Your Brain on Depression: A Fascinating Interview with Neuroscientist, Dr. Alex Korb

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The following is an edited transcript of the podcast recorded interview with Dr. Alex Korb.  

Hi, I’m Dan Lukasik from lawyerswithdepression.com. Today’s guest is Dr. Alex Korb. Dr. Korb is a neuroscientist, writer, and coach.  He’s studied the brain for over fifteen years, attending Brown University as an undergraduate and earning his Ph.D. in neuroscience from UCLA. He has over a dozen peer-reviewed journal articles on depression and is also the author of the book, The Upward Spiral: Using Neuroscience to Reverse the Course of Depression One Small Change at a Time. Interesting, he’s also coached the UCLA Women’s Ultimate Frisbee team for twelve seasons and is a three-time winner for Ultimate Coach of the Year.  His expertise extends into leadership and motivation, stress and anxietymindfulness, physical fitness, and even standup comedy. Welcome to the show.

Why We Need to Talk About Lawyers’ Mental Health Now

Big law has a big problem.

The reality that lawyers suffer from high rates of mental health problems, addiction, and problem drinking can no longer be denied in light of the 2016 study conducted by the ABA Commission on Lawyer Assistance Programs and the Hazelden Betty Ford Foundation which has a nationally renowned drug and alcohol treatment center.

Now what?

A “National Task Force on Attorney Well-Being” was assembled following this study to make recommendations on what law schools, law firms, bar associations, and others, can do about these serious problems. I have read both the study, the task force’s report, and recent press reports coverage about how the recommendations of the task force are to be implemented.

To be frank, I am disappointed.

Finding Meaning in the Legal Profession:An Interview with Dr James Hollis

This is my interview with psychoanalyst, James Hollis, Ph.D., author of the best-selling books, “What Matters Most: Living a More Considered Life,” and “Finding Meaning in the Second Half of Life: How to Finally, Really Grow Up

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,

The Link Between Disorganization, Depression and Anxiety

Although it appears to be a mundane sort of thing, I find disorganization and chaos to be one of the biggest problems reported by depressed and anxious individuals. Emotional baggage has a way of building up and then expressing itself in an outward display of turmoil — as if a tornado had let loose in your brain and your surroundings.

The symptoms of feeling overwhelmed and not wanting to face the day often stem from not knowing where to start or not wanting to face the mountain of tasks that lay ahead.  I have found folks to be so bogged down with even the everyday task of leaving the house on time that their entire day is a mess before they ever get started. By 8 am they are frazzled.

There are screaming children, pets that need walking, work begins at a certain time, the laundry isn’t done, and available clothing is something picked out of the bin from the week before that didn’t make it to the dry cleaner.  Stress chemicals are running rampant, and irritability and panic set in as well as resentment of the household, job, family and everything else.

What is worse is that typically if disorganization is a problem at home it is a problem at work as well. A cluttered desk, half-finished tasks, and unmet deadlines are the career version of the problem and are also with you all day.

Does your automobile look like a homeless person’s shopping cart?  If so, none of your major environments is peaceful. There is nothing pleasant about your surroundings, and this is a major stressor.

The problem is not that you have too much to do or work full time, it is that you have not found a routine and effective organizational plan, or you found one but are not consistent in following the plan.

Running around willy-nilly, being chronically late, never being able to find things, and having a dirty or sloppy house are stressful conditions and contribute to the anxiety depression cycle. Things scattered about affect your ability to concentrate, and irritability sets in if not outright anger.

Simply put, the stress chemicals from disorganization eat up the good chemicals needed for mood stabilization. With that process in effect, you feel depressed and overwhelmed.

Look around your house. It should be your sanctuary, not a hell-hole screaming your name to come clean it.  The house and time management issues are all about the planning and execution of a schedule and routine. If something is not getting done or is causing you distress in the household it is because you have not found the right system for you.

Very simply, a place for everything and everything in its place is a good saying to live by. Think of the simplicity of that statement. Yet this is the biggest bug-a-boo I see, not knowing where you left your car keys, clothing, sports equipment, checkbook, you name it.

We often allow our emotional state to dictate these sorts of practical matters. “I am so depressed I don’t care what the house looks like.” “I am so nervous I can’t concentrate.” “I am so ADD (Attention Deficit Disorder), I will never be able to organize myself.” It does not matter if you are depressed or anxious, your house and time need streamlining, and with that will come an improvement in your symptoms. You will feel an immediate shift just from the empowerment and taking control of your life. If you really are ADD then organization and time management are the very set of skills that you need.

Getting Started

To get started take an inventory of the areas where you need organizing. Maybe there is just one area out of control or maybe the entire place needs an overhaul. Either way, it can get done and not be overwhelming by breaking it down into sections and tasks. The major areas that cause disruption are your house, car, purse or wallet, finances, and paperwork.

I am now going to take you through a general plan that you can begin to institute immediately.

  1. Get out a pad of paper and look around. Jot down room by room what the major problems are such as laundry everywhere, kid’s toys, and paper clutter. Where are the major stressors?
  2. Now go to where these items would ideally reside. Is there enough room for them all to be put away at once? Do you need to get rid of some of it or do you need more space or better organization of it? If you have enough space, then it is probably more a problem of time management and routine. If there isn’t enough space, you may be keeping too much stuff or just not have the proper storage solutions.
  3. List all chores that require travel such as groceries and dry-cleaning. Can you do those on your way home from work? Can you do them all at once in order to be more efficient rather than make multiple trips?
  4. Think through your morning routine, this is usually where the day starts to go downhill. How much time do you need to get yourself ready? Pets? Kids? Breakfast? Pick up your house before you leave so as not to come home to a depressing mess. If you have a family, I suggest getting up 2 hours prior to when you need to leave or when they need to be out the door. This gives you time to get ready, get them up and ready, prepare and have breakfast as a family, and squeeze in a 30-minute walk or exercise of some sort. In order to do this, you will need to have already planned the night before for things such as:
  • Lunches
  • Clothing
  • Homework
  • Projects of your own
  • List of priorities for the day, knowing exactly where to focus your energies on any given day
  • Gas in the car

Now think through your evening routine. How do you get the above things done? Is there too much stuff in your evenings? Maybe the kids are in too many activities or you need help getting them around. Are you eating healthy food at night? Are you eating too late and not cleaning up because you are exhausted? Then you have to get up to a mess and again it’s all downhill from there. Remember you are in control of your schedule and your life, and sometimes too much is just too much. Even though you are trying to provide a quality of life by having many activities available for your family, it is not a quality of life if you are depressed and agitated and the house is a mess and you are eating takeout every night. Think about the memories you are creating.

Now you should have an idea of where the problem areas are and where your time is being utilized. Here are some general guidelines that will make a world of difference immediately if you put them to work for you.

House

  1. Keep dishes and plates put away all the time, fill dishwasher after every meal.
  2. Do a good cleaning once a week. Enlist the family, including children, to help especially in their own rooms. Many people feel guilty making their children learn chores but there is nothing to feel guilty about. They are simply participating in the household and will have to run their own households someday. If they learn now they will not have to struggle with these issues later.
  3. Keep money matters in one place as well as files for all your important papers and issues such as credit card information, taxes, medical, legal, travel, etc.… It is very nice to be able to put your hands right on something the minute you want it.
  4. A place for everything and everything in its place. It’s really that simple.
  5. Go with a schedule for cleaning, weekly daily, monthly and seasonally. Then stick to it.

Car

Does your car look like you live in it? This too is very stressful and carries chaos from your home into your driving. You will be more distracted and harried while driving if your car is a mess.

  1. Clean it out daily from anything you may have eaten, wrappers, coffee cups and work-related papers.
  2. Wipe console free of dust and grime with a wipe made for this to free your view of dirt.
  3. Take it to the car wash once a week if finances permit or at least every other week. Allow them to vacuum it and wipe it down.
  4. Each child riding in the car is responsible for his or her own seat area if old enough.
  5. Dog nose prints on window wiped off daily.

Purse/Wallet

Another war zone, filled with extra papers, bunched up money, cough drops, candy with dirt embedded in a wrapper, year-old receipts, hair items and cosmetics. This is a virtual dumping ground of things we collect daily. None of them should be here.

Go through all purses and wallets, and take out all junk. If you use multiple purses clean out one per day until they are all done.

Vacuum or wipe out purses as you go.

I know these things sound very simplistic and not the topic you might think to bring to a psychologist. But I really can’t tell you the number of times that I have seen clients experience great relief from their symptoms of depression, anxiety, and anger just from taking control of their life routines and belongings. It frees up your time for more constructive thinking, planning and daydreaming!

There are many books, as well as internet resources, pertaining to organization and time management. If this is an issue for you, begin reading one today! It’s never too soon to start, and you won’t believe how just 15 minutes a day dedicated to organizing your home can make you feel better fast!

About Audrey Sherman, Ph.D.

Sherman is a psychologist, speaker and author of the book Dysfunction Interrupted-How to Quickly Overcome Depression, Anxiety and Anger Starting Now. She has been working with individuals and families for over 20 years and her expertise is in helping others to overcome the emotional baggage that keeps them stuck in unhappy and unproductive relationships, jobs and more. She currently works with clients in person or via Skype or telephone. To learn more about Dr. Sherman, her book, and workshops you can visit her website, PsychSkills.com.

 

 

Rewire Your Burned-out Brain

Burnout often results from extended periods enduring the emotional stress precipitated by unaccomplished expectations or failure to fulfill unreasonable demands. The symptoms can include intensified emotional exhaustion, physical fatigue, lowered self-worth, changes in eating and exercising habits, social withdrawal, sleep disorders, anxiety, and depression.

If You’re Burned Out, Your Brain Has Rewired to Survival Mode

There are specific and reproducible patterns of changing neural activity and brain connectivity associated with the stress buildup that leads to burnout. In the high-stress state subjects’ neuroimaging scans reveal less activity in the higher, reflective brain (Prefrontal cortex/PFC) and more activity in the lower, reactive brain that controls involuntary behaviors and emotional responses. Prolonged stress correlates with structural increases in the density and speed of the neuron-to-neuron connections in the emotion-driven reactive networks of the lower brain and corresponding decreases connections in prefrontal cortex conscious and reflective control centers.

The explanation of these changes is attributed to the brain’s neuroplasticity defined by the phrase: “neurons that fire together, wire together.” The brain literally rewires to be more efficient in conducting information through the circuits that are most frequently activated.

When stress is frequent, the more frequent activation of the neural pathways to the lower, stress-reactive brain results in their strengthening from enhanced wiring (dendrites, synapses, myelinated axons). These pathways can become so strong that they become your brain’s fast route to its lower, reactive control centers. The stressful, burned out state when the lower, reactive brain is in charge overcomes the calm, reflective, and productive higher neural processing in the (PFC) – the preferred brain locale for control of behavior and emotional self-management.

As your efforts to achieve unreasonable goals are thwarted or increasing demands recur, and the lower brain dominates more frequently, you lose touch with your reflective brain. With less management coming from your reflective PFC, it becomes harder and harder to logically see these challenges in realistic perspective or to solve problems creatively.

Disappointments take on more emotional power and without your higher brain’s perspective, they are interpreted as personal failures. Your self-doubt and stress further activate and strengthen your brain’s involuntary, reactive neural networks. The spiral down to burnout accelerates as these circuits become the automatic go-to networks. Your brain achieves less success in problem-solving and emotional control and ultimately reacts by withholding efforts to escape the burnout state.

Reset Your Brain’s Default Neural Network from Retreat to IGNITE!

The good news is you can apply what we’ve learned from neuroscience about your brain’s survival mode to take actions to retrieve voluntary control of your choices and emotional wellbeing.

You can activate the same neuroplasticity, that gave dominance to the lower brain networks in the burnout state, to construct a new, stronger positive default response. With increasing successful experiences in achieving goals, you can reset the circuits to redirect your brain to access its highest cognitive resources. You can build up newly improved circuitry switching your responses from retreat to IGNITE for mindful awareness and creative problem-solving!

Since an effort-failure pattern sets up the brain’s survival response to withhold effort, you’ll need to strengthen your brain’s recognition that effort toward your goals can result in success. Your weapon of mass reconstruction can come from your brain’s very powerful drive for its own intrinsic neurochemical reward— dopamine and the deeply satisfying and motivating pleasure it brings. When the brain releases dopamine in rewarding bursts, you experience a deep intrinsic satisfaction along with increased motivation, curiosity, perseverance, and memory. Dopamine is particularly released when your brain recognizes that you’ve achieved a challenge (from the “I get it” of figuring out a joke to the satisfaction of completing a marathon).

To get the dopamine-pleasure response from challenges achieved, you’ll need to plan for your brain to experience frequent recognition (feedback awareness) of incremental progress. The choices of what you set as a goal should be guided by their desirability and the goal’s suitability to be broken down into clear segments. You want to set goals, the progress of which, you can chart or easily recognize with each stepwise challenge and success. The pleasure burst of dopamine’s intrinsic motivation accompanying your brain’s recognition of each progressive increment achieved in the goal pathway will keep you motivated to persevere.

Goal Buy-In for Your Brain’s Neural REWIRING

Buy-in and relevance are important in choosing your rewiring goal. Since your goal is to rewire your brain’s expectations that your goal efforts do yield progress, despite increasing challenge, you need to really want the goal. This is not the time to challenge yourself with something you feel you should do, but won’t really look forward to, such as dieting, climbing stadium stairs, or flossing after every meal.

The idea of planning and achieving goals as a burnout intervention is probably not new to you. These are likely to be activities you’ve considered but didn’t do for the obvious reason. They take time. when it comes to adding another activity to your schedule, past experiences have left you with the expectation that there is not enough time.

These first goals that can provide ongoing awareness of your progress are often tangible (visible, such as planting a garden or making pottery on a wheel, or auditory such as playing an instrument, or physical such as learning tai chi), but your goal can also be spending more time at something you already do, but want to do more frequently or successfully, such as journaling, practicing yoga, or sketching.

You’ll Find Your Own Goal for Buy-In, but Here are Some Examples of Planning 

Physical goals: Notice I didn’t say exercise. That’s not as motivating as “training” for a physical goal you want to achieve, even though they often overlap. If you want to run a 10K, and you enjoy running, the goal for an achievable challenge could first be building up to the distance starting with your baseline distance you comfortably run now. Then, plot out the increments that you’ll consider progressive successes, such as adding 100M each day or a week (with increments based on what you consider both challenging and achievable). Once you reach 10K goal, speed can become the next goal again plotted out in segments of incremental progress before you start.

Hobbies: From woodworking to shooting wooden arrows, hobbies really are opportunities for brain rewiring. Again, plan your stepwise achievable challenge increments. If you select darts, start with a home dartboard—low initial investment and throw from a close, but challenging distance at first. As you get better in accuracy move back further. Record your results with the notations of the distance of each improvement you set as an achievable challenge. If you get so good that you are no longer challenged by the dartboard, try that archery!

Mindfulness and meditation are certainly positive interventions for burnout and will be topics of a subsequent blog.

Your Rewired Brain’s Default Changes from Defeat to Ignite

With your understanding of what happened in your brain to create the hopeless frustration of burnout, you’ll hopefully have more positive expectations to help you put in the effort to try (or retry) suggested interventions. Your own natural dopamine-reward system will then be at work deconstructing the resistance network built by your burnout as you reset your circuits of motivation.

The repeated experiences of dopamine-reward you’ll experience as you monitor your goal progress will literally change your brain’s circuitry. Repeated effort-reward experiences promote the neuroplasticity creating neural networks that expect positive outcomes in your new default network. This is because your brain will build stronger connections into the memory pattern. The expectation in achieving this challenge will bring pleasure. As with other less used networks, the previous lower brain stress-activated go-to response network you developed in burn-out, that caused you to react negatively to stressors, will be pruned away from disuse.

You’ll be rewired with optimism and renew positive expectations about your self-efficacy. With your higher, reflective brain back in control, as you access your perseverance, innovation, and creative problem-solving when you need them.

Just be sure to take the time to break down big challenges into opportunities to recognize incremental progress as you achieve each small step en route to your goals. With that positive recharge, your well-deserved dopamine reward will sustain your brain’s motivated perseverance on to the next step of the path to your goals.

Dr. Judy Willis is a board-certified neurologist and middle school teacher, specializing in brain research regarding learning and the brain. With a unique background as both a neurologist and classroom teacher, she writes extensively for professional educational and parenting journals and has written six books about applying the mind, brain, and education research to classroom teaching and parenting strategies. The Association of Educational Publishers honored Dr. Willis as a finalist for the Distinguished Achievement Award for her educational writing. Check out her website.

 

 

Lawyer Wellness Should Be a Priority, Report Says

The Minnesota Lawyer reports, “In its entirety, the report provides an overview of a 2016 ABA study of 13,000 lawyers that showed between 21 and 36 percent of them qualify as problem drinkers and that approximately 28 percent, 19 percent, and 23 percent are struggling with some level of depression, anxiety, and stress, respectively.” Read the entire article here.

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Some Law Schools Take The Lead in Students’ Well-Being, Report Finds

The National Task Force on Lawyer Well-Being said in a report released earlier this week that law schools must change their cultures so that everyone—professors, administrators, and students—takes responsibility for student well-being. The report, issued by a coalition of groups including the American Bar Association and the Association of Professional Responsibility Lawyers, stems from a groundbreaking study published last year showing that more than 40 percent of students felt they needed mental-health help and a quarter were at risk for problem drinking. Read the rest of the story here.

‘Better Call Saul’ Highlights Stress and Mental Illness in the Legal Profession

The ABA Journal reports: “Chuck McGill’s suicide in Better Call Saul reflects what is happening within the legal profession throughout the United States. But anxiety and depression are not confined to practicing lawyers. A study of law school students at Yale University found that 70 percent admitted to suffering from some form of mental health issues. Eighty percent of those respondents considered help, but only half of them actually sought it out. Read the article.

 

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