Me, Mom, Dad, and Depression: A Family Affair

lukasik_parents_cropped“If you look deeply into the palm of your hand, you will see your parents and all generations of your ancestors. All of them are alive in the moment. Each is present in your body. You are the continuation of each of these people” – Thich Nhat Hanh

Like all parents, my Mom and Dad were flawed people – as I am. Yet, they were something more than that.

I’ve struggled to understand them much of my adult life; maybe more so now that they’re both gone. Here’s a picture of them from 1946 cleaning up the reception hall after a two-day celebration.

The nineteenth-century German philosopher Arthur Schopenhauer once wrote: “The first forty years of life furnish the text, while the remaining thirty supply the commentary.” Maybe it isn’t till midlife that we really work hard to interpret the stories of our past. I believe there’s a strong urge in all of us to make a comprehensible story of one’s life at this juncture. And our parents are a large part of that tale.

The Ten Best-Ever Depression Management Techniques: An Interview with Dr. Margaret Wehrenberg

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I’m Dan Lukasik from Lawyerswithdepression.com. Today’s guest is Dr. Margaret Wehrenberg. Dr. Wehrenberg is a clinical psychologist in Naperville, Illinois. She is the author of six books on the treatment of anxiety and depression published by W.W. Norton, including, “The Ten Best-Ever Depression Management Techniques: Understanding How Your Brain Makes You Depressed and What You Can Do to Change It” and “Anxiety + Depression: Effective Treatment of the Big Two Co-Occurring Disorders.” An international trainer of mental health professionals, Dr. Wehrenberg coaches people with anxiety via the internet and phone. She’s a frequent contributor to the award-winning magazine, Psychotherapy Networker and she blogs on depression for the magazine Psychology Today.

Dan:

What is the difference between sadness and depression and why do people confuse the two so often?

Dr. Wehrenberg:

Because depression comprises sadness. Sadness is a response to a specific situation in which we usually have some kind of loss. The loss of a self-esteem, a loss of a loved one, the loss of a desired goal. Depression is really more about the energy – whether it’s mental energy or physical energy – to make an effective response. So, sadness is an appropriate and transient emotion, but depression sticks around and affects all of our daily behaviors and interactions.

Dan:

What causes depression? Sadness, as you say, is an appropriate response to loss.  What is depression a response to?  What are the causes of depression?

 Dr. Wehrenberg:

Over the course of my career, I’ve developed the idea that there are four potential causes to depression.  This comes from working with people for forty years; it comes from reading a lot of research.

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The first part is genetics. You are born with a brain that is going to tend toward depression because of the function of neurotransmitters in your brain. It’s a genetic predisposition towards depression. With poor self-care, poor nutrition, you may end up stimulating or starting that feeling of low energy, of low interest in the world around you. Then if you pull back from the world around you, now you start to have fewer experiences that keep you interested in the world.

Another possible and probable cause is with people who are experiencing situational stress that goes on, and on, and on. That could be the stress of not being able to earn enough money, and you’ve got two jobs, and kids, and a life filled with stress. It could be the stress that comes on while caring for someone in your family circle who’s got a disability, or a chronic illness; that increases with severity over time. So, you’re stuck in stress, and you deplete yourself. And you can become depressed.

The state of the depression is a lot like the state of being sick. If you had the flu, you wouldn’t feel like sitting around eating and drinking; you wouldn’t feel like playing a round of tennis. If somebody says, “Let’s watch a really interesting T.V. show” and you say, “No, I want to go to sleep instead,” that’s pulling back from the world is healing.  People have the same feeling when they’re depressed, but those feelings don’t lead toward healing because they’re persistent.

Two other causes that people would certainly be aware of are trauma or coming from early childhood adversity where early in your childhood you were not treated well, you were neglected, had some other abusive situation, and those two very difficult situations can lead people to function in a depressed way.

Dan:

Let’s talk about the issue of stigma. As a person who’s had depression for the past 15 years, it’s something that I’ve had to deal with. Why is there so much stigma surrounding depression?

Dr. Wehrenberg:

Part of it is because we have this mentality in this country that you should be able to pull yourself up by your bootstraps. And we look at people who are low energy, who aren’t completing tasks, and we judge them as doing it on purpose. People who aren’t depressed are of the impression that you could just decide to do it differently.

I was speaking with a 21-year old client of mine the other day who said, “I can’t make myself do the work, and I hate it that I am that lazy.” So, he judges himself as lazy, even though it’s the depression that’s robbing him of energy and mental tenacity. So, even depression sufferers judge themselves to be wrong, lazy, and bad and believe they should do better. So, I think the cultural expectation that you should be more productive. Also, people don’t see it as the medical problem it is. It’s just that it’s not a very “visible” medical problem.

Dan:

In the past 40 years or so that you’ve been a therapist and have treated people with depression, what have you observed about the rate of depression in our country and our understanding of it?

Dr. Wehrenberg:

I think the rate of depression, everybody would agree, is growing. More and more people are suffering depression.

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There are different reasons why when we look at this.

Culturally, one of them is that American culture is a highly stressed culture.  But it’s stress not over life and death, but that’s certainly the case for many living in poverty who have to worry where their next meal is coming from, but usually, what we look at is the stress of always needing to be more, to do more, to get more status and money. That’s not a very good way to feel good about yourself because there’s a limit, a human limit of time, a limit of money, a limit of talent or ability, a limit to resources or access to achievement.

Dan:

Following up on what you just said earlier, you talked about some possible causes of depression including genetics and family of origin issues. Now you’re talking about American culture and its connection to depression. What is the connection?

Dr. Wehrenberg:

We have a culture that values productivity, money, and status, and not everybody can achieve goals of status or financial success and it gets depressing to see how valuable those seem to be in our country.

We don’t value something everybody can do. Like, be a person of good character. We value how much status you’ve got, which is very different.

Dr. Andrew Weil, who is a real guru of physical health and mental health, says he thinks that stress equals inflammation in your whole body and that inflammation is a trigger for depression.

Dan:

Why did you write the book, “The Ten Best-Ever Depression Management Techniques?” It’s a great read. I recommend all my listeners and readers at lawyerswithdepression.com to pick it up.

Dr. Wehrenberg:

I wrote it because I believe both consumers and therapists need ideas for what to do right now other than to investigate, in some more general way, a life history, what do you do today that will make you feel somewhat better, to start you moving out of the depression. I wanted to present as many practical ideas as I could that would help people start to lift out of depression with the help and advice of a therapist and also for the general public that could read this book and say, “Oh, there are things I can do that would make me feel better.” And they’re simple; they’re not complicated.

Dan:

Can you share with our listeners some of the techniques you recommend in your book?

Dr. Wehrenberg:

Let’s start with somebody with low energy. Almost everybody who is depressed is doing something even while they are depressed. Playing a game on their phone, watching T.V. or watching Netflix.  They are doing something. Unless, they are sleeping, of course.  But I want to use what you’re already doing to help motivate you to do something you think you should do. So, for example, I often see people with depression that aren’t doing good health care, they’re not doing good care of their environment, they are not doing dishes, they are not doing laundry, stuff like that. So if you just think about household stuff for a second, what I want my clients to do is to break down the task into its parts.

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If you’re going to do laundry, the first thing you have to do is pick it up off the floor. So, I don’t want you to think, “Oh, I’ve got to get all the laundry done.”  If you’re depressed, that won’t work. What I want you to do is think is, “All I have to do is pick up the dirty clothes in the family room and then I’m going to sit down for 15 minutes and do what I’m willing to do anyway – play a game on the phone, turn on Netflix. Set a timer for 15 minutes of enjoyment of your show and then when the timer goes off, you just get up and pick up the clothes off the floor of your bedroom. Little pieces, okay.

What we know about depression is those small accomplishments are perceived in the brain as positive and encouraging, and you start to feel, “Oh, I can do something for myself.” You begin to have just a little rise in your overall energy. If you can do that consistently, then pretty soon, you get the task of doing the laundry over with. It may take a few days, but it’s done. Then you have a positive self-appraisal. That’s what I’m going for, for example, with a very simple way to think about raising your energy through small increments.

Dan:

So the small steps and small behaviors affect neurochemistry?

Dr. Wehrenberg:

They do, indeed. Because when you take action and it has a positive outcome, you have just changed the level of the neurochemical called dopamine, which I call the “James Brown” of the brain.  It’s the “I feel good,” when dopamine is released in your brain you feel better. We know that people who decide, “I am going to do this,” and do it, they get a rise in dopamine and change your neurochemistry.

Dan:

I want to discuss your second book, “Anxiety + Depression: Effective Treatment of the Two Co-Occurring Disorders.” I struggle with both anxiety and depression with depression being the primary diagnosis. Many people I meet struggle with both.  Why do the two co-occur together and sometimes not?

Dr. Wehrenberg:

Very often, if you are looking at brain function and structure, what you see in people who have both anxiety and depression, which, by the way, is about fifty-percent of the time, is that people who have one, have the other. Often, the anxiety comes first, and it’s not treated well. There’s a neurochemical called serotonin which is related to something called rumination or you might think of it as “brooding.” When people brood, when they go over and over a failure or fear, they get stuck mentally. It raises anxiety because it’s hard to solve a problem that you’re just brooding about and it raises depression because you don’t feel like you’re moving very much in your behavior or your thinking. That’s a pretty simplistic statement. And people will say, yes, but there are far more theories about the underlying neurochemistry.  That’s true, but the chemistry that relates to brooding is related to both anxiety and depression, the repetitive, negative thinking.

Dan:

Regarding your history as a therapist treating people with anxiety and depression, are there some techniques that work better with anxiety versus depression? Or, do all these techniques work equally well with both conditions?

 Dr. Wehrenberg:

I think you have to look at the energy level. Some people with anxiety and also depression have a fair amount of energy to cope with the depressive quality of repetitive, negative thinking. And you use the energy of that anxious person to be more assertive with yourself to say, “I’m going to take charge of this.”

But what I also find that works very well with anxiety and depression together is to work on mindful awareness, to try to stay in the moment, not to try to predict a negative outcome, but rather to pull yourself into the moment. And mindfulness, which can be done by meditating to stay in the present moment, but you can also just keep pulling yourself back to this moment by saying to yourself, “What’s happening now?” This pulls you back from predicting negative outcomes and then getting upset about what might happen. If you stay in the now, you can say I can do this activity now, this action now, and all I have to worry about is now. And then you tend to get better outcomes. So, that’s good for both for anxiety and depression.

Anxiety is “I worry about the future; I fret about the past.” And depression includes, “I think the future will be grim.” So if you stay in the moment, you’re addressing both of them.

Dan:

As a psychologist and therapist who’s worked with people with anxiety and depression for decades, tell us a little bit why a person struggling with depression and anxiety should see a psychologist, a therapist? What benefit could be obtained from seeing someone such as yourself and how does that work?

Dr. Wehrenberg:

We know that medication, which is often people’s first choice, can be extremely helpful. But what I say to my clients is that medication can help you feel somewhat better, but it doesn’t teach you anything about managing your life. Psychotherapy, when it’s practical, when I’m looking at it through the “The Ten Best-Ever Depression Management Techniques,” what it’s teaching you is how to handle your negative mood, what to do when you don’t have energy. It’s teaching you behavior that will rewire your brain. It talks about how and why exercise and nutrition are important.

But also why taking even a small action on your behalf changes your neurochemistry.  So, psychotherapy immediately affects brain function. But, you usually need a psychotherapist to give you ideas, help you find ideas of how you stop yourself, how you block yourself, and to help you find the most effective tools for you in your specific situation. A psychotherapist can be very helpful in teaching you how to get rid of these negative symptoms and feel better for life.

Dan:

Dr. Wehrenberg, what’s the best way for our listeners and readers to get in contact with you?

Dr. Wehrenberg:

Well, if you’re able to spell my name, you can look me up on Margaretwehrenberg.com.  I work in Naperville, Illinois. But my website has my telephone contact and a link. And if you went to the Psychology Today magazine website, you can look at my blog on depression, and you would be able to contact me through there as well. I have a really good “Contact me” on my website.

Dan:

On behalf of your listeners at Lawyerswithdepression.com., I want to take the time to thank you for this insightful interview. I think it’s going to help many people.

Dr. Wehrenberg:

Thank you for having me. I appreciate it.

 

 

Success Syndrome: The Ambition-Depression Connection

“I’m trying to get comfortable with the idea that I am a human BEING not DOING, and that being a child of God is enough. With therapy and lots of soul searching, I am digging inside for the strength that lies at my core — naked, unassociated with any accolade or achievement,” writes Therese Borchard. Read her Blog

Down is the Way to Well-being: The Dangers of Living at Altitude

Parker Palmer, Ph.D., writes, “When you’re depressed, it seems insulting, even insane for someone to suggest that the soul-sucking spawn of Satan that has sunk its claws into you is your BFF. And yet, as time went by, the image of depression as a befriending force began to work on me, slowly reframing my misery and helping me find a way through. Something in me knew what my therapist knew: down is the way to well-being.” Read the Blog

An Interview with Will Meyerhofter About Depression in the Law

Will Meyerhofer, JD LCSW, is an author and a psychotherapist in private practice in NYC.  He holds degrees from Harvard, NYU School of Law and The Hunter College School of Social Work.  Following law school, he worked as an associate at the BigLaw firm of Sullivan & Cromwell in New York City before becoming a therapist. He is also the creator of the website and blog The Peoples’ Therapist.  I spoke with Will about what depression is, how it forms and why so many lawyers are afflicted by it.

Dan:  As someone who has suffered from depression and treats people for depression, what is depression and how does it develop?

Will:  When Freud was asked why he went into neurology, and medicine, the career which developed, for him, into psychoanalysis, he said he was inspired by Charles Darwin’s astonishing breakthrough with the theory of evolution.  Freud was an admirer of Darwin.  That’s relevant, because evolution, I believe, plays an important role in depression.  Depression is an evolutionary adaptation of humankind gone wrong.

It’s a bit like Sickle Cell Anemia, which is actually an adaptation in our blood intended to prevent Malaria.  Unfortunately, that adaptation can also go too far and result in a harmful blood disorder.
Human beings have an enormously long childhood – the period of dependency following birth.  That is chiefly due to our single most important adaptation – large brains, which at full size, would never fit through the birth canal.  So we are born with a partially developed brain, about a third of its full size.  As a result, our brains require a strikingly long period following birth– at least compared to most other higher species – to develop and mature.  During that time, we’re utterly helpless.  Many species are born, brush themselves off, and a couple of hours or days later, they are up and running around – just think of horses birthing foals.  That’s not true for people.  Humans take 10-14 years before they’re in any shape to take care of themselves.  Our brains don’t even reach their full size until we’re about 6 years old.

Dan:  What does this long period of childhood have to do with depression?

Will:  We humans experience a very long period in our lives in which we demand and require enormous amounts of care in order to survive.  Otherwise, we’d die.  Little children comprehend that situation on a cellular level.  If you walk away from a little child – make it clear that you are planning to abandon him for any length of time – that little child is going to absolutely flip; he is going to scream so loudly it will peel the paint off the walls.  That’s because he knows he could die if he is abandoned.  A child will always experience solitude as abandonment.  To put it bluntly – the role of a human child is to please.  It’s more intense for humans than for other life forms, because we require a lot more care and for a much longer period of time.  Reptiles lay eggs and disappear.  They might even feed on their own young and not think much of it.  But mammals need care – milk from the mother.  And of all the mammals, humans need the most care – years and years of it.  So humans spend many years learning to please.  We grow up with this directive to please – and blame ourselves if we fail at that task.  It gets coded into our brains and becomes a trained behavior, an instinct.  Keep in mind, the threat of death is real.  Historically, as a species, humans display high rates of infanticide.  This phenomenon exists in many species.  Birds often cull their young and throw hatchlings out of the nest if there is insufficient food.  But with humans, because we require so much care in our early years, if things are bad, it would not be uncommon to take a child who is disfavored – perhaps an illegitimate or disabled or otherwise undesirable child – and leave it out in the woods to die or simply abandon it as a street urchin.  It is incumbent upon every human child to please so he can receive care and survive.

Ok, so how does this apply to depression?  Under stress, humans regress – they fall back instinctively into old, unconscious behaviors acquired during childhood.  In our case, that means falling back into the childhood pattern of locating the fault within –  feeling that you’ve failed to please and that if you’re not pleasing, you are going to die.  So, when you are under stress and things aren’t going well for you, you blame yourself – it must be your fault.  Instead of acting like an adult, and getting angry and thinking – I’m not being treated well, I have a right to get angry and advocate for myself, or take care of myself, if no one else is going to do it – instead of that healthy, adult functioning, it’s the old regression, to “I’ve failed.  It’s my fault.  I’ll die because I’ve failed to please.”

An adult – unlike a child – does not have to experience solitude as abandonment.  You can say I am an adult.  I am independent.  I can take care of myself.  Not only that, I can choose an environment that’s healthy for me and I can reassure myself.  I can self-sooth, I can self-parent.  I can say to myself, hey you are a good person, come on.  You choose who you are going to be each day. You are proud of who you are. You make that determination.  You make that judgment whether you are worthy of being valued and receiving care each day.  And you can tell yourself, Hey cheer up, you are going to get through this.  You’re going to surround yourself with people who value you because that’s what you deserve and you are going to take care of yourself.  And you can feel angry if you’re not receiving the care you deserve.  That – in a nutshell – is how you address depression.  You snap out of the regression to behaving like a dependent child and become an adult, a parent for your own child.

Dan: What signs do you look for to diagnose depression?

Will:  There are two major indicators for depression that give it away each and every time.

First, I see an absence of appropriate anger.  A child does not get angry when the parent fails to provide him with suitable care – the child sees himself as helpless.  You can’t get angry at someone if you need them desperately, the way a child needs a parent.  It’s not where the hell are you, I need a feeding, my diaper needs to be changed.   Instead, the child’s in absolute panic and thinking I’m bad, I’m bad, I’ve failed here, I have failed to please – now they’ll leave me to die.  That is the first characteristic of depression – absence of appropriate anger.  If I ask a depressed client “Are you angry right now?” I’ll always hear the same answer.  It will always be some variation of “I’m only angry at myself.”  The rest of that statement would be “. . . because I’ve failed to please and can’t survive on my own.”

The Second indicator of depression is a dismantling of a person’s self-esteem apparatus. There’s no sense of pride in yourself or a sense of value in who you are and what you do. You think I failed, I hate being me.  A depressed person will insist, over and over again – “I’m only angry at myself.  I don’t like who I am.”  That’s because the depressed person’s fantasy is to escape into someone else – someone who will please, and therefore be worthy of care – and survival.

Dan:  The absence of appropriate anger and a dismantled self-esteem.  I think those are two things that people on the street and even lawyers would associate with lawyers. We expect them to be tough and strong.  We expect them to have high self-esteem and take pride in what they do. In your experience, why is the exact opposite true for lawyers struggling with depression?

Will:  At a law firm, you are reduced to a child-like helplessness.  You have no right to speak your mind, to self-advocate – to stand up to authority.  Instead, you go helpless, and try to please.  Any anger, if it is acknowledged to any degree, is tightly bottled.  You can’t show it.  The environment at law firms is uptight, rigid and extremely constrained.  You can’t say to the partner – “Oh, for heaven sake, it’s Friday – why are you bothering me with this?”  You say – “Yes, sir.  I’ll do it right away.”  If the partner – who is clearly exploiting you to make money – announces you are going to be working all weekend, you say “Absolutely, no problem.”   You do not put up any kind of a fight.  Lawyers, especially young lawyers, imagine themselves as helpless as young children in the law firm environment – utterly dependent on the partners, utterly incapable of advocating for themselves, or providing themselves with the care they need on their own.  They permit themselves to be abused in an extremely toxic, exploitative environment – they often don’t even seem to realize they’re being abused.  They’re too busy attempting to please their abusers.

Dan:  Will, you treat a lot of lawyers with depression.  Is depression in some way different for lawyers?  Are there different causes for their depression?

Will:  If I were to design an environment specifically to create depression, I would design a law firm.  The reason is that lawyers are pleasers.  A lawyer tends to be the kid with the best grades in the class – a generalist whose primary skill is getting good grades – pleasing teachers.   If you are really good at math, you become a mathematician or a scientist.  If you are particularly skilled on the violin, you become a musician.  But if you get an “A” in everything, then your only skill set is getting good grades – and to monetize that skill set, you wind up heading to law school.  That’s pretty much how I did it.  I got into Harvard and then went on to NYU Law.  I wasn’t spectacular at any one thing – I was a generalist.   I was also the teacher’s pet.  I was an excellent student – but what is an excellent student?  It’s someone who gives the teachers what they want. Bill Gates, Mark Zuckerberg, they dropped out of Harvard, they weren’t good students – because they – and others like them – were geniuses, and entrepreneurs, not good students.  Lots of geniuses drop out of college – it’s a common feature they share.  They’re not pleasers. Einstein struggled to complete the academic rigamarole required to get a teaching post – he was too busy re-inventing physics.

Lawyers tend to be good students.  A genius or an entrepreneur – an individualist – says I’m going to do it my own way and the hell with you.  Screw Harvard. I don’t need it.   This is in contrast to lawyer, the pleaser – the type of person who says I’m going to compete viciously with my peers and get straight A’s at Harvard and then go to a top law school and compete some more to get more straight A’s and then get a job at a top law firm and keep on competing.  What happens to a pleaser when you get to these top firms? You do what you are told.  And you compete.  That’s a very typical lawyer behavior – you are essentially pleasing partners who are replacements for your parents and teachers, what therapists call the idealized parent object, the primary object – the person you’re programmed to please.  And you are killing off your peers – the other children who compete for parental attention and care.

Dan:  Big firms then have collections of pleasers and demanding partners.  What does that do to the psyche of a lawyer?

Will:  A law firm takes all these pleasers, herds all these kids who have always gotten A’s, and concentrates them in one giant feeding lot.  So you have an entire law firm stocked with pleasers, and no one to please!  There are no more teachers.  The partners are the closest thing to a parent-object, and they’re overgrown pleasers themselves.   It ends up with everyone competing with everyone else and everyone feeling like they’re failing.  Throwing people under the bus is not a management technique except in a law firm.   Anyone who’s ever worked in big law firms will tell you that folks get thrown under the bus every day at those places.  It’s the antithesis of good management.   That’s because they’re all competing – no one is stepping back and getting pleased, and saying – hey, you’re doing a terrific job!  Good management is a requirement for happiness at a workplace.  Everyone seems to realize that but lawyers.  Employees need to feel supported, appreciated and motivated.  They’ll do better work if they believe they’re good at what they do.  Employees need to feel like they want to come in everyday because they like their workplace.  Every time you walk in, you need to feel like Yeah, I know everybody here, my boss knows me, he respects me, he thanks me for my work.  A good manager understands this – it isn’t rocket science.  A fundamental management principle is that a review process needs to be supportive.  There should be about 90% praise, and the constructive suggestions should be just that – constructive and suggestions.  You don’t get anything remotely resembling that in a law firm because everyone is busy instinctively competing with each other like little baby animals trying to kill off the other baby animals as though they might die if someone else succeeds.  Management technique, at a big law firm, amounts to throwing someone else under a bus, and thinking you feel better afterwards – like, somehow you’re now in a safer position.  It’s madness.

Dan:  Please tell us about your two books.

Will:  My first book, Life is a Brief Opportunity for Joy, actually started out as notes for  young therapists.  I was doing training for volunteer counselors at a hospital and I kept repeating the same things over and over to them, explaining anxiety and depression.  So I started with these notes and realized there was a book there that I could use with my clients.  That’s one way to look at therapy – as educating your clients – training them, really, to be therapists themselves, to the extent that they gain an understanding of emotions and how they work.

The first part of the book is about gaining awareness and understanding how anxiety and depression work. The second part tackles applying that knowledge to your life as you live it.

It’s interesting, how I came up with the title.  I wrote this phrase, somewhere around the middle of the book – “Life is a brief opportunity for joy.”  It was a literary agent, later on, who read the book and spotted it and said, that’s your title Will.  It seemed to sum up the entire book.  Let’s face it:  We are all heading to the same place – oblivion – a hole in the ground.  It’s a brief trip and it goes by quickly. Our mission is to be joyous. Life is a gift – it really is.

Many many lawyers make themselves incredibly unhappy. I think sometimes it’s as if they’re determined to make themselves miserable.  And depression is, at its heart, a self- punitive behavior.  You are doing this to yourself.  You are beating yourself up. You are being a bad parent to your inner child, by abandoning him to panic and attack himself for failing to please.

Dan:  So when someone struggles with depression as an adult, they’re basically repeating the maladaptive patterns they learned in childhood – – but this time they’re doing it to themselves.

Will:  Pretty much.  You’re not pleasing others, so you blame yourself for that failure.  You place the fault within and dismantle your self-esteem.  That’s what I did.  Instead of saying to myself maybe I don’t belong here, I kidded myself I did belong there.  The truth is, I never belonged in the legal profession.  I went because of the money and to try to please my mother in some misguided way.  I was a writer and a young therapist, at heart.   I would have become a therapist if my parents had done a better job handling my coming out as a gay man.  I  would have gone into mental health right away because I was fascinated by it.  But my parents hated that I was gay and sent me to a psychiatrist to be “cured.”  That scared me away from mental health, and in the end, I wanted to make my parents happy and provide them all the money and the status to compensate for being gay.  I didn’t even understand what law was. I just went into it blindly thinking well, okay, status and money.

Dan:  Now, tell us about the second book and why you wrote it?

Will:  Well, the second book has a silly title, Way Worse than Being a Dentist: The Lawyer’s Quest for Meaning.  I have a literary agent friend who always seems to come up with my titles and she came up with this one, too.  We were kidding over coffee and I said, well basically  if you’re not smart enough to get into medical school, you have two choices.  You can aim a little lower and go to dental school or you can become a lawyer.  Weirdly enough, I’ve had people write me who read the book and said,“You know, I went into dentistry and I am glad I did.”  Or, “I went law and damn I should have gone into dentistry.

So that was the idea – you should have been a dentist.  There are people who bash dentists and talk about their high rate of suicide or depression.  In actuality, I think that’s a myth.  The dentists I know are fascinated by it and doing a lot of good for people.  I have a bunch of dentist friends.

But anyway, I came up with this silly title and the book was based on a bunch of columns I wrote for Above the Law, along with additional materials that were either too personal or too honest or too long or too – something – to get included in the originally published columns.  Every time I wrote a column, I thought of more I wanted to say and I realized I was starting to exorcise my own demons from that very traumatic experience of trying to be a lawyer years before. I dedicated the book to the partners of Sullivan and Cromwell, just for a laugh.  The back photo, if you really look at it, is my firm’s facebook photo from my very first day at Sullivan. They took my photo in a suit and tie – I was terrified, but trying to look confident and successful.

Dan:  Give us just a few thoughts or ideas about how lawyers can recover from depression.

Will:  First of all:  Remember who you are.  I had a friend at the firm, years ago, a brilliant guy. He went to Yale Law School and then onto Sullivan and Cromwell.  I remember him looking at me one day as if he were saying the most forbidden thing he could ever admit: “Will I just don’t think I’m very good at this.”  And I remember thinking, God, that’s how I feel.  This guy was so accomplished and I thought, My God, they have really torn him down. He has forgotten who he is. I told him “Look at your record. You were a Yale undergrad and then Yale Law” and on and on; top of his class in everything and I said “How did they do this to you?”

How do you remember who you are?  There are a couple of things that can help to snap you out of depressive thinking.

One, remember that you are not always right, but you are not always wrong either.  It might not be your fault when things don’t go right at work.  Depressed people tend to put the entire fault on themselves.  Everything is their fault, they failed and they feel they have no right to anger. I always tell my clients “Look, you have the right to have anger, even if you’re just angry that it’s raining outside.  Get angry about something.”  It’s about dignity.  The inherent dignity of being an adult and possessing a right to your own opinion, a right to your anger.

A child doesn’t really get angry.  He gets scared and terrified.  But an adult can say, hey, maybe this isn’t the right environment for me.  I remember someone at Sullivan & Cromwell, at some point, very sadistically telling me, “Maybe you’re not cut out for this place.” At the time I was desperate. I went to my office and wept because I had to be cut out for it. I had to succeed.  Then I realized maybe I am not cut out for this.   And I remember laughing and then I thought Oh my God, there is a way out. I don’t have to please.  I can please myself.  I can remember who I actually am.

I pose this question all the time to my lawyer clients:  Who are you really, inside?  They say “Well, come to think of it, I was an English major, I loved reading, I loved computer games and I always wanted to go bicycling,” or whatever.   It starts to come back and they remember who they are “You know, I love to bake cupcakes and I love to go hiking. I’m mad about punk music from the 70’s.”  Whatever floats their boat – their very individual, quirky, personal boat.  And then a person starts to come back to who they really are, to their true self.  That’s the beginning of the end of depression – simply remembering who you are, giving yourself the dignity to be you – not trying to care for yourself by pleasing others, but doing it directly – by caring for yourself, in the way you need to be cared for, the way the child inside you – who celebrates life and drinks deep of joy – needs to be cared for.  That’s how you beat depression.

 

 

When Working Out Doesn’t Always, Well, Work Out

I had a tough spell of moderate depression that started two weeks ago and just ended recently.

I had little energy. I was glued to my seat.  Before this, I had been exercising religiously three times per week.  I noticed that exercise had a wonderful cumulative effect on my mood that carried over from day-to-day as long as I kept at it.  I actually looked forward to going to the gym.

But then, something happened.  I got a horrible head cold. I couldn’t work out.  As I laid on the couch, I felt myself sinking.  I was cranky. More followed.

image0I got a call a few weeks ago from folks that wanted to write an article about my parents and I.  They had found me by reading a blog I had written, Our Parents, Our Depression.”  They interviewed me then asked if I would rummage through some old pictures of my parents.  I dug around in some boxes. I found an old black and white of my parents. Probably when they were in their early fifties.  It brought me down.  They had depression also. Though I didn’t know that as a child. And they probably didn’t think of it that way.  But they clearly had all the symptoms.

This whole thing brought up a lot of sadness. Some of it because of the unhappy lives they led – much of it punctured by episodes of depression, drinking, and violence.  I feel connected to them still years after their deaths. I thought about how powerful the link, genetic, emotional and psychological, is between where we come from and where we find ourselves now.  Given this history, I sometimes feel like my depression is insurmountable.  Why even try? I think. It’s just going to come back away.

So, back to working out.  I just couldn’t get going.  Just thinking of the 10-minute drive from Starbucks made me weary. I drank more coffee to get a boost, but it had no effect.

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I started feeling a bit better yesterday. I still didn’t want to go to the gym but had enough energy to push through my resistance.  I got to the gym parking lot. My legs felt heavy as walked to my workout.  I got through 20 minutes on the elliptical and pumped weights.  I felt great the rest of the day and today the depression is gone.  I feel back to my old self.  While exercise and movement aren’t a panacea, it is one powerful tool to coping with this onerous illness.

This experience taught me something: exercise isn’t just something that healthy for someone like me who has depression.  It’s essential.  It has powerful effects on the brain that are difficult to achieve with therapy and/or medication. In fact, for mild to moderate levels of depression, studies show that exercise is just as effective as the meds.  As it turns out, exercise actually boosts the positive effects of antidepressants.

So build up a regular workout regimen.  There will be times that you’ll fall off the wagon. You’ll find that working out just doesn’t isn’t working out when you’re blue.

But get back on the wagon. And get your heart and spirit pumping again.

Check out the excellent book, Spark: The Revolutionary New Science of Exercise and the Brain for a wonderful explanation of what goes on in the brain during a depression and how exercise counteracts it.

Copyright, 2016 by Daniel T. Lukasik

The Connection between Depression and Trauma and Neglect

Why do people become depressed? A popular theory is that it is the brain chemistry that is in disarray. But this way of thinking often obscures the issue.

Depression rarely comes out of nowhere. It almost always has an explanation, even if it is not apparent to us. Also, read “What is Your Depression Telling You?”

A better explanation for why many people become depressed is, in my opinion, that we develop vulnerabilities earlier on in our life that predispose us to live a life that is lacking in zest, enjoyment, and meaning.

Oftentimes these earlier vulnerabilities point us to experiences of trauma, neglect, or interpersonal disappointments that may or may not be fully apparent to us.

We almost all undergo some kind of trauma, neglect, or serious interpersonal disappointments at some point in our life, and how we deal with these events can prepare the ground for a later depressive episode. To understand why this is is to understand how humans function.

 Responding to Trauma by Losing Ourselves:

When we go through difficult events that we don’t know how to deal with, our psyche responds just like a lizard that loses its tail because it is afraid of a predator. It helps us make an adaptation out of fear, but always at the cost of making us a little less human, or little less ourselves.

Overwhelming shame, for example, might make us abandon a piece of who we are, or in the worst case, our entire person.

How Sexual Abuse Can Lead to Depression:

If I was sexually abused, for example, and didn’t know how to deal with my conflicted emotions and loyalties, it might make me feel bad about wanting and desiring. I might be confused about whether I myself sent out the wrong signals, and might question if the sensation of pleasure I felt, really meant that I desired the abuse, or that my desires are bad.

The psychological compromise I can make to rid myself of my shame is to begin to live a passive life where my awareness of my desires and wants is dimmed, or totally banished. This might mean that I get involved in relationships that are not particularly good for me, that I put up with mistreatment or one-sided relationships because I am reluctant to say “no”, or that I unconsciously seek out bad relationships because I at some level believe I should not get what I really want, or deserve to be punished in some way to atone for my badness.

This compromise I have made to deal with the unbearable experience of sexual abuse has now prepared me for life of lackluster results and lack of enjoyment.

If I become depressed, this is therefore not because there is something wrong with my brain. It is because some part of me doesn’t want the life that I have. My depression is like the last call to me deep from within that indicates that I need to make changes to my life situation because the status quo is antithetical to life. My adaptations to a difficult situation, have now become destructive to what life is really about. Life has turned against life, and my depression is thankfully alerting me to this fact.

Trauma Comes in Many Forms:

Trauma does not have to imply a big dramatic calamitous event, but can refer to any moment when we felt overwhelmed with painful or distressing emotions we did not get the help to deal with. Sexual abuse, physical violence, or growing up with alcoholic parents are some of the more apparent reasons why a person might get exposed to emotional overwhelm, but there are many others.

gifted

One of the more frequent causes of adaptations out of fear is the fear of losing love from the people we depend on. In Alice Miller’s book “The Gifted Child”, she describes how this can happen due to growing up with narcissistic parents.

A child, she says, has the need to look into their parent’s eyes and see themselves reflected. If I cry, I need my parent to validate that I am feeling sad, and if I am happy, I need my parents to be happy for me. Unfortunately, some of us look into our parents eyes, and see our parents feelings, not our own. When we are sad, they feel inadequate and get annoyed with us. When we are excited, they are too busy watching TV, and tell us to shush.

These kinds of experiences when they accumulate over time can create serious distortions to our self-image, and can make us abandon ourselves in a pursuit to become more acceptable to our parents.

Research has shown that threats to our sense of safe connection with a caregiver register in our brain as panic, and that losing our connection completely registers as pain. To avoid feeling these unbearable emotions, we will do a lot, even if it means ridding ourselves of our natural spontaneous desires and feelings.

Other ways to deal with the threat of loss is to become numb, or to become what the psychiatrist Karl Jaspers has described as a “dead person with wakeful eyes”.

What Does Depression Have to Do with It?

When we pay too big of a price to stay safe early on in life, we enter into adulthood ill prepared to deal with life’s challenges.

If we have gotten used to numbing ourselves to unpleasant emotions, we will likely also find it difficult to feel joy and excitement.

If we have learned to live our life in an effort to please our parents, our accomplishments won’t really mean much to us, and we will pursue goals that are not aligned with what we really want.

If we had to abandon ourselves because of shame about our needs or our feelings, we will forever have a sense of emptiness inside because we aren’t fully honoring and accepting who we are.

In many cases, when we really look at the reasons why people become depressed, we find a childhood history of trauma, abandonment, or neglect that has resulted in adaptations that are currently getting in the way of living a meaningful life.

Depression is often simply telling us that we are not really living our lives as ourselves.

To resolve this situation is to confront the underlying reasons why we make the choices we do, and to see to what extent we are really living a life based on avoiding shame, anxiety, guilt, and pain, and not a life based on our genuine feelings, needs, and aspirations.

Rune Moelbak, Ph.D., is a psychologist and depression specialist in Houston, Texas. He is the owner of Better Therapy, a therapy practice for people who want to discover the underlying roots of their current psychological problems.

 

 

One Woman Lawyer’s Journey Through Depression

Acknowledging my depression for the first time during my third year of law school was as terrifying a realization as it was liberating.  Between finishing up final classes, getting ready for the bar exam, and preparing for the first semester of my LL.M degree program, I fought every day to simply get out of my own way, and I fought even harder to hide it.  I would wake up in the morning in tears, yet by the afternoon I was at school, going through the motions, and relieved to just make it to the end of the day.

This contradiction of being in law school and living with depression was an unbearable secret.  At my core, I was beyond ashamed and embarrassed. I would beat myself up over and over again with the same though: how did I mange get myself to law school only to end up feeling this way?  I was so lost, and I was experiencing a pain that was as indescribable and unfamiliar as it was pervasive and present.   I convinced myself this that feeling this way was the price I had to pay to become a lawyer, to live up to this expectation I had created about myself.  So just get through it, I told myself.   This is the way it’s to be done.  Suck it up.  Survive.

In the months to come, however, my depression worsened.  Despite having passed the bar exam, started course work toward my LL.M degree, and a relationship with a man who said he cared for me, I crashed.  I spent entire days in bed, with no one to the wiser.  I stopped answering my phone and emails, and I wasn’t going to classes.  Getting out of bed felt like stepping off the edge of a cliff.  Life having any sense of forward momentum and progress was something that seemed to happening for other people, and I was left struggling, trying to figure out how to keep up.

Something inside me managed to articulate clearly and loudly that something was wrong with me that went beyond telling myself to suck it up.  One morning, moved by forces that to this day are still a mystery to me, I found my way to the university’s student counseling services.  A social worker took me in a back room for an intake interview.  Directly and clearly, I was honest for the first time about what was happening to me.  The next thing I knew I had a calendar filled with multiple weekly appointments with a psychiatrist who immediately put me on an anti-depressant and talk therapy.

Believe me when I say that those talk therapy sessions in the student counseling center changed my life.  My therapist saw through me with kindness and compassion in a way I didn’t think was possible for another person to do, and she understood the how and why of what was happening to me.  She helped me put words to emotions and thoughts that existed only in my head.  I learned that I could say I was dealing with depression, and that with work it was something I could learn to manage.

But my therapist also told me this was only the beginning for me with understanding and successfully managing my depression.  She said we had only scratched the surface. Her words were profound and prescient.  As my experience with law evolved from getting through the competitive and pressure filled environment of  law school to the demands of practice, so did my experience with depression and its affect on my ability to know and to listen to love myself.  For a while, I felt good, and depression felt like memory.  I found I was more comfortable with and better at being a working lawyer than I was a law student.  Practice requires you to touch more upon your true nature more, I think, than law school.  There was less posturing and more action, and I am more suited for that reality.  I still, however, had a lot to learn about asserting myself and holding my own in intense environments.   As the red flags of my depressive behaviors and thoughts would pop up, I realized that no matter what anti-depressant I was on, or what words of wisdom I tried desperately to recall from a therapy session, I was still out of sync with myself emotionally and my surroundings.  This was a powerful insight, but I still could not in the moment handle the stresses I experienced on a daily basis successfully or in a way that felt true to myself.  Sexism, cutthroat competitive colleagues, long hours, bitter partners who saw heaping insult upon you as affective training and as lawyerly karmic right.  The romantic ideal of the practice of law as noble and worthwhile was elusive and false.  The reality was all too much.

Even as I become more successful in advancing my career, obtaining a Federal clerkship and a Big Law job, my depression didn’t dissipate and disappear, as I had naively hoped it would (because as all lawyers know, the right job and status fix things, right?).  Instead, its presence became more insidious, because when I felt it, I immediately knew it meant that something was dreadfully wrong, and the fear of where it could take me became all-consuming.  The energy it took for me to hold my own with colleagues and clients and still at the end of the day deliver good work took over, and any healthy sense of self-care I had learned when I first acknowledged depression in my life was pushed aside.  I now felt like a failure at the most fundamental level because I couldn’t control my depression.  Even as my experiences with depressive tendencies became more insightful and clearer to me in their meaning, I was still at a loss as to what to do, and I brutally beat myself up for not being able to fix it.

After completion of a project I was on in 2009, I left my job, and I left life as a working lawyer.  And again, I crashed.  For a time, I swung too far in the other direction, internalizing depression to the point where it became my identity.  I didn’t know where depression ended and my sense of self began, and concluded that the entirety of my life would be determined by its presence.  Therapy and medication again were options, but this time, I knew in my gut what I needed was beyond the relief they would provide.

Only with time and by stepping back from thinking of myself as both a lawyer and as someone with depression have I have learned that ultimately I am neither one of those things.  I have learned that when I fight and ignore my intuition is when I get into trouble.  That is what depression at its worst takes from me.  It takes away my voice.  When outside noise and pressure and people are too loud, and are in turn amplified in my mind by my depressive thinking, I, in the most glorious sense of the word, am gone.  The “I” whose evidence of worth is proved by mere existence; the “I” that only has to live and breathe to be worthy, is nothing to me.  All I can see is worry and striving and other people’s judgments, and my own judgments, and angst and pain.

I don’t know that I will work in law again, but I entertain the thought now and then.  This thought isn’t without a realistic notion of what it will take to get back into the profession, so, equally, I honor the thought that I may never find a fit for myself in law.  I’ve also accepted depression in my life as a siren meant to warn me I’m headed for trouble. This clarity isn’t without fear.  I’ve had hard times since I left my last job as a lawyer, but I can honestly say that what I’ve learned about myself and life since has so far been worth it all.

By Anonymous

 

One Trial Lawyer’s Journey From Severe Depression to Greater Fulfillment

I do not consider myself a lawyer. I am a human being who took on the role and career of a lawyer for 25 years. Unlike some people who entered law school with a burning passion to practice law, I ended up there because I was confused about my career direction and had no career counseling. Stop here. If you don’t feel excitement and joy when thinking about a career my hindsight advice is don’t enter it!

After a couple of years in NYC working for a small firm I quit because I hated following orders due to my anti-authoritarian streak dating back to early childhood. When I left for California I passed the CA bar exam, worked briefly for a solo practitioner, and then opened up my own solo practice. During my first few years I took whatever I could get including cases involving wrongful employment termination, wrongful eviction, workers compensation, and personal injury. I gradually steered my practice completely into plaintiff’s personal injury because I come from a family of physicians and I was truly fascinated by the medical aspects of these cases.

After I while I became rather successful as a lawyer, especially because I had a nose for what made a good case, I enjoyed investigating the facts, I cared about my clients (most of them anyway), and I frequently knew more about the medical/psychological aspects of the client’s injury than the defense. My Achilles heel was my biological tendency toward anxiety and depression which, to my mind, are two sides of the same coin.

Although I got excellent results in my cases I was plagued by fears of failure and so I worked myself to the bone when it came to preparing for depositions, hearings, and trials or opposing motions to compel discovery or obtain summary judgment. Although I was never sued by a client in 25 years I always worried that the innately disgruntled ones who complained about everything in their lives might sue me. So I worked extra hard to make sure their cases turned out well. To put in all these hours I gave up on exercise, sat more, and ate unhealthy, high salt, high sugar foods to give me some compensatory pleasure. Stop. If you are doing these things you will damage your physical and mental health. Our bodies crave outdoor exercise in the fresh air and they crave real food, not the processed crap made in factories.

At the beginning of the 1990s I took on some new challenges. I moved to a larger, more expensive office. I became a homeowner. And, my wife became pregnant with our first child. In the mid-1990s, I developed a bridge phobia, a phobia involving the fear I would fall out of the window of a tall office building, and panicky dread over crime in our neighborhood which seemed to be getting worse every day. To help myself through these irrational fears I became a good friend of Jack Daniels. This nearly led my wife to divorce me. The threat of divorce woke me up like a cold shower. I went to see a psychiatrist who put me on Zoloft and I stopped drinking. Things got better. We had a second child, a son. In the coming years I became a very good father. I adore my kids. They adore me. Both kids are flourishing. This is something I am very proud of.

In the decade between 1995-2005 I handled an increasing number of cases involving traumatic brain injury and made significant income. Initially these cases were very exciting. Over time they became a drag. Why? The defense, which had paid up relatively quickly in the early days, now used scorched earth tactics by hiring experts in human factors, biomechanics, neurology, psychiatry, neuropsychiatry, neuroradiology, etc. I had to hire counter experts in each field and I had to pay to depose every over-priced, hostile defense expert who gave me all their specious reasons why each client was a neurotic, a hysteric or a malingerer.

I felt like Sisyphus, the man condemned by the gods to roll a boulder up a steep hill every day. The litigation costs drained my coffers to the point where I was late on my rent, my copier machine rental, my records fees, and witness fees every month. In the midst of these depressing circumstances my mother suddenly died of a brain virus. And then, one day, my wife noticed we were completely out of money and our home equity lines were maxed out. I instantly plunged into what my psychiatrist called a psychotic depression in which I heard a voice from within me tell me to die over and over again, relentlessly 24/7 until after 4 days of it, I went to a hospital emergency room.

The psychiatrists who cared for me in the hospital told me I had snapped as a result of an inborn vulnerability to depression, years of stress from legal practice, and the trauma of my mother’s death and insolvency. They told me never to return to legal practice. My past 8 years have been a journey back from severe depression and into a new, more fulfilling life. Thanks to a private, own-occupation disability policy I was able to pay my family’s living expenses while recovering.

upward-spiral

I researched and wrote my book for lawyers, The Upward Spiral: Getting Lawyers from Daily Misery to Lifetime Wellbeing, on stress and depression while studying and practicing Buddhist meditation. I became ordained as an interfaith chaplain and sat with dying patients at a local hospital. More recently I entered an MS program in mental health counseling at Capella University. I anticipate becoming a Licensed Professional Clinical Counselor at the beginning of 2017. I am finding my studies, practicums, and internships in mental health graduate school to be very meaningful and fulfilling.

Law is a very stressful profession which produces severe depression in one out of every five lawyers. What is my message to my colleagues in the law who suffer depression?

First, face the depression. Do not deny it and self-medicate it with unhealthy substance or behavioral addictions.

Second, try medication. For a depression with obsessive, suicidal rumination (like mine) it can be life-saving.

Third, see a therapist (a psychologist, MFT, counselor or social worker) so you can explore and understand the bio-psychosocial roots of your depression and choose the best form of therapy to resolve your depression.

Fourth, consider couples counseling or family therapy so your spouse and children can understand your depression and have an opportunity to educate you as to how it is affecting them. This can lead to improved understanding, communication, and cooperation at home within the family system.

Fifth, consult experts in nutrition, exercise, and sleep to develop ways for you to eat healthier, exercise more, and sleep better. A wonderful book on these topics is Go Wild by Dr. John Ratey.

Sixth, spend more time in nature because there is nothing better to quiet the mind, ease the sore psyche or restore the spirit.

Seventh, take time to actualize your potential as a unique self through whatever activity calls to you, be it photography, calligraphy, water color painting, baking, cooking, etc.

Good luck. I know you can beat depression and be happier.

Harvey Hyman, J.D. spent 25 successful yet stressful years practicing personal injury law in New York and California.  Thanks to an episode of severe depression in 2007, he found happiness and joy that had always eluded him.

 

No Longer Wanting to Die

From The New York Times, a powerful piece by Will Lippincott who writes, “When depressed, the self-esteem I presented to the world belied just how out of control I felt inside.”  Read the News

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