The Elephant in the Room at Law Firms? Lawyer Depression

I was 40 years old when depression first struck.

I was a trial lawyer and managing partner at my firm. From the outside, I was successful: a high-paying career, interesting work, a great family, and lots of friends.

From the inside, however, something was terribly wrong.

There was a deep sadness that wouldn’t go away. Before this time, I had gone to therapists for stress-related issues. Therapy always worked. After a few months talking things through, I always felt better and stopped going.

But this time, it was different. Things didn’t get better.

Bottoms Up: My Drunk Dad, My Depression

My dad was an alcoholic.

He died at age 56 from too much drinking. Almost 40 years ago.

I was 19 at the time, a sophomore at a local state college. I lived upstairs from my Polish grandma who, was a big woman with arms as strong as an elephant’s trunk.

One morning, my Aunt Clara, who, with her husband Eddie (who was genuinely cross-eyed), lived with grandma downstairs, came up to tell me, “Your father died today.”

I had never heard my dad called “father.” It sounded formal, like, “The President of the United States died today.”

My dad had been ill for months. The year he died, 1981, Hospice wasn’t around. Most people, as sick as my dad with cancer and cirrhosis of the liver, met their end in the hospital.

Too Much Depression, Too Little Sleep: 3 Things You Can Do to Get a Better Night’s Slumber

The worst thing in the world is to try to sleep and not to. – F. Scott Fitzgerald

When first diagnosed with depression, my sleep became fragmented in a way I had never experienced before.

Before this time, I, like most frenzied lawyers, had periods of restless sleep tinged by stress and anxiety. But my sleep would return to normal after a lengthy trial or round of contentious depositions.

But this was different.

Lots of Depression, Little Sleep

I was always tired, but couldn’t sleep through the night. I went to bed early, exhausted from trying to make it through another day with depression. Trouble sleeping is a symptom of major depression.  Kay Redfield Jamison, M.D., a psychiatrist, writes:

The body is bone-weary; there is no will; nothing is that is not an effort, and nothing at all seems worth it. Sleep is fragmented, elusive, or all-consuming. Like an unstable, gas, an irritable exhaustion seeps into every crevice of thought and action.”

The Suicide of a Law Student Hits Home

When people are suicidal, their thinking is paralyzed, their options appear spare or nonexistent, their mood is despairing, and hopelessness permeates their entire mental domain. The future cannot be separated from the present, and the present is painful beyond solace. ‘This is my last experiment,’ wrote a young chemist in his suicide note. ‘If there is any eternal torment worse than mine I’ll have to be shown.’ – Kay Redfield Jamison, M.D., “Night Falls Fast: Understanding Suicide”

A second-year law student at the University at Buffalo School of Law, Matthew Benedict, died by suicide earlier this week by leaping from the Liberty Building he had been clerking at according to the Buffalo News. Another account of Matt’s life and suicide was reported in The New York Law Journal.

Matt’s funeral is tomorrow. By all account’s he was a tremendous, loving, talented, bright young man.Matt was kind-hearted, passionate and driven.

Slogging Through the Swamp of Lawyer Depression With Dr. James Hollis

Here is my fascinating interview with Dr. James Hollis, psychoanalyst and author of several best-selling books including “Swampland of the Soul” and “What Matters Most: Living a More Considered Life.”

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.

You Can Recover From Depression

I am 57 years old. I am a lawyer. And I struggle with depression.

I was diagnosed when I turned forty.  I didn’t know what was happening to me. But I knew something was wrong. I was crying quite a bit.  My sleep became disrupted. It became difficult to concentrate.  I felt no joy in my life.

Ultimately, my family doctor diagnosed me with major depression and provided me with the help I needed. I started going to therapy and was put on anti-depressants. This saved my life.

Since being diagnosed all those years ago, I have learned to live with depression as have many of the 20 million people who are living with this illness right now in this country.

Tackling Depression in the Workplace

I recently interviewed a friend and former co-worker who lost a career and a 13-year job due, in large part, to a bout of severe depression and anxiety that was not being managed well by her behavioral health specialist. This friend has depression in her family and had been through several depressive episodes in her life, but had come out of each of them with a combination of medication, support from friends, therapy, and self-exploration. In her 30+ years of working, she had never before lost a job because of her mental health issues.

Prior to this episode, she had been widely praised at her company for over a decade, and most of the time had received praise, bonuses, and regular raises. Her social security reports showed a steady upward trend in her compensation over the years that she had been in the workforce, the way it was supposed to. She felt she had done well professionally.

But then, things got hard. She had just left an abusive relationship, and the combination of trauma and her genetic predisposition to depression had sent her into a spiral of sometimes-suicidal depression, for which she sought professional help.

Recovery from Depression: The Power of Expectation

Recovery from depression depends in part on what you believe is possible for the future. If you are to recover at all, you have to take action at some point. It could be a series of small steps about your daily routine – eating breakfast, walking out the door to get fresh air and natural light, making a point of talking to someone each day.

Or it could be much larger, like going to a psychiatrist and starting treatment, regularly meditating, exercising frequently, taking long walks. Whatever it is, you need to feel motivated to overcome the inertia, to stop the loss of warming energy to the cold stillness of depression.

To feel motivation, you need to believe, however tentatively, that you can change for the better, to expect recovery from the worst symptoms. You’re likely to hit a lot of barriers, though, that make it hard to keep up positive expectations.

When you expect to fail, it often happens that you stop taking action to help yourself recover. The deeply ingrained habits of depressive thinking and belief can quickly take over. You might start making rules and setting goals.

If recovery is not total and permanent, it’s not recovery. Treatments can’t fail, depression relapse can’t happen. You can’t be recovered if you’re still on medication. You have to get better in six months or a year, or some fixed period of time.

Of course, the rules and goals are entirely your invention, but they’re part of the expectations you feel in your gut. If you can’t meet them, the disappointment confirms your deepest conviction that you can never succeed.

10 Tips for Dealing with Depression During the Holidays

While most of us are so busy with doing that, we have little time for being, the days surrounding major holidays can feel especially overwhelming. Most of us seem to lose touch with our connection to the natural world until we experience a life-changing event that locks that moment down into the month or the season. “The Holiday Season,” with capital letters, is one of those markers that is meant to provide a space for reflection, wonder, and deep joy. Advertisers capitalize on our sentiment through advertisers using images of families or neighbors coming together to cheer up individuals who are portrayed as alone and lonely, if not downright abandoned.

Unfortunately, many lonely people do not have a cheering group of neighbors, friends, or families eager to surprise them with holiday lights, tins of cookies, or invitations to join them for a holiday meal. Loneliness and hopelessness can increase while images of altruistic concern and heartwarming moments seem to be the bar against which all holiday experiences should be measured.

Once the first day of winter arrives, the shortened days and decreased exposure to sunlight generate unexpected feelings of depression for many along with lethargy that comes from the resultant vitamin D production in the body. If you have experienced loss, heartache, or depression, the change in season can send you spiraling deep into a very dark place. Putting on a brave face for others can be especially difficult when the world is blasting us with images of group hugs and the memory of your final hug with someone you love is all that you can think about.

No matter what the cause of your holiday lows might be, here are ten tips that might help you cope during this season:

Don’t completely isolate yourself from other people. Social connection has great healing power – attend a faith-based service, even if you are not committed to a particular religion, just to experience the positive feelings of being surrounded by others.

Allow yourself space to acknowledge any losses, despair, or hurt you are feeling, but do not let yourself use the loss as an excuse to escape through alcohol or other addictive substances.

If a particular ritual is just too painful to try and continue this year, accept that there are limits to what you are capable of doing and forgive yourself for that.

Don’t allow yourself to use any holiday-related time off from work as an excuse to hide from the world – stick to as regular a schedule as you can.

Don’t binge eat or binge drink – while these may offer a sense of temporary escape, they are not healthy coping methods.

If you’re recovering from a broken relationship, it’s especially important not to dwell on the past, an imagined future, or thoughts of revenge. Make sure that your ex’s contact information is wiped from your phone to help you avoid any temptation to make any desperate attempts at reaching out.

If you’re recovering from grief at the loss of a loved one, create a special new ritual that honors the person who is no longer there. Light a special candle and offer a silent or spoken tribute to this person. Add a special decoration to your collection and display it in this person’s honor. Choose a special recipe that was always a favorite and prepare it each year – saying a special prayer in their honor before consuming it.

Reflect on what has brought the most joy to you during this season in past, happier years. Force yourself to engage in this aspect of the holiday with as much energy and commitment that you can muster. If it was the lights of the season, throw your heart into decorating your home with the lights that always brought a smile! If it was the cookies, bake your heart out – even if you aren’t the most talented chef, enjoy doing something that your loved one would have enjoyed seeing happen. If it was the carols and songs of the season, let the CDs, Sirius, or Pandora serenade the silence with the songs this person loved.

Remind yourself that at this time of year, the shortest day falls on the last day of autumn. Winter may bring the coldest weather, the deepest hibernation of animal life, the barren trees may stand out starkly against the winter sky, but remind yourself that once the first day of winter has arrived, the days are once again growing in length and the nights are beginning to shorten. This is a magic time when we can feel the change in the natural world on a very deep level. The feelings of depression or deep grief you feel may ebb and flow like a tide, but remind yourself that there is a natural rhythm in life and it truly is always darkest before the dawn.

Honor your feelings, but don’t allow yourself to get so wrapped up in despair or hopelessness that you retreat fully from the world around you. When we let ourselves get sucked into a place of abject despair and darkness, we are sacrificing the potential for joy that others might bring you – or that you, yourself, could bring others.

If your holiday season is a time of depression, grief, or hurt, know that you are not alone. Others also are suffering as the world blares entreaties to be “merry and bright,” but sadness and heartache are filling your heart. Keep active over this period, show up in life, and remind yourself that each day that you do, it’s one less day you’ve given depression the power to take from your life.

By Suzanne Degges-White, Ph.D., LPC, LMHC, NCC. Susan is professor and chair of the Counseling, Adult and Higher Education department at Northern Illinois University. She is a licensed counselor whose focus includes working with individuals and families facing transitions. Her academic research explores development over the lifespan with a strong focus on women’s relationships and women’s developmental transitions. She is currently president of the Association for Adult Development and Aging, a division of the American Counseling Association.

 

 

 

 

Good is Not Enough: You Need More Than Getting Rid of Your Depression Symptoms

If you asked any one of us, we would say that top on our list of what we want is to feel better.  But what is “better”?  To most, it means that the symptoms of depression have gone away.  However, just the absence of symptoms is not enough to feel well.  Being well is not only freedom from the episodes of a mood disorder or depression symptoms.  It’s an ongoing process that includes participating in the world around you, being in control of your life, having a sense of personal growth and relationships that matter.  It means that you have a sense of competence and mastery in the things you do in your life and that you feel good about who you are.  How do you get there?

There is an interesting professional article by C.D. Ryff from the University of Wisconsin-Madison (2014) that discusses psychological well-being.  In the past psychologists thought of well-being as happiness, satisfaction with life, and a positive affect (similar to mood).  Thinking about well-being in deeper terms, Ryff describes the essential features of well-being which I will summarize for you here.

What are the components of well-being?  First is having a purpose in life, where you feel your life has meaning, purpose, and direction.  You might find this as a working or volunteer person, student, parent, or whatever it is that guides you.  It’s something that’s easy to forget when we are depressed, so you do have to work on it.  Next is whether you are living a life based on your own personal convictions, beliefs, opinions, and principles.  You are free to make decisions for yourself (that is called autonomy).  For example, if you are an adult, do you feel controlled by another person?   The third feature of well-being is making use of your personal talents and potential, called personal growth.  This could be in your work, school, volunteering, or family life.  Another feature is how well you are managing your life situations, the ups, and downs of daily life called mastering your environment.  We all have fluctuations: the key is how we learn to deal with them.

The fifth feature of well-being is in having positive relationships, with deep ties to others.  It could be with friends or family members, just as long as you have close personal connections.  That is very important to maintaining your mental health balance and definitely helps with depression, a time when isolation can occur.  The last is self-acceptance, which means having knowledge and acceptance of who you are, including your own personal limitations.  Nobody’s perfect – we all have our strengths and weaknesses and do better when we learn to accept and work with them.

This list must seem daunting!  How in the world can I be well if I have to achieve all of these things that are difficult for anyone to do, let alone someone with a mood disorder?  Good question!   It’s not the kind of thing that happens overnight; it takes a lot of time and effort on your part.  And you don’t have to master them all, certainly not all at once.  Begin by having a conversation with your therapist about this and try to identify one or two areas in your life from this list that you want to work on.  Then put those two areas into a clearly stated goal.  Having a goal set in this way helps you to achieve the kind of life you want.  Understand what you have going for you that will help you, such as your strengths, and what you might have to change about yourself and your world to reach this goal.  Try to identify how you personally impact the situation and potentially get in the way of reaching your goal.  Is it negative thoughts you may have?  Are there barriers that exist to achieve your goal?  Find a way to work around them.  Make a list of the first 3-5 steps to reach your goal.  Stay focused on the goal and not how difficult it is.  Care for yourself as you work to achieve it.

For example, your goal might be a purpose in life and personal growth as a musician. You might state it as “I want to improve my skills as a musician and get more professional gigs.  That will make me feel good about myself, bring people pleasure, and earn some money to support myself.”  You might then identify that you are not always consistent with practice time, and feel shy about going out and promoting your musical performance.  Neighbors might complain about hearing you practice. Thinking about it, you may identify one or two negative thoughts you have about your skills (I’m not very good” or “Nobody will hire me”) that are behind these behaviors.  Use CBT to challenge those negative thoughts and behaviors and replace them with more realistic thoughts.  Then think of your strengths, of past successes you have had in this area, and use these to boost your confidence.

Next make a to-do list of what steps you might take to make this happen, and who can help support you in this. That might include: set aside a specific practice time and place each day; take a music lesson(s); make a CD of your performance and bring it around to a few places where you want to perform; put a small sample of your music on social media to attract audience members , such as YouTube, Facebook, LinkedIn, Twitter; make attractive posters to promote your skills and performance dates; put the posters on social media and hang them up in a few select areas around your town announcing your performances and availability.  It’s a lot to do when depressed; have a friend help you.  Do these one-at-a-time, so you don’t get overwhelmed. It is possible and realistic for those of us who have depression to expect wellness.

By Susan J. Noonan, MD, MPH.

Susan is a graduate of Mount Holyoke College, Tufts University School of Medicine, and the Harvard School of Public Health. She is a long-term patient and the author of two books on managing depressionManaging Your Depression; What You Can Do To Feel Better, and When Someone You Know Has Depression: Words to Say and Things to Do, with a companion website and blog. She is also a mental health Certified Peer Specialist, counseling fellow persons with mental illness. In these ways, she bridges that space between recipient and provider of healthcare services. This blog was previously posted, in modified form, on website www.susannoonanmd.com.

 

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