. Each is present in your body. You are the continuation of each of these people” – Thich Nhat Hanh
Like all parents, my Mom and Dad were flawed people – as I am. Yet, they were something more than that.
I’ve struggled to understand them much of my adult life; maybe more so now that they’re both gone. Here’s a picture of them from 1946 cleaning up the reception hall after a two-day celebration.
The nineteenth-century German philosopher Arthur Schopenhauer once wrote: