How to Stay Positive (Even When You’re Struggling With Depression)

Blogger Ashley Trexler writes, “I wanted her to be a fighter, to always look for the best in others, to fall down and get back up again—and again, and again. I decided to be an optimist not just for myself, but for my child.It’s a struggle to stay positive, and pessimism desperately wants to be BFFs. My negative alter-ego is always sitting on my shoulder, whispering in my ear, “Isn’t life unfair?” Read the rest of her blog here.

 

Hope Counts: One Lawyer With Depression’s Testimony

I am a lawyer, as many of you.

I went to law school and passed the bar exam like you.

I also struggle with depression like too many of you,  as well.

A new study by the American Bar Association and the Hazelden Betty Ford Foundation found that twenty-eight percent of over 12,825 practicing lawyers polled reported a problem with depression.  This is over three times the rate found in the general population. When put in perspective, of the 1.2 million attorneys in this country, over 336,000 reported symptoms of clinical depression.

Levels of stress, anxiety, and problem drinking were also significant, with 23%, 19%, and 20.6% experiencing symptoms of stress, anxiety, and hazardous drinking, respectively.

“This is a mainstream problem in the legal profession,” said the study’s lead author, Patrick Krill, director of the Legal Professionals Program at the Hazelden Betty Ford Foundation, and a lawyer himself. “There needs to be

Why So Many Lawyers Suffer From So Much Depression

As to being happy, I fear that happiness isn’t in my line. Perhaps the happy days that Roosevelt promises will come to me along with others, but I fear that all trouble is in the disposition that was given to me at birth, and so far as I know, there is no necromancy in an act of Congress that can work a resolution there.” – Benjamin N. Cardozo, February 15, 1933

Law is a prestigious and remunerative profession, and law school classrooms are full of fresh candidates. In a recent poll, however, 52% of practicing lawyers describe themselves as dissatisfied. Certainly, the problem is not financial. Associates at top firms could earn up to $200,000 per year just starting out, and lawyers long ago surpassed doctors as the highest-paid professionals. In addition to being disenchanted, lawyers are in remarkably poor mental health. They are at much greater risk than the general population for depression. Researchers at John Hopkins University found statistically significant elevations of major depressive disorder in only 3 of 104 occupations surveyed. When adjusted for sociodemographics, lawyers topped the list, suffering from depression at a rate of 3.6 times higher than employed persons generally. ( A more recent study from 2016 found that lawyer suffered from depression at a rate nearly three times that of the general public). Lawyers also suffer from alcoholism and illegal drug use at rates far higher than nonlawyers. The divorce rate among lawyers, especially women, also appears to be higher than the divorce rate among other professionals. Thus, by any measure, lawyers embody the paradox of money losing its hold. They are the best-paid professionals, and yet they are disproportionately unhappy and unhealthy. And lawyers know it; many are retiring early or leaving the profession altogether.

Positive Psychology sees three principal causes of the demoralization among lawyers.

Pessimism

pessimism

First is pessimism, defined not in the colloquial sense (seeing the glass as half empty) but rather as the pessimistic explanatory style. These pessimists tend to attribute the causes of negative events as stable and global factors (“It’s going to last forever, and it’s going to undermine everything.”). The pessimist views bad events as pervasive, permanent, and uncontrollable, while the optimist sees them as local, temporary and changeable. Pessimism is maladaptive in most endeavors: Pessimistic life insurance agents sell less and drop out sooner than optimistic agents. Pessimistic undergraduates get lower grades, relative to their SAT scores and past academic record, than optimistic students. Pessimistic swimmers have more substandard times and bounce back from poor efforts worse than do optimistic swimmers. Pessimistic pitchers and hitters do worse in close games than optimistic pitchers and hitters. Pessimistic NBA teams lose to the point spread more often than optimistic teams.

Thus, pessimists are losers on many fronts. But there is one glaring exception: Pessimists do better at law. We tested the entire entering class of the Virginia Law School in 1990 with a variant of the optimism-pessimism test. These students were then followed throughout the three years of law school. In sharp contrast with the results of prior studies in other realms of life, the pessimistic law students on average fared better than their optimistic peers. Specifically, the pessimist outperformed more optimistic students on the traditional measures of achievement, such as grade point averages and law journal success.

Pessimism is seen as a plus among lawyers because seeing troubles as pervasive and permanent is a component of what the law profession deems prudence. A prudent perspective enables a good lawyer to see every conceivable snare and catastrophe that might occur in any transaction. The ability to anticipate the whole range of problems and betrayals that non-lawyers are blind to is highly adaptive for the practicing lawyer who can, by so doing, help his clients defend against these far-fetched eventualities. If you don’t have this prudence to begin with, law school will seek to teach it to you. Unfortunately, though, a trait that makes you good at your profession does not always make you a happy human being.

Sandra is a well-known East Coast psychotherapist who is, I think, a white witch. She has one skill that I have never seen in any other diagnostician: She can predict schizophrenia in preschoolers. Schizophrenia is a disorder that does not become manifest until after puberty, but since it is partly genetic, families who have experienced schizophrenia are very concerned about which of their children will come down with it. It would be enormously useful to know which children are particularly vulnerable because all manner of protective, social and cognitive skills might be tried to immunize the vulnerable child. Families from all over the eastern United States send Sandra their 4-year-olds; she spends an hour with each of them and makes an assessment of the child’s future likelihood of schizophrenia, an assessment that is widely thought of as uncannily accurate.

This skill of seeing the underside of innocent behavior is super for Sandra’s work, but not for the rest of her life. Going out to dinner with her is an ordeal. The only thing she can usually see is the underside of the meal – people chewing. Whatever witchy skill enables Sandra to see so acutely the underside of the innocent-looking behavior of a 4-year-old does not get turned off during dinner, and it prevents her from thoroughly enjoying normal adults in normal society. Lawyers, likewise, can not easily turn off their character trait of prudence (or pessimism) when they leave the office. Lawyers who can see clearly how badly things might turn out for their clients can also see clearly how badly things might turn out for themselves. Pessimistic lawyers are more likely to believe they will not make partner, that their profession is a racket, that their spouse is unfaithful, or that the economy is headed for disaster much more readily than will optimistic persons. In this manner, pessimism that is adaptive in the profession brings in its wake a very high risk of depression in personal life. The challenge, often unmet, is to remain prudent and yet contain this tendency outside the practice of law.

Low Decision Latitude

stressed

A second psychological factor that demoralizes lawyers, particularly junior ones, is low decision latitude in high-stress situations. Decision latitude refers to the number of choices one has – or, as it turns out, the choices one believes one has – on the job. An important study of the relationship of job conditions with depression and coronary disease measures both job demands and decision latitude. There is one combination particularly inimical to health and moral: high job demands coupled with low decision latitude. Individuals with these jobs have much more coronary disease and depression than individuals in other three quadrants.

Nurses and secretaries are the usual occupations consigned to that unhealthy category, but in recent years, junior associates in major firms can be added to the list. These young lawyers often fall into this cusp of high pressure accompanied by low choice. Along with the shared load of law practice (“this firm is founded on broken marriages”), associates often have little voice about their work, only limited contact with their superiors, and virtually no client contact. Instead, for at least their first few years of practice, many remain isolated in a library, researching and drafting memos on topics of the partners’ choosing.

A Win-loss Game

winloss

The deepest of all the psychological factors making lawyers unhappy is that American law is becoming increasingly a win-loss game. Barry Schwartz distinguishes practices that have their own internal “goods” as a goal from free-market enterprises focused on profits. Amateur athletics, for instance, is a practice that has virtuosity as its good. Teaching is a practice that has learning as its good. Medicine is a practice that has healing as its good. Friendship is a practice that has intimacy as its good. When these practices brush up against the free market, their internal goods become subordinated to the bottom line. Night baseball sells more tickets, even though you cannot really see the ball at night. Teaching gives way to the academic star system, medicine to managed care, and friendship to what-have-you-done-for-me-lately. American law has similarly migrated from being a practice in which good counsel about justice and fairness was the primary good to being a big business in which billable hours, take-no-prisoners victories, and the bottom line are now the principle ends.

Practices and their internal goods are almost always win-win-games: both teacher and student grow together, and successful healing benefits everyone. Bottom-line businesses are often, but not always, closer to win-loss games: managed care cuts mental health benefits to save dollars; star academics get giant raises from a fixed pool, keeping junior teachers at below-cost-of-living raises; and multi-billion dollar lawsuits for silicon implants put Dow-Corning out of business. There is an emotional cost to being part of a win-loss endeavor. In Chapter 3 of my book, I argue that positive emotions are the fuel of win-win (positive-sum) games, while negative emotions like anger, anxiety, and sadness have evolved to switch in during win-loss games. To the extent that the job of lawyering now consists of more win-loss games, there is more negative emotion in the daily life of lawyers.

Win-loss games cannot simply be wished away in the legal profession, however, for the sake of more pleasant emotional life among its practitioners. The adversarial process lies at the heart of the American system of law because it is thought to be the royal road to truth, but it does embody a classic win-loss game: one side’s win equals exactly the other side’s loss. Competition is at its zenith. Lawyers are trained to be aggressive, judgmental, intellectual, analytical and emotionally detached. This produces predictable emotional consequences for the legal practitioner: he or she will be depressed, anxious and angry a lot of the time.

Countering Lawyer and Unhappiness

new-lawyers

As Positive Psychology diagnoses the problem of demoralization among lawyers, three factors emerge.Pessimism, low decision latitude, and being part of a giant win-loss enterprise. The first two each have an antidote. I discussed part of the antidote for depression in Chapter 6, in my book

Pessimism, low decision latitude, and being part of a giant win-loss enterprise. The first two each have an antidote. Chapter 6 of my book details a program for lastingly and effectively countering catastrophic thoughts. More important for lawyers is the pervasive dimension-generalizing pessimism beyond the law – and there are exercises in Chapter 12 of my book, Learned Optimism that can help lawyers who see the worst in every setting to be more discriminating in the other corners of their lives. The key move is credible disputation: treating the catastrophic thoughts (“I’ll never make partner,” “My husband is probably unfaithful”) as if they were uttered by an external person whose mission is to make your life miserable, and then marshaling evidence against the thoughts. These techniques can teach lawyers to use optimism in their personal lives, yet maintain the adaptable pessimism in their professional lives. It is well documented that flexible optimism can be taught in a group setting, such as a law firm or class. If firms and schools are willing to experiment, I believe the positive effects on the performance and moral of the young lawyers will be significant.

As to the high pressure-low decision latitude problem, there is a remedy as well. I recognize that grueling pressure is an inescapable aspect of law practice. Working under expanded decision latitude, however, will make young lawyers both more satisfied and more productive. One way to do this is to tailor the lawyer’s day so there is considerably more personal control over work. Volvo solved a similar problem on the assembly lines in the 1960’s by giving its workers the choice of building a whole car in a group, rather than repeatedly building the same part. Similarly, a junior associate can be given a better sense of the whole picture, introduced to clients, mentored by partners, and involved in transactional discussions. Many law firms have begun this process as they confront the unprecedented resignations of young associates.

The zero-sum nature of law has no easy antidote. For better or for worse, the adversarial process, confrontation, maximizing billable hours, and the “ethic” of getting as much as you possibly can for your clients are much too deeply entrenched. More pro bono activity, more mediation, more out-of-court settlements, and “therapeutic jurisprudence” are all in the spirit of countering the zero-sum mentality, but I expect these recommendations are not cures, but Band-Aids. I believe the idea of signature strengths, however, may allow law to have its cake and eat it too – both to retain the virtues of the adversarial system and to create happier lawyers.

When a young lawyer enters a firm, he or she comes equipped not only with the trait of prudence in lawyerly talents like high verbal intelligence, but with an additional set of unused signature strengths (for example, leadership, originality, fairness, enthusiasm, perseverance, or social intelligence). As lawyers’ jobs are crafted now, these strengths do not get much play. Even when situations do call for them, since the strengths are unmeasured, handling these situations does not necessarily fall to those who have the applicable strengths.

Every law firm should discover what the particular signature strengths of their associates are. Exploiting these strengths will make the difference between a demoralized colleague and an energized, productive one. Reserve five hours of the work week for “signature strength time,” a non-routine assignment that uses individual strengths in the service of the firm’s goals.

There is nothing particular to the field of law in the re-crafting of jobs. Rather, there are two basic points to keep in mind as you think about these examples and try to apply them to your work setting. The first is that the exercise of signature strengths is almost always a win-win game. When Stacy gathers the complaints and feelings of her peers, they feel increased respect for her. When she presents them to the partners, even if they don’t act, the partners learn more about the morale of their employees – and of course, Stacy herself derives authentic positive emotion from the exercise of her strengths. This leads to the second basic point: There is a clear relation between positive emotion at work, high productivity, low turnover and high loyalty. The exercise of a strength releases positive emotion. Most importantly, Stacy and her colleagues will likely stay longer with the firm if their strengths are recognized and used. Even though they spend five hours each week on non-billable activity, they will, in the long run, generate more billable hours.

Law is intended as but one rich illustration of how an institution (such as a law firm) can encourage its employees to re-craft the work they do, and how individuals within any setting can reshape their jobs to make them more gratifying. To know that a job is a win-loss in its ultimate goal – the bottom line of a quarterly report, or a favorable jury verdict – does not mean the job cannot be win-win in its means to obtaining that goal. Competitive sports and war are both eminently win-loss games, but both sides have many win-win options. Business and athletic competitions, or even war itself, can be won by individual heroics or by team building. There are clear benefits of choosing the win-win option by using signature strengths to better advantage. This approach makes work more fun, transforms the job or the career into a calling, increases flow, builds loyalty, and it its decidedly more profitable. Moreover, by filling work with gratification, it is a long stride on the road to the good life.

Martin E. P. Seligman, Ph.D., is the Fox Leadership Professor of Psychology at the University of Pennsylvania, the Director of the Positive Psychology Network, and former President of the American Psychological Association. Among his 20 books are Learned Optimism and The Optimistic Child. Here, from his book Authentic Happiness: Using the New Positive Psychology to Realize Your Potential for Lasting Fulfillment, is his chapter entitled “Why Are Lawyers So Unhappy?”

© by Martin Seligman. Reprinted with permission from the author.

Are you a law student or lawyer struggling with depression? Do you need help developing a practical, constructive game plan to help you cope and recover from depression?  If so, I can help.  I created my life coaching practice specifically devoted to helping law students and lawyers who struggle with this condition. Visit my website at www.yourdepression.com to learn more.Share this:

Weathering the Dead Zone of Depression

There is a dead zone in a depressed person’s life where nothing seems to happen.

Except for the pain of the absence of everything.

Such anguish is so overwhelming that every other concern is squashed in its wake.  Our capacity for willful actions seems to be gone; we can’t “figure it out.”

We are stuck.  And it sucks.

I have learned a lot about this “zone” over the years, its patterns, and how to handle it.  It’s really like learning to surf a giant, dark wave.  To handle these waves, you need to prepare yourself before the next big ones roll in.

When I’m entering a dead zone, I use positive affirmations I’ve created to “talk back” to my depression. I don’t let the toxic voice of depression drown me out.  It’s important to empower yourself in whatever ways you can during these times because depression will lead you to falsely conclude that

10 Ways Our Thinking Can Fuel Depression and Anxiety

Psychologist Elvira Aletta writes, “Right now, you and I can see clearly how those thoughts are exaggerated, over-the-top, unreasonable. It’s not so easy to see when we are caught up in the moment. Luckily, to make this task easier for us, Dr David Burns did a lot of work categorizing ten basic ways we distort our thinking. Study these categories. Highlight the ones you tend to use. Think of your own real life examples”.  Read her Blog

With Depression, Sometimes it Pays to Be Patient

Blogger Therese Borchard writes, “The harder you try, the more negative things can get. A study published in August 2007 in The Journal of Neuroscience showed that there was a breakdown in normal patterns of emotional processing that prevented depressed and anxious people from suppressing negative emotions. In fact, the more they tried, the more they activated the fear center of their brain — the amygdala — which fed them more negative messages.” Read the Blog

Treating Anxiety & Depression With a Smartphone App

Two English universities have joined forces to assess how a new smartphone app can help people manage their psychological issues. The Catch It app uses some of the key principles of psychological approaches to mental health and well-being, specifically cognitive behavioral therapy (CBT), according to researchers.  Read the News

Lawyer Depression: What is it, What Causes it, and What You Can Do About it

Are you a lawyer suffering from depression?  Do you know a colleague that struggles with it?

If so, you’re not alone.

depressed_businessman-300x220

A new landmark study conducted by the Hazelden Betty Ford Foundation and the American Bar Association Commission on Lawyer Assistance Programs published this February reveals that 21 percent of licensed, employed attorneys currently qualify as problem drinkers, 28 percent struggle with some level of clinical depression and 19 percent demonstrate symptoms of anxiety. Forty-six percent (46%) reported concerns with depression at some point in their legal careers.

When put in perspective, that means that of the 1.2 million lawyers in the U.S., 336,000 lawyers have struggled with some form of depression this past year. A staggering number when one considers the rate of depression in the general population is ten-percent.

WHAT IS DEPRESSION?

Depression can be mild, moderate or severe in intensity. According to the National Institute of Mental Health, symptoms include:

Whether or not you’re clinically depressed can only be determined by a mental health professional. To be so deemed, you must have at least five of the above symptoms for at least two weeks.

But many people never get to the point of receiving such an evaluation or treatment because they or others see their symptoms as a “slump,” “sadness,” or even burnout. Perhaps a vacation will cure the blues, some say. Others take the tough love approach and tell the depressed lawyer to “snap out of it.”  But none of this works.

richard_oconnor_2_001

That’s because depression isn’t sadness. Richard O’Connor, Ph.D., author of the best-selling book, Undoing Depression, writes:

The opposite of depression is not happiness, but vitality – the ability to experience a full range of emotions, including happiness, excitement, sadness, and grief. Depression is not an emotion itself; it’s the loss of feelings; a big heavy blanket that insulates you from the world yet hurts at the same time. It’s not sadness or grief, it’s an illness.

WHAT CAUSES DEPRESSION?

Depression has many causes:  A genetic history of depression in one’s family, hormone imbalances, and biological differences, among others. Certain personality traits, such as low self-esteem, a pessimistic outlook, chronic stress at work or home, childhood trauma, drug or alcohol abuse and other risk factors increase the likelihood of developing or triggering depression.

Why do lawyers experience depression at higher rates?

According to Patrick Krill, J.D., LLM., director of the Hazelden Betty Ford Foundation’s Legal Professionals Program, just why lawyers have such sky-high rates of melancholy isn’t always easy to see:

(The) rampant and multidimensional stress of the profession is certainly a factor. And not surprisingly, there are also some personality traits common among lawyers – self-reliance, ambition, perfectionism and competitiveness – that aren’t always consistent with healthy coping skills and the type of emotional elasticity necessary to endure the unrelenting pressures and unexpected disappointments that a career in the law can bring.

MartinSeligman

According to Martin Seligman, Ph.D., it has to do with negative thinking:

One factor is a pessimistic outlook defined not in the colloquial sense (seeing the glass as half empty) but rather as the pessimistic explanatory style. These pessimists tend to attribute the causes of negative events as stable and global factors (“It’s going to last forever, and it’s going to undermine everything.”) The pessimist views bad events as pervasive, permanent, and uncontrollable while the optimist sees them as local, temporary and changeable. Pessimism is maladaptive in most endeavors.

But there is one glaring exception: Pessimists do better at law. Pessimism is seen as a plus among lawyers because seeing troubles as pervasive and permanent is a component of what the law profession deems prudent. A prudent perspective enables a good lawyer to see every conceivable snare and catastrophe that might occur in any transaction. The ability to anticipate the whole range of problems and betrayals that non-lawyers are blind to is highly adaptive for the practicing lawyer who can, by so doing, help his clients defend against these far-fetched eventualities. If you don’t have this prudence to begin with, then law school will seek to teach it to you. Unfortunately, though, a trait that makes you good at your profession does not always make you a happy human being.

tyger-latham

Tyger Latham, Ph.D., a psychologist in Washington, D.C., who treats many lawyers with depression, writes:

. . . I’ve come to recognize some common characteristics amongst those in the profession.  Most, from my experience, tend to be “Type A’s” (i.e., highly ambitious and over-achieving individuals). They also have a tendency toward perfectionism, not just in their professional pursuits but in nearly every aspect of their lives.  While this characteristic is not unique to the legal profession – nor is it necessarily a bad thing – when rigidly applied, it can be problematic. The propensity of many law students and attorneys to be perfectionistic can sometimes impede their ability to be flexible and accommodating, qualities that are important in so many non-legal domains.

WHAT YOU CAN DO ABOUT IT?

1. Join a Depression Support Group

You can (a) join or (b) start a support group in your community. These groups provide a place for the depressed to share their struggles and gain the encouragement and support they need to recover and remain well.

(a) Join a Group

A depression support group is not “group therapy”. The group is run by those who attend the meetings. To see if there’s a lawyer group in your community, go to the Commission on Lawyer Assistance Programs’ website to find such information. To see if there’s such a group in your city that isn’t lawyer specific, go to the Depression & Bipolar Support Alliance’s website at www.dbsa.org.

(b) Start a depression support group for lawyers in your legal community.

If there’s not one in your hometown or the ones’ you’ve attended aren’t a good fit, think about starting one yourself or with another friend or two.

Read my previous post, “18 Tips on How To Start a Depression Support Group“.

2. Get Educated

There are plenty of great websites to educate you about what depression is and the variety of ways it can be treated.  A great resource can be found at the University of Michigan’s Depression Center website at www.depressioncenter.org.

Also, read my previous post, “Dan’s Top 10 Depression Books“.

3. Work with a Lawyer Life Coach

If you would wish to work one-on-one with a life coach, I offer such services at  www.yourdepressioncoach.comMy practice is unique in that I am a fellow lawyer who has struggled with depression over the years while practicing law. I believe I can help you if you answer “yes” to any of the following questions:

  • You need someone to listen with a sense of compassion.  I am that person. I will care.  I will be in your corner.
  • You need a sense of structure at a time when life may seem pointless and meaningless. I can be an anchor for you, a safe port in a storm, a place to go and share your deepest struggles and concerns about home and work.
  • You need someone to educate you about what depression and anxiety are and their symptoms and causes.
  • You need guidance as you weave through the matrix of treatment options to find a plan that works for you.
  • In addition to treating with a psychologist and/or psychiatrist, you find that you get more encouragement, insight, and support to help you keep moving forward.
  • You suffer from anxiety and depression.  If so, you’re far from alone.  Studies show that as much as 60% of all people with depression also suffer from an anxiety disorder.

I will work with you on whatever specific problem most pressing to you.  Here are some areas where depression and anxiety may be causing real pain and trouble in your life:

You need help getting things done at work.  You’re falling behind and because of you’re the depression and/or anxiety. I can help by providing insight, support, and exercises to help you deal with this all too common and critical issue.

You want to leave your job.  You’ve been coping with work-related depression and/or anxiety for some time and decided “enough is enough”. You want to make plans to transition to another job or career. I can help you develop your game plan to do so and hold you accountable for following through and take the necessary steps to make this a reality.

You’re a “Depression Veteran”. You might be further down the road in your recovery from depression and/or anxiety but still need help and encouragement. Or you’ve been struggling with off-and-on depression and/or anxiety for years. I will work with you to develop a program to make sure you do things that will help you recover and stay well. I will hold you accountable for actually following through with your program.  I can help to motivate you to stick with a healthy game plan.

You are just plain unhappy.  Many people, while not clinically depressed, are very unhappy with their lives.  They have too much stress.  Aren’t happy in their careers. Or don’t have a sense of meaning and purpose in their lives. The support and structure I provide for depression sufferers are easily transferable to getting to the heart of what’s causing your unhappiness.  I will work with you to build a different set of skills and make different life choices to lead a happier and healthier life.

You need help explaining your depression to others.  For loved ones and business associates that have never been through depression, it’s difficult for them to really understand your pain because they really don’t have a point of reference for psychic pain someone undergoes with clinical depression.  They mistake it for “the blues” or everyday sadness, which it clearly is not.  I can work with you to develop a language and actions that could help others understand.  If you wish, I would also be happy to talk with others as your work to educate them about what depression is and ways that might be able to help and support you.

If you relate to any of these issues and think coaching might be a good fit for you, I offer a free twenty-minute consultation.  You can contact me at www.yourdepressioncoach.com to schedule a meeting. I coach clients around the country via Skype and over the phone.

Copyright, 2016 by Daniel T. Lukasik, Esq.

 

 

 

Depression’s Vicious Circle

Here’s a brief discussion of how depression leads to hurting yourself, sometimes in ways you’re not even aware of.

Depression is best understood as a vicious circle, the result of current stress acting on a vulnerable individual to push him or her into this cycle that feeds itself: depressed moods lead to depressed thinking and behavior, which leads to a more depressed mood, and so on in a downward spiral. Depression is also accompanied by negative thinking (I can’t. . .The cards are stacked against me. . .There’s no use trying) and hopelessness.  In addition, depression affects the brain directly:  we stop producing dopamine (hence have less drive and energy) and the cells that are meant to receive endorphins, the happy hormones, shrivel away so that we can’t experience good feelings.  The depressed person is usually slowed down, stuck in molasses, unable to think clearly or see a better future; his/her speech is often a slow monotone that sounds like an effort and conveys no feeling at all.  What does it matter. . .why bother. . .it’s useless. 

If you have a mood disorder, by definition you have trouble with self-destructive behavior.  It’s usually a passive form of self-destruction—staying home isolated, giving up hope, expecting the worst—though there are angry depressed people who get into fights and emotionally abuse others.  You may turn to alcohol or drugs to help comfort you.  Depression is usually accompanied by suicidal thoughts and impulses, and suicide is often a real risk.  Impulses like driving into a bridge abutment or stepping off a high place can come out of nowhere and convince you that you are going crazy, though they’re very common with depression.

Your assumptive world changes drastically with depression, and the depressed assumptions turn into self-fulfilling prophecies that just make you feel worse.  Depressed people tend to take too much responsibility for the bad things that happen in life, but feel that the good things are just accidents that they had nothing to do with and are unlikely to happen again.  If you’re depressed, you are probably quite pessimistic in your thinking, assuming that everything is getting worse all the time, and there’s nothing you can do about it.  You feel that you have to be in control every moment, and if you relax, things will fall apart; at the same time you don’t really believe that your efforts to control will really do any good.  The glass is always half empty, good things are temporary and unreliable, bad things are permanent and pervasive, other people are always better, more attractive, more successful than you.  When you know what you ought to do to feel better, but are too depressed to do it, you blame yourself for lacking will power, as if it’s a character trait that you either have or don’t have, and that adds to your low self-esteem.

Here are some of the self-destructive behaviors most commonly associated with depression:

  • Overeating to comfort yourself, a consolation prize
  • Social isolation because you don’t feel worthy of attention
  • Substance abuse
  • Procrastination—for all kinds of reasons
  • A cycle of overwork and collapse
  • Staying in destructive situations—letting your partner, boss, or coworkers take advantage of you
  • Neglecting your health because you don’t feel you’re worth the effort
  • Poor sleep—insomnia or waking at 4 AM and obsessively ruminating is a classic sign of depression
  • Not exercising—you don’t have the energy and you don’t think it’ll do any good
  • Won’t ask for help because you’re ashamed and guilty
  • Suffering in silence—not expressing your feelings is both a cause and symptom of depression
  • Depressed shopping, spending money you don’t have to buy things you hope will make you feel better
  • Parasuicide—nonfatal suicide attempts, suicidal gestures
  • Self mutilation
  • Anorexia/bulimia
  • “Wearing the victim sign”—unconsciously communicating that you can be taken advantage of
  • And many more

All these things obviously interfere with recovery, but they also make your mood problems worse.  Every time you try to get control over these patterns and fail, you have another experience that confirms your own shame about your illness.  You blame yourself, and you become more hopeless.

If you ask depressed people to spend ten minutes thinking about their problems, they become more depressed (because of all their negative thinking patterns).  If you give them another subject to spend ten minutes thinking about, they become less depressed.  Pay attention to this, because it’s counterintuitive; it’s important to our worldview to believe that if we just apply mental power to our problems, we’ll find a way out.  But that just backfires with depression, because the illness has so pervaded our minds that our beliefs and assumptions are twisted, and our ability to concentrate and make decisions is damaged.  In fact, it’s rather obvious that if the ordinary powers of the conscious mind were able to counter depression, we wouldn’t be depressed to begin with.  This is a very ironic form of self-destructive behavior, and why I refer to depression as the Catch-22 of mental illness; trying your best to figure out what’s wrong and what to do about it just makes you feel worse.  But no one recognizes this without help.

That doesn’t mean there’s nothing you can do about it.  I ask people to keep a log of their depressed mood shifts, what’s going on around them at the time, and what their thoughts and feelings were.  They thus learn to identify their triggers, and develop some control because they can strategize how to avoid or respond differently to things that make them feel bad.  At the same time, they develop some of that metacognitive awareness that accompanies mindfulness; the fact that there are explanations for their mood shifts means that they’re not crazy or out of control, and lends hope.

By Richard O’Connor, Ph.D.

Dr. O’Connor is a psychotherapist in NYC and Connecticut who specializes in treating those with depression. He is the author of the bestselling books, Undoing Depression: What Medication Can’t Give You and Therapy Can’t Teach You.

 

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