One Therapist’s Take on Lawyer Addiction & Mental Health

This is a guest blog by Nicole Roder, LCSW-C, a bilingual DBT therapist in Bethesda, MD, certified by the DBT-Linehan Board of Certification. She is intensively trained in DBT, DBT prolonged exposure for PTSD, DBT for parents, couples, and families, and DBT for substance use disorders. In her practice, she treats adults and adolescents with BPD, PTSD, DMDD, SUD, and related disorders.

As a therapist who treats addictions, I have seen many people who use alcohol to cope with high-stress jobs. I have also seen people suffer terrible losses when that coping mechanism becomes an addiction. Fortunately, there are well-researched treatments that can help attorneys overcome addiction. Let’s take a look at the data on addiction among lawyers, the consequences of addiction, and some resources that might help overcome the problem.

Leading a Mindful Life in the Law: An Interview with Lawyer and Meditation Teacher, Courtney Schulnick

This podcast features my interview with Courtney Schulnick, Esq., a lawyer and certified mindfulness educator. She is Special Counsel at the law firm of Marshall Dennehey in Philadelphia, defending individuals and businesses in casualty matters in the local, state, and federal courts.  She holds a law degree from the Rutgers School of Law and earned her undergraduate degree at the University of Pennsylvania.

The stress and anxiety she experienced led to her enrollment in the Mindfulness-Based Stress Reduction (MBSR) Program at the Myrna Brind Center for Mindfulness at Thomas Jefferson University in Philadephia. Now a certified trainer, Courtney gives presentations at law firms, law schools, and other organizations. You can learn more about her and her services on her website.

Courtney weaves together the practice of mindfulness into her daily life as a lawyer, wife, and mother of three young boys. All lawyers seek greater work/life balance, and mindfulness is a path toward that goal. Sincere, kind, and insightful, everyone who listens to Courtney will be encouraged to integrate mindfulness into their lives.

Can Creativity Help You Heal Depression? An Interview with Psychiatrist, Dr. Carrie Barron

Dr. Carrie Barron is a board-certified psychiatrist on the Columbia College of Physicians an Surgeons clinical faculty who also has a private practice in New York City.  She has published in peer-reviewed journals, won several academic awards, and presented original works related to creativity and self-expression at national meetings of the American Psychoanalytic Association. Along with her husband, Alton Barron, M.D., a hand and shoulder surgeon, she co-authored the book The Creativity Cure: How to Build Happiness with Your Own Two Hands.

Dan:

Why is depression such a problem in our culture?

Carrie:

I think the stress level has increased enormously because we have so much to do, and we’re on twenty-four hours a day. So I think because of technology, which offers us so many great things but gives us much to do. I think that’s part of it. I also believe, especially for children, we’re in a striving, ambitious,  productive time mentality – for children and adults. We need to play, we need to hang out, we need to have spontaneous time. I think spontaneous thought does a lot for alleviating depression and anxiety.

Dan:

We have so many different words in our culture for unpleasant experiences. We might say things like, “I’m sad,” “I’m burnt-out,” “I’m stressed out,” or “I’m depressed.”  But what is the difference in your mind, as a clinician, between sadness, say, and depression?

Depression as a Loss of Heart

This article was written by John Welwood, an American clinical psychologist, psychotherapist, teacher, and author, known for integrating psychological and spiritual concepts. He died in 2019. He wrote eight books, including Challenge of the Heart (1985), Journey of the Heart (1990), and Love and Awakening (1996). Trained in existential psychology, Welwood earned a Ph.D. in clinical psychology from the University of Chicago.

Depression is one of the most common problems in modern society. It appears in chronic low-grade forms that can drain a person’s energy and in more acute forms that can be completely debilitating. Our materialistic culture breeds depression by promoting distorted and unattainable goals for human life. And our commonly held psychological theories make it hard for people to make direct contact with depression as a living experience, by framing it as an objective “mental disorder” to be quickly eliminated. The current treatments of choice — drugs, cognitive restructuring, or behavioral retraining — are primarily technical, and often keep depression at arm’s length. However, in order to help people with depression, we must see how they create and maintain this state of mind in their moment-to-moment experience. This will help us understand depression not merely as an affliction, but as an opportunity to relate to one’s life situation more honestly and directly.

Treating Lawyers with Depression: One Psychologist’s Top 10 Tips

 

Here is an interview I did with Dr. Tyger Latham, a clinical psychologist and psychoanalyst in Washington, D.C. and the Commonwealth of Virginia. He received his Ph.D. George Washington University.

What is depression?

Depression is a mental health disorder that affects roughly 10 to 15 percent of the general population. According to the DSM, the manual used by psychiatrists and psychologists to diagnose depression, a person is diagnosed with depression if she/he experiences depressed mood, along with several other related symptoms, for a minimum of 2 weeks. Some of these other symptoms include: disrupted sleep; diminished energy; changes in appetite or weight; difficulties with concentration; restlessness or lethargy; feelings of guilt, worthless, and helplessness; and, in extreme cases, thoughts of death or suicide. This is the medical definition of depression. However, this definition fails to capture the experience of what it’s like to be depressed. I think Paul Simon has described depression best when he wrote: “Hiding in my room, safe within my womb, I touch no one and no one touches me. I am a rock, I am an island. And a rock feels no pain; and an island never cries.”

Have you treated many law students, lawyers and judges for it?

At any one time, I would say about a third of my practice is comprised of lawyers or law students, of which a large majority suffer from depression or some related mood disorder such as persistent depressive disorder or bipolar disorder.

Can you tell us what kind of issues concerning depression lawyers come to you for? (E.g. problems on job, marital)

As with all of my clients, I find that lawyers come to therapy for a myriad of reasons, including depression. In the case of lawyers, however, the practice of law often serves as a backdrop for their presenting concerns. I have yet to work with an attorney whose work was not adversely affected by their depression. In fact, many lawyers who are diagnosed with depression only become aware of it after it begins to affect their productivity. These lawyers might complain of being unable to concentrate; feeling indifferent or apathetic about their work; withdrawing from colleagues; or, in some cases, they talk with me about feeling burned-out or they might share fantasies of leaving the practice of law altogether. All of these symptoms can be associated with depression and when taken together they build a strong case for clinical depression.

Attorneys will often employ a number of coping strategies – some adaptive, others not-so-adaptive – to deal with their depression. Most attorneys are accustom to working long hours, so I often see many attorneys with depression pour themselves into their work as a way to escape. I’ve also worked with a number of attorneys who have resorted to alcohol and drugs as a way of managing their symptoms. While I wouldn’t say all attorneys who are depressed abuse alcohol and drugs, the majority of attorneys who abuse alcohol and drugs almost always suffer from some form of a mood disorder like depression, bipolar, or anxiety.

Perfectionism in the Legal Profession & Its Relationship to Lawyer and Law Student Mental Health: An Interview with Jordana Confino

With a J.D. from Yale Law School, a B.A. in Psychology from Yale University, Certifications in Coaching and Applied Positive Psychology, two federal judicial clerkships, and a former Adjunct Law Professor of the Year award at Fordham, Jordana Confino understands the unique stressors and demands of the legal profession. And as a recovering perfectionist and overachiever, she is excruciatingly familiar with the limiting beliefs that prevent people from reaching their highest potential. Jordana transformed her own life by leveraging the science of positive psychology and human motivation theory, and she has seen these techniques work time and time again in the lives of her clients and students.

Nothing lights Jordana up more than helping overachievers get out of their own way so they can soar higher than they’ve ever imagined possible. Jordana is a certified professional coach, speaker, and advisor. She is valued for her expertise in positive psychology and well-being and unparalleled ability to connect with and inspire everyone she meets. Seven years after graduating from Yale Law School, she founded JC Coaching & Consulting to empower lawyers and other high-achieving professionals to transform their lives and work for the better.

Unpacking Depression: An Interview with Psychologist Dr. Margaret Wehrenberg

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.

The Twin Pillars of Depression

“Once you choose hope, anything is possible.” – Christopher Reeve

There are two pillars upon which depression rests.

Helplessness

When in the grip of depression, we feel helpless despite our efforts to pull out. The more we struggle, the more exhausted we become. In her book Eat, Pray, Love, Elizabeth Gilbert writes, “They flank me – Depression on my left, loneliness on my right. They don’t need to show their badges. I know these guys very well . . . then they frisk me. They empty my pockets of any joy I had been carrying there.”

Hopelessness

Helplessness often leads to profound hopelessness about the future. In her book Prozac Nation, Elizabeth Wurtzel writes, “That’s the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious and compounds daily that it’s impossible to ever see the end.”

What I have learned over the past twenty years of living with depression is we need to chisel away at these twin pillars. I began to discover helplessness and hopelessness are disempowering: I had no choice but to live my days under this rock of sadness. My healing involved learning that I did have options in how I related to life when depressed. And I found this power to choose empowering and life-affirming.

How did I leave helplessness and hopelessness behind?

Putting Pen to Paper: Writers on Depression

That terrible mood of depression, whether it’s any good or not, is what is known as The Artist’s Reward. Ernest Hemmingway

Others imply that they know what it is like to be depressed because they have gone through a divorce, lost a job, or broken up with someone. But these experiences carry with them feelings. Depression, instead, is flat, hollow, and unendurable. It is also tiresome. People cannot abide being around you when you are depressed. They might think that they ought to, and they might even try, but you know, and they know that you are tedious beyond belief: you are irritable and paranoid and humorless and lifeless and critical and demanding, and no reassurance is ever enough. You’re frightened, and you’re frightening, and you’re “not at all like yourself but will be soon,” but you know you won’t. Kay Redfield Jamison, Night Falls Fast

That’s the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it’s impossible to ever see the end.  Elizabeth Wurtzel, Prozac Nation: Young and Depressed in America

In depression . . . faith in deliverance, in ultimate restoration, is absent. The pain is unrelenting, and what makes the condition intolerable is the foreknowledge that no remedy will come – – not in a day, an hour, a month, or a minute . . . It is hopelessness even more than pain that crushes the soul. William Styron, Darkness Visible: A Memoir of Madness

They flank me-Depression on my left, loneliness on my right. They don’t need to show their badges. I know these guys very well. …then they frisk me. They empty my pockets of any joy I had been carrying there. Depression even confiscates my identity; but he always does that. Elizabeth Gilbert, Eat, Pray, Love

Depression is nourished by a lifetime of ungrieved and unforgiven hurts. Penelope Sweet

The Depression Journey: Walking the Rocky Trail With a Therapist

 

Diagnosed with major depression by a psychiatrist when I was forty years old, I had to find a therapist who could help me. The physical side of the illness pounded me: sleeplessness, fatigue, and the inability to concentrate and be productive at my job as a lawyer. But also the psychological dimension: feelings of low self-worth, chronic sadness, and negative thoughts about my ability to recover and be happy again.

A friend recommended me to the man who would become my therapist for the next twenty years. Jerry was a psychology professor at a local university. From the Bronx, he has a wonderful, salty sense of humor. Not only was he brilliant, but he was also warm and engaging. I felt at home, and we quickly bonded.

During this dark time in my life, I felt isolated. More often than not, I felt lonely and didn’t know anyone with depression that could understand what I was going through. Jerry did. He became my closest ally, who was with me every step of the way as I dug my way out of the dark cellar of depression. It took time. And patience that was tough to come by as I slogged through depression for years. But his strong and kind presence saw me through. He gave me insight into what depression was and the ruminative, distorted thinking that the disease would churn out. Jerry called this “crooked thinking.” I learned to recognize such thoughts as not part of who I truly was but as part of the illness. It gave me a distance from them and made it easier not to identify with them. This opened up the possibility – and hope – that I could let go of these destructive thoughts and embrace more realistic, positive ones.

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