Richard O'Connor Ph.D Archives - Lawyers With Depression

Procrastination, Depression and the Myth of Multitasking

Most people who are depressed have a hard time being productive. Work—and here I mean everything from paid employment to child-rearing and housekeeping to the kinds of “work” we assign ourselves, like reading a good book or planting a garden—is a chore to the depressed. It drains us, leaves us feeling as bad as before, physically worn out and emotionally depleted, instead of proud of ourselves and invigorated. Other people with depression seem to work very hard all the time, but there is little payoff for their efforts. As with so much of depression, there is a real chicken-or-egg question—is work so difficult because we’re depressed, or are we depressed in part because we can’t accomplish anything? And as with so many chicken-or-egg situations, we face a false dichotomy: the truth is, poor work habits and depression reinforce each other.

Depressed people tend to be great procrastinators. Procrastination means putting off for a later time what “should” be done now. The “should” may come from without, as with the teenager who dawdles over homework, or from within, as with me planting my garden. When it comes from without, it’s easy to see the rebelliousness that procrastination expresses. When it comes from within, it’s hard to see immediately what purpose procrastination serves—but it may serve many.

False Assumptions

Procrastinators have some big false assumptions about how work works. They assume that really productive people are always in a positive, energetic frame of mind that lets them jump right into piles of paper and quickly do what needs to be done, only emerging when the task is accomplished. On the contrary, motivation follows action instead of the other way around. When we make ourselves face the task ahead of us, it usually isn’t as bad as we think, and we begin to feel good about the progress we start making. Work comes first, and then comes the positive frame of mind.

Closely allied to this misunderstanding about motivation is the idea that things should be easy. Depressed people assume that people who are good at work skills always feel confident and easily attain their goals; because they themselves don’t feel this way, they assume that they will never be successful. But again, most people who are really successful assume that there are going to be hard times, frustrations, and setbacks along the way. Knowing this in advance, they don’t get thrown for a loop and descend into self-blame whenever there’s a problem. If we wait until we feel completely prepared and feeling really motivated, we’ll spend a lot of our lives waiting. See my page on developing greater willpower.

Protecting Self-Esteem With Procrastination

Procrastination can also help protect the depressed person’s precarious self-esteem. We can always tell ourselves we would have done it better if. . .. The paradigm is the college term paper rushed together in a furious all-nighter. The student protects himself from the risk of exposing his best work by never having the time to do it right. This allows him to protect his fantasied sense of himself as special and uniquely gifted. Procrastination is also a result of the depressed person’s tendency toward perfectionism, a crippling problem. Research has shown that the more perfectionistic a depressed person is, the worse his chances of recovery. Trying so hard to make every single little piece of a project perfect, we doom ourselves to disappointment and frustration.

Chaining

There is a simple, useful process psychologists call chaining or making one event depend on another event’s being accomplished first. You can make chains that help you get a lot of work done. I want to go play Tomb Raider on my computer, but I’m going to let that be my reward for first going through the outdated magazines. As I go through the pile, I find there’s one I really must renew my subscription to. Now I have to do that as well before I play Tomb Raider. Renewing that subscription reminds me that I have a stack of unpaid bills nagging at me. Maybe I can’t get the bills all paid, but I can take twenty minutes to get them organized and make a commitment to myself to pay them tomorrow. Now I can go play my computer game feeling a little less overwhelmed by events and a little more deserving of some time to goof off. As you get used to this practice, your chains can get longer and longer without getting burdensome.

Finally, there’s also the Irish way of overcoming procrastination. Confronted with a wall too high to climb, the Irishman throws his hat over it. Now he must find a way over the wall. If I have to paint a room, I’ll likely get the paint and start the first coat as soon as I can, disrupting the whole household in the process. That way I’m fully committed and have to finish quickly.

Gluing Yourself to Your Seat

Controlling procrastination is more like controlling eating or exercise than smoking or drinking; it’s impossible to never procrastinate. For one thing, often it’s not clear which of two is the most important activity. Study for the exam right now, or eat dinner and then study? Or eat dinner, take out the garbage, walk the dog, call a friend, check Facebook, and then study? But procrastination is a habit that can gradually be replaced by the habit of not putting things off.

Rita Emmett, in The Procrastinator’s Handbook, gives us Emmett’s Law: “The dread of doing a task uses up more time and energy than doing the task itself.” Here’s O’Connor’s corollary: “It’s amazing what you can accomplish when you finally get down to work.” So my first advice for overcoming procrastination is to glue your seat to the chair, ignore distractions, and work for five minutes. Then you can take a short break if you feel it’s necessary, but put in another five minutes after your break. The procrastinating impulse in your mindless self won’t respond to logical argument, but it may respond to a narrowing of focus. You’ll get in a groove, start feeling productive, and the impulse to procrastinate further will dwindle. If it doesn’t work today, try again tomorrow.

One Task At a Time

A second piece of advice: while you’re sitting glued to your chair, you’re not allowed to do anything other than the task you’re there for, no matter what attractive distraction might come to mind. You don’t have to work on your primary task, but you can’t do anything else. This can be torture, but it’s great mental discipline. You’ll quickly see how easily distracted you are, but you’re forced to develop the willpower to withstand temptation. Eventually, you’ll get something constructive done.

Hold yourself to pre-commitments. No television (Internet, email) until I’ve worked for a half hour. If I get X done, I’ll reward myself with pizza tonight; otherwise, it’s peanut butter. Be sure to keep these commitments reasonable and don’t set yourself up to fail. If you practice and get consistent at this, you can start to up the ante.

Reward Yourself

Procrastinators don’t reward themselves for finishing. A drink with friends, a special dessert—things that normal people might do to celebrate an accomplishment—these things don’t occur to procrastinators (partly because they’re never satisfied with their results). But it’s important to practice these rituals because, in our minds, the pleasure that comes with the reward comes to be associated with doing a job well. In this way, work itself becomes more satisfying.

The Stress of a Mess

Clutter is highly associated with procrastination. Each of those extraneous items on your desk, workspace, or computer desktop is a distraction, a reminder of something else to do. Mental clutter works the same way; if you have a set of nagging chores, just making a list will help you focus on the present. The list will contain the nagging. Every time we are distracted, we lose efficiency. You can reduce your procrastination greatly by eliminating distracting cues.

Unplugging

Of course, personal computers and wireless communication have created many more temptations to procrastinate—games, Facebook updates, checking on the news. Tweets, cell phone calls, and instant messages constantly break our concentration. If we really want to focus on something, we have to remove temptation and prevent interruptions. If you work on your computer, turn off your Internet browser and make it difficult to get back on. Put the phone on silent. Multitasking is a myth.

By Richard O’Connor, Ph.D. Dr. O’Connor is the author of Undoing Depression, Undoing Perpetual Stress, and Happy at Last. For fourteen years he was executive director of the Northwest Center for Family Service and Mental Health, a nonprofit mental health clinic, where he oversaw the work of twenty mental health professionals in treating almost a thousand patients per year. He is a practicing psychotherapist with offices in Connecticut and New York and lives in Lakeville, Connecticut.

Further Reading:

Get It Done When You’re Depressed – great book!

“Three Strategies For Getting Things Done When Depressed” – Psycentral website

“Ten Ways To Get Things Done Despite Depression” – Everyday Health website

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

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“Plop, Plop, Fizz, Fizz” – Oh, What a Relief it is? Our Relationship with Antidepressants

Most folks with depression have a complicated relationship with their antidepressant medications.

I certainly do.

While these pills saved my life years ago when major depression struck, years later, I often wonder if I still need to take them, or, if they’re still effective.

If I feel tired and flat on a particular afternoon, is it depression, the side effects of my meds or a jumble of both? Or maybe, it’s just my persistently pensive nature?

I think about this a lot these days – and maybe you do as well.

While the one-two punch of Cymbalta and Lamictal have kept me out of the dungeon of major depression for years, its comes with a cost. I have interludes of passivity, numbness, and fatigue. Maybe a low-grade depression at times, as well. If I ditch the drugs, maybe I will feel more “alive,” I think. I fantasize that cutting my ties with meds could lessen the days lost to the deadening grayness of a medically induced sense of normalcy I sometimes go through.

But I also feel anxiety. If I went cold turkey and lived medication-free, would it end, well, in disaster? A return to the swampland of depression? A deadman’s land if ever there was one. Can I take that chance? Should I?

There’s scary research that suggests once you stop antidepressants that work (or sort-of-work) for you and try to go back on the same ones because being off of them caused your depression to return (or you just couldn’t tolerate the horrible side effects that can come with discontinuation), there’s a good chance they won’t be as effective.

So, what’s a depressed person supposed to do? What should I do?

There are two camps that offer some guidance on this issue. Both have persuasive arguments about why those afflicted should or shouldn’t stay on meds.

The Stay on the Meds Camp

If depression is an “illness,” like diabetes or heart disease, I need these meds to balance out my of whacky neurochemistry. Given my risk factors: a family history of depression (genetics), a crazy childhood with a nutty, abusive and alcoholic father, and a high-pressure job with too much stress, I should stay on the pills.

In his insightful essay in the New York Times, In Defense of Antidepressants, psychiatrist, Peter Kramer, author of the best-selling books, Listening to Prozac and Against Depression, suggest that studies show this: for mild or moderate depression, talk-therapy is as or more effective that medication. But for the Moby Dick sized sucker called Major Depression? Medications are warranted, and, indeed, lifesavers. They help many to function and live productive lives, albeit with a range of mild to more severe side effects.

The Get off the Meds Camp

Some people (including psychiatrists) see meds as the devil’s handiwork: supposed chemical solutions to emotional problems that flat-out don’t work. Many psychiatrists’ (and family doctors who write the overwhelming majority of scripts for these drugs in the U.S.), they maintain, are “pill pushers” who do the bidding of “BigPharma”, a multi-billion dollar industry in this country. Antidepressants aren’t so much a cure as a curse.

Irving Kirsh, Ph.D., author of The Emperor’s New Drugs: Exploding the Antidepressant Myth, writes:

“Putting all [the research] together leads to the conclusion that the relatively small difference between drugs and placebos might not be a real drug effect at all. Instead, it might be an enhanced placebo effect, produced by the fact that some patients have broken [the] blind and have come to realize whether they were given drug or placebo. If this is the case, then there is no real antidepressant drug effect at all. Rather than comparing placebo to drug, we have been comparing ‘regular’ placebos to ‘extra-strength’ placebos.”

The remedy from this group? Psychotherapy. They see depression as the result of off-kiltered, negative thinking patterns. The way out of these ruminative, pessimistic thoughts involves working with a therapist who uses, most often, Cognitive Behavioral Therapy, to challenge and encourage patients to replace such thoughts with more realistic and positive ones.

In his book Undoing Depression: What Therapy Doesn’t Teach You and Medication Can’t Give You, Richard O’Connor, Ph.D. argues that both therapy and medication are effective, but limited in certain respects. He advocates an additional factor often overlooked in depression recovery: our own habits. Unwittingly we get good at depression. We learn how to hide it, how to work around it. We may even achieve great things, but with constant struggle rather than satisfaction. Relying on these methods to make it through each day, we deprive ourselves of true recovery, of deep joy and healthy emotion.

The book teaches us how to replace depressive patterns with a new and more effective set of skills. We already know how to “do” depression-and we can learn how to undo it.

Some Recent News on the Meds and Therapy Conundum

The New York Times reports that a large, multicenter study by Dr. Charles Nemeroff, then a professor of psychiatry at Emory and now at the University of Miami, found that for depressed adults without a history of abuse, there was a clear ranking order of treatment efficacy: Combined psychotherapy (using a form of cognitive behavior therapy) and an antidepressant (in this case, Serzone) was superior to either treatment alone. But for those who had a history of childhood trauma, the results were strikingly different: 48 percent of these patients achieved remission with psychotherapy alone, but only 33 percent of these patients responded to an antidepressant alone. The combination of psychotherapy and a drug was not significantly better than psychotherapy alone.

So what’s a depressed person supposed to do?

I don’t know, really.

We’re in a pickle, aren’t we?

Maybe there’ll be a soon-to-be discovered test that can guide us on precisely what to do. But for now, many of us will stay-the-course and, for better or worse, stick to the “plop, plop, fizz, fix”.

I see myself somewhere in the middle of all this. I’ve never been hospitalized or tried to commit suicide. But I have known depression’s scorching winds, gales that have torn the flesh from my body. I will never forget this pain. It’s scarred me. And I never want to return to it.

If you’re thinking of discontinuing your meds, here’s a great article on how to do it safely.

I welcome your comments about your depression journey with or without medicaton.

Copyright, 2017

by Daniel T. Lukasik

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.

Did You Know That Lawyers Suffer From Depression More Often Than the General Public?

The idea that lawyers shouldn’t have problems increases the sense of isolation for those suffering from this debilitating disorder. People with depression often feel emotionally numb, empty and completely alone, even when surrounded by other people. Many lawyers who struggle with depression suffer in silence so as not to appear weak to colleagues. The Washington D.C. Bar offers help. Read the Blog

Can Creativity Help Depression? An Interview with Carrie Barron, M.D.

Dan: Why did you write The Creativity Cure?

Carrie: I felt that the solutions out there for people with anxiety and depression were partial solutions, incomplete remedies. The way we live now causes stress for many people – the pace, the lack of rest or leisure, the relentless striving. Our technological, cerebrally focused culture has taken us out of our bodies and ourselves. Addiction to devices causes an imbalance and a malaise. When you are tied to a device 24-7 you may not be experiencing the fullness of all 5 senses, the things that make you feel energized. The primal satisfaction of making things and using the hands are slowly slipping away from us. For wellbeing, we have to make a conscious effort to maintain them. When my patients make and fix things, they feel better. Research shows that manual effort and creativity are antidotes for malaise. The Creativity Cure was written to help people find another way.

Dan: I deal with lawyers with depression and other professionals that are on their phones and computers a lot. What kinds of things would you recommend that they do with their hands for physical?

Carrie: It’s about getting out of your head. There are many cerebrally oriented people, but “ I think therefore I am” (Descartes) may not be the answer in the current culture. It is really becoming I think therefore I’m not. Too much thinking at the exclusion of physical and manual activity can make us depressed. Physicality, creativity and using your hands – – cooking or washing cars or crafting, painting walls or using watercolors — honor anatomical intent. Long ago manual action in everyday life was necessary for physical survival. Now we need these actions for psychological survival.

The need to create is primal. Paint a wooden board or do Legos with your child. Do that thing you were always drawn and do it clumsily, imperfectly. You don’t have to have any experience as an artist or a maker of things. You don’t have to have a fine result. You can just explore, begin and build. The beauty is in the inner experience. Research has shown that meaningful hand use decreases depression.

Dan: In your book, write about the unconscious mind. What do you mean by that?

Carrie: The unconscious mind, the deepest most hidden layer of our mind houses our , primal self, our instincts, our intuitions and our truth. The unconscious is a treasure trove of clues about our natural self, our unique self. We can get in touch with the deepest layer of our mind via dreams and seemingly random thoughts. Noting where our minds naturally drift helps us learn about where we need to be and what we need to do. The unconscious is a very powerful resource.

Dan: What is our unconscious trying to tell us for people who suffer with anxiety and depression?

Carrie: Depression can have many different causes: biological, situational, genetic or hormonal. It can also be the result of trauma. Self-knowledge and insight – knowing what resides in your unconscious mind – helps with depression because as the saying goes, the truth sets us free. Talking to a pastor or a mental health professional can elucidate information that moves you forward. Understanding yourself: who you really are, what your instincts are or what you are actually upset about is key for positive change. Sometimes you think your concern is one thing and your deeper self tells you that it is another. Following unconscious clues helps you live more truthfully and happily.

Dan: You mentioned “clues” from the unconscious. Can people that are dealing with anxiety and depression unearth these clues themselves? If a person did receive such clues, how would a person know, without talking to a therapist, know what to make of these clues?

Carrie: Writing is helpful. Keep a journal. Take walks, try yoga, breathe, self-reflect, fiddle with paint, doodle, just let. Important material bubbles up when your mind slows down. Be curious and wonder, “Who am I that I love that, what does this leaning say about me, how can I this passion be part of my regular life?” Paying attention to the feeling that accompanies certain thoughts can help you. Certain involvements can make you unhappy but they are habitual so you just keep on. Acknowledging your true inner responses enables you to change. Breaking through denial is key.

Dan: In my work helping lawyers with burnout, anxiety and depression, many of them that seem to contact me are middle-aged. Do you find that a lot of the people, the clients you see are coming to you in midlife?

Carrie: Yes, and midlife can be the best time of life. Loss and disruption, while initially causing depression or anxiety, can lead to positive inner transformation. If we learn to seek pleasure, solace or a feeling of elevation from friendships, family, creativity, and tending to those we love, we are empowered. If you are dependent on an outside institution for your self-esteem, you are less in control of your life and more vulnerable. Define yourself; don’t let it come from the outside.

Dan: I’d like to follow up on a point you make in your book when you talk about people not being in contact with their physical bodies and a visceral since of being alive. I spoke recently with Richard O’Connor, a psychologist in New York City who wrote the book Undoing Depression. He said that depression really wasn’t really about the emotion of sadness – – but about the absence of all emotion. Is that something that you see with the depressed patients you treat?

Carrie: I think it was Andrew Solomon, author of The Noonday Demon: An Atlas of Depression, who offered that beautiful juxtaposition: the opposite of depression is vitality – – not happiness. That really captures it.

Dan: In your book you make a distinction. You indicated that The Creativity Cure is a good fit for people with mild to moderate depression anxiety, but maybe not major depression. Why?

Carrie: For those who suffer from major depression and feel that their depression is well managed, The Creativity Cure is a great option for finding more vitality. Those who at baseline have mild to moderate depression and find that meds do not help enough can discover ways to unleash creativity and happiness in the book. It takes some motivation, but once you get going, you will have more energy and a greater number of happy moments.

Dan: What percentage of your patients would you say depression plays a role in their maladies for which they’re seeing you?

Carrie: Eighty percent.

Dan: Wow – -that many. And to actually put The Creativity Cure into effect, how long do you generally work with somebody to get to the point where they can do it on their own?

Carrie: We start right away by finding out as much as we can about who that person is and what makes him or her feel alive. We think about what is working and what is not, why certain choices were made and ways to redirect the self. Through the Five Part Prescription: Insight, Movement, Mind Rest, Using Your Own Two Hands and Mind Shift people can uncover their true leanings and find more vigor, inspiration, passion. For positive change, integrate the methods into your lifestyle over several weeks. Little steps! True change is all about a little at a time and building.

Dan: In your career as therapist, have you treated lawyers with depression?

Carrie: Yes, yes.

Dan: Have you found anything about their life style that contributes to their depression?

Carrie: I think its three things for lawyers, especially those in high-pressure positions. My client Marnie comes to mind. She is a 28 year-old lawyer who has to give up her personal life at the drop of a hat when she is needed. It is tough. Number one, she is often exhausted because 17 -hour days are not uncommon. Number two, there is a lack of autonomy because this 17 -hour day can be thrust upon her at anytime and continue for weeks. Marnie, professional, committed and with good attitude, has to be available in the moment, late nights, on weekends.

But, compliance takes a toll. It makes her depressed to be in the office and not see sunlight. Not being in control of her time is hard. Even if the work is interesting, she has to give up other important involvements. Marnie feels lonely and isolated because she has little opportunity to be with old friends or to develop new ones. We are working on ways she can maintain friendships, even in text message or email shoot-outs if an in- the- flesh visit must be delayed.

Number three is that living in your head all the time, no matter how brilliant you are, is not healthy. Smart as a whip with facts and numbers, Marnie garners much more pleasure from aesthetics. She likes design but has not felt free enough to develop this interest. Colors, shapes, proportions – thinking about these things makes her happy. It is a sensual, visual way of moving through the world. A big part of the treatment is making her interest in design part of her ongoing life.

I think lawyers in general are really smart people who are great at using their minds. They have been reinforced for this all their lives, but for a richer, higher, happier state, many of these cerebral people need to get out of their heads and start using their hands. Go into a creative world. Balance mind, hands and body.

Dan: I have given many talks around the country on the topic of lawyer and one of the things I like to say is that lawyers have the most active fantasy lives of most professionals I’ve ever spoke to, where they dream of doing something else than lawyering. Can those be clues that would fit in with The Creativity Cure?

Carrie: Fantasizing is a sign of mental health. It’s a good thing. Learning about your inclinations through daydreams might lead you to change your life in a big way or make it better in small ways. Tiny steps allow for big changes because they foster consistency and this builds a new self in a solid way. If you’re interested in learning how to make beautiful cupcakes you can do that for an hour on the weekend. Play guitar, write poems, tend tomatoes in a vegetable garden and do it for a few minutes a day. Start small and make it part of you. Keep dreaming and keep doing. Contentment is about maintaining an identity that integrates your creative

Depression Takes the Fun Out of Life: How to Bounce Back!

You probably take life very seriously if you’re depressed. It’s probably the result of neurochemistry gone awry and a particularly dark and pessimistic take on reality that makes you feel helpless and hopeless.

Getting pleasure out of life, playing and fun are often lost in depression’s onslaught.

When not depressed, I have a goofy sense of humor that bursts forth without warning: just ask my family! I also love to laugh at unabashedly juvenile movies – – Blazing Saddles and Anchorman, come to mind. But when depressed? I can’t muster a simple smile, my face locked in a type of grim sadness. In fact, it seems at such times as if everyone else is effortlessly enjoying life – – except me. And that feels pretty lonely.

I can also get pretty angry. I feel that depression is cheating me out of the sweetness of life that everyone has a right to: the ability to enjoy myself.

Richard O’Connor, Ph.D. writes that the cause of our loss of joy and laughter when depressed emanates from a damaged sense of self:

“Depression is a loss of parts of the self. Instead of experiencing our inner selves as strong, vital, and joyful, we see ourselves as weak, damaged, or blameworthy. We wish that others could make us feel better, but we can’t usually express such wishes directly; instead we use various self-defeating defense mechanisms to keep our wishes out of consciousness. Play is essential to nurturing the self. The depressive, trying to hide from his own punitive ego like Adam from a wrathful Jehovah, feels that he’d better never let his guard down, always be busy, and always be productive. But play changes moods. Play can lift depression.”

But just how do we go about starting to play? Here’s Dr. O’Connor’s take on what play is and how to partake in it:

1. Play is usually physical. Our bodies are engaged. We move, we use our large muscles, we can sweat.

2. Play often involves a conscious abandonment of dignity, sometimes by putting us into roles or positions that are outside our usual behavior.

3. Play usually involves others. Solitary play is okay if there is no one available, but it’s more fun with other people.

4. Play involves being spontaneous, doing what our impulses tell us. This may require planning. Games have rules to keep our spontaneity in safe limits. Spontaneity helps us lose self-consciousness, which seems to be a major point of play.”

Grownups like you and I all too often dismiss having fun as a remedy for depression. In my experience, this is a big mistake. It should be part of everyone’s depression toolkit. It dismissive attitude is rooted in the negative, ruminative thinking that goes in our heads before even trying to participate in play. Dr. Hara Estroff Marano talks writes about the value of play:

“As welcome and wonderful as those feelings generated by play are, it’s value among adults is too often vastly underrated. We would all agree that play lifts stress from us. It refreshes us and recharges us. It restores our optimism. It changes our perspective, stimulating creativity. It renews our ability to accomplish the work of the world. By anyone’s reckoning, those are remarkably worthy achievements.”

Once you’ve jumped in feet first, the flow of pleasurable experiences takes over and the benefits sink in.

Is play missing from your daily round?

Don’t let your depression squash all the joy out of your life. Go play and have fun!

Undoing Depression in Lawyers

There’s some interesting research to suggest that happy people view the world through certain comforting illusions, while depressed people see things more realistically. [i] For instance, the illusion of control. You can take a random sample of people and sit them in front of a video monitor with a joystick, and tell them their joystick is controlling the action of the game on the screen. (But the point of experiment is that it actually doesn’t). Depressed people will soon turn to the lab assistant and complain that their joystick isn’t hooked up correctly. Normal people, on the other hand, will go on happily playing the game for quite some time.

I think this explains a lot about why lawyers are so prone to depression. Because of their experience with the law, most attorneys have lost their rose-colored glasses some time ago. (Or else they never had them and chose the law as a career because it suited their personality). Attorneys know that life is hard, and doesn’t play fair. They’re trained to look for every conceivable thing that could go wrong in any scenario, and they rarely are able to leave that attitude at the office. They see the worst in people (sometimes they see the best, but that’s rare). They tend to be strivers and individualists, not wanting to rely on others for support. They have high expectations of success, but they often find that when they’ve attained success, they have no one to play with, and have forgotten how to enjoy themselves anyway.

All this makes it hard for attorneys to get help with their depression. They tend not to recognize it as such; they just think it’s stress, or burn out, or life. They don’t expect that anyone is going to be able to help. Most of my attorney-patients have contacted me because their relationships are falling apart, but they don’t see that it’s depression that makes them such a lousy partner – tense, irritable, critical, joyless, tired all of the time, relying on alcohol or other drugs. If they’d gotten help for the depression a couple of years previously, their spouse wouldn’t be moving out now. The truth about depression is that it not only makes you feel horrible, it wrecks your life. And that’s why I wrote the book, Undoing Depression, in the first place. I was running an outpatient clinic, and grew exasperated with seeing the people whose lives wouldn’t have been so ruined if they had got some help when they first needed it – before they alienated their children and spouse, got fired, went into debt, developed a substance abuse problem, etc. I thought there was a need for an intelligent self-help book, one that points out all the bad habits that depression engenders and which, in a vicious circle, keeps reinforcing the disease. But the truth is that self-help isn’t nearly enough for most depression sufferers. It’s as if you stepped over an invisible cliff, and you can’t find your way back doing what you normally do, because that’s what led you over the cliff in the first place. Depression is the original mind/body disease; your physical brain is damaged because of the stress in your mind, and you’re unlikely to undo that damage without help.

Depression is highly treatable, but if you want a lasting recovery you have to change your life. The ugly fact is that depression is very likely to reoccur. If you had one episode of major depression, chances are 50:50 that you’ll have another; if you have three episodes, it’s 10:1 you’ll have more. But you can improve those odds if you get good professional help, with medication and with talk therapy. We won’t put your rose-colored glasses back on, but we can help you see how negative thinking and the negative acting is contributing to your disease.

[i] See for example, Shelly Taylor: Positive Illusions; and Julie Noren: The Positive Power of Negative Thinking.

Richard O’Connor, Ph.D., is the author of two noteworthy books, Undoing Perpetual Stress: The Missing Connection Between Depression, Anxiety, and 21st Century Illness and Undoing Depression: What Therapy Doesn’t Teach You and Medication Can’t Give You. He is a practicing psychotherapist with offices in New York City and Canaan, Connecticut. He has suffered from clinical depression and is a member of a depression support group.

Dan’s Latest Top 10 Book Recommendations on Stress, Stress-Management and Anxiety

Over the years, I’ve read too many books to count about stress, anxiety, and depression. Like most people, I’m always looking for tips and clues about how to handle things better.

Some of these books have turned out to be real stinkers. Others, retreads of books and articles that have said the same things over and over again.

I have found some gems, though. Books that have something original to say, or are well-written.

I’ve found that the most useful ones make me want to read them further after the first 25-pages, or so. Good rule of thumb.

I hope you find help, hope, and insight between their pages.

Manage Your Time to Reduce Your Stress: A Handbook for the Overworked, Overscheduled, and Overwhelmed — Rita Emmett

The title of this book grabbed my attention because it seemed to capture so much more than just stress management. Stress management is truly about managing being overworked, overscheduled, and overwhelmed.

According to the author, the key is not time management but “stuff management — taking control of all those tasks to do, people to see, commitments and obligations to fulfill. Mismanagement of all that “to-do” stuff is what leads to stress. Emmett combines quick, easy-to-digest tips and infectious good humor to give readers positive ways to handle stress and their overly busy lives.

You can also check out her website for other helpful tips and ideas.

Monkey Mind: A Memoir on Anxiety — Daniel Smith

I first read about Smith’s book in a New York Times article called “Panic Buttons“. This memoir on stress and anxiety is not only informative and insightful, it’s well-written and funny.

The long list of things that, over the years, have made Daniel Smith nervous includes sex, death, work, water, food, air travel, disease, amateur theater, people he’s related to and people he’s not related to, so the prospect of a book review probably wouldn’t seem like a very big deal to him. Or would it?

This fleet, exhausting memoir, is an attempt to grapple with a lifetime of anxiety: to locate its causes, describe its effects and possibly identify a cure. Or, if not a cure, at least a temporary cessation of the worry that’s been plaguing him since his youth.

Check out his website, The Monkey Mind Chronicles, for more interesting stuff.

Hardwiring Happiness: The New Brain Science of Contentment, Calm, and Confidence — Rick Hanson

Rick Hanson, Ph.D. is a neuropsychologist and best-selling New York Times author.

Hardwiring Happiness lays out a simple method that uses the hidden power of everyday experiences to build new neural structures full of happiness, love, confidence, and peace.

In an interview discussing the book, he states:

“So, how do you get good things—such as resilience, self-worth, or love—into your brain? These inner strengths are grown mainly from positive experiences. Unfortunately, to help our ancestors survive, the brain evolved a negativity bias that makes it less adept at learning from positive experiences but efficient at learning from negative ones. In effect, it’s like Velcro for the bad but Teflon for the good.

This built-in negativity bias makes us extra stressed, worried, irritated, and blue. Plus it creates a kind of bottleneck in the brain that makes it hard to gain any lasting value from our experiences, which is disheartening and the central weakness in personal development, mindfulness training, and psychotherapy”.

Check out his website for more information about the book and his suggestions.

Why Zebras Don’t Get Ulcers: An Updated Guide to Stress, Stress-Related Diseases and Coping – Robert Sapolsky, Ph.D.

Why don’t zebras get ulcers–or heart disease, clinical anxiety, diabetes and other chronic diseases–when people do?

In a fascinating that looks at the science of stress, Stanford biologist Robert Sapolsky presents an intriguing case, that people develop such diseases partly because our bodies aren’t designed for the constant stresses of a modern-day life – – like sitting in daily traffic jams or racing through e-mails, texting and running to pick up our kids after a tough day at work. Rather, humans seem more built for the kind of short-term stress faced by a zebra–like outrunning a lion.

This book is a primer about stress, stress-related disease, and the mechanisms of coping with stress. How is it that our bodies can adapt to some stressful emergencies, while other ones make us sick? Why are some of us especially vulnerable to stress-related diseases and what does that have to do with our personalities?”

Sapolsky, a neuroscientist, concludes with a hopeful chapter, titled “Managing Stress.” Although he doesn’t subscribe to the school of thought that hope cures all disease, Sapolsky highlights the studies that suggest we do have some control over stress-related ailments, based on how we perceive the stress and the kinds of social support we have.

Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness – John Kabat-Zinn, M.D.

As a busy lawyer, I was immediately attracted to the title Full Catastrophe Living. It literally leapt of the bookshelf and cracked me on the head. Who doesn’t live a life so jammed with stuff to do that it feels like a catastrophe?

Chronic stress saps our energy, undermining our health, and making us more vulnerable to anxiety, depression, and disease. The heart of the book is based on Kabat-Zinn’s renowned mindfulness-based stress reduction program at the University at Massachusetts Medical Center.

The author takes the phrase “full catastrophe living” from book and movie “Zorba the Greek”. If you’ve never seen it, an Englishman Basil – – who is half-Greek – – inherits a run down mine in a small Greek town. To help him restore it, he hires a local character named Zorba to be the foreman of the local laborers. Zorba, full of the zest of a life truly lived, is asked by Basil, “Do you have a family?” Zorba responds “Wife, children, house – – the full catastrophe!!!”

Undoing Perpetual Stress: The Missing Connection Between Depression, Anxiety and 21st Century Illness – Richard O’Connor, Ph.D.

Author of my favorite book on depression, “Undoing Depression”, Richard O’Connor, Ph.D., has written another simply brilliant book on the consequences of “perpetual” stress in our lives – the alarming and escalating rates of clinical anxiety and depression. This was the first book I read that made clear to me the connection between stress, anxiety, and depression. It formed the basis for my blog on the topic How Stress and Anxiety Become Depression. The human nervous system was never meant to handle this many stressors. It’s as if the circuit breakers in our brains are blown by too much stress running through our brain’s circuitry. This book is a perfect fit if you want to learn a lot about the brain and physiology of stress – I found it fascinating. If you’re looking for a quick read and pick-me-up, this isn’t it. Check out his website.

A Mindfulness-Based Stress Reduction Workbook — Bob Stahl

The author writes that the key to maintaining balance is responding to stress not with frustration and self-criticism, but with mindful, nonjudgemental awareness of our bodies and minds.

This book employs some of the same mindfulness strategies discussed in Full Catastrophe Living but does it in the format of a workbook. I find this format very helpful because it’s practical and gives me exercises to do to put into practice mindfulness to reduce my daily stress load.

The 10 Best-Ever Anxiety Management Techniques – Margaret Wehrenberg, Ph.D.

Medication, once considered the treatment of choice, is losing favor as more and more sufferers complain of unpleasant side effects and its temporary, quick-fix nature. Now, thanks to a flood of fresh neurobiology research and insights into the anatomy of the anxious brain, effective, practical strategies have emerged allowing us to manage day-to-day anxiety on our own without medication. Addressing physical, emotional, and behavioral symptoms, Margaret Wehrenberg, Ph.D., a leading mental health clinician, draws on basic brain science to highlight the top ten anxiety-defeating tips. Everything from breathing techniques to cognitive control and self-talk are included. I really like that the 10 chapters are highly readable and short. Dr. Wehrenberg is also a frequent blogger at the Psychology Today website. Here’s one of her blogs, The One-Two Punch of Negativity and Fear.

Things Might Go Terribly, Horribly Wrong: A Guide to Life Liberated from Anxiety – Troy DuFrene

This book approaches the problem of anxiety a little differently than most. Instead of trying to help you overcome or reduce feelings of anxiety, it will help you climb inside these feelings, sit in that place, and see what it would be like to have anxiety and still make room in your life to breathe and rest and live, really and truly live, in a way that matters to you. This approach is based upon a research-supported form of psychotherapy called Acceptance and Commitment Therapy, also known as ACT which starts with the assumption that the normal condition of human existence is suffering and struggle, ACT works by first encouraging individuals to accept their lives as they are in the here and now. This acceptance is an antidote to the problem of avoidance, which ACT views as among the greatest risk factors for unnecessary suffering and poor mental health

The Worry Cure – Robert L. Leahy

For “highly worried people,” or those who suffer from the “what-if disease,” this book presents a systematic, accessible self-help guide to gaining control over debilitating anxiety. Leahy is an expert in changing thought processes, and he walks worriers step-by-step through problems in the way they think, with pointers on how to change these biases. The author then outlines a seven-step worry-reduction plan (remember, I love plans!) beginning with identifying productive and unproductive worry, progressing to improving skills for accepting reality, challenging worried thinking and learning to harness unpleasant emotions such as fear or anger.

Self-Coaching: The Powerful Guide to Beat Anxiety – Joseph J. Luciani, Ph.D.

This is a good book for those who don’t want to see a therapist or, if they do, need extra doses of encouragement and practice to overcome their stress and anxiety. The author advises readers to identify themselves as specific personality types (e.g., “Worrywarts,” “Hedgehogs,” “Perfectionists”) and then gives specific instructions on how to change the particular thought patterns associated with this type of personality. So many people who struggle with anxiety never got what they needed while growing up – – enough love, encouragement, and affirmation. Lacking these core experiences, we develop can develop particular maladaptive strategies to cope with people and situations that push our buttons. This is the only book that I’ve read that pairs specific coping recommendations with particular personality types.

What books would you recommend? Hit the comment button and submit your favorites.

Next Steps:

If you are interested in talking to Dan about CLE eligible trainings he offers law firms, call him at (716) 913-6309 or via our contact form. One-on-one coaching is also available for lawyers who need individualized attention. Go to Dan’s website Yourdepressioncoach.com to download his free book and schedule a consultation.

Tag: Richard O’Connor Ph.D