Health Archives - Lawyers With Depression

How Stress and Anxiety Become Depression

Lawyers suffer from depression at an alarming rate. I am one of them.

I have been a litigator for more than 22 years, and I didn’t suffer depression in the beginning of my career. But I did have trouble managing the stress of my practice.

Over time, this constant stress developed into anxiety. I started feeling like I couldn’t control everything. I would go to bed fearing the problems and disasters to confront me the next morning. After years of this, the pendulum swung from states of anxiety to states of depression. Why did this happen? It took me a long time to understand.

Recently, scientists have been focusing on the connection between stress and anxiety and the role they play in triggering and maintaining depression. This is something that should be of concern to all lawyers, who carry high stress loads in their law practices.

Too Much Stress Can Lead to Anxiety

“Stress” is anything in our environment that knocks our bodies out of their homeostatic balance. Stress responses are the physiological adaptations that ultimately reestablish balance. Most of the time, our bodies do adapt, and a state of balance is restored. However, “if stress is chronic, repeated challenges may demand repeated bursts of vigilance,” warns Dr. Robert Sapolsky, an expert on stress-related illnesses and author of the best-selling book, Why Zebras Don’t Get Ulcers: An Updated Guide to Stress, Stress Related Diseases and Coping. “At some point, vigilance becomes over-generalized, leading us to conclude that we must always be on guard – even in the absence of stress. And thus the realm of anxiety is entered,” writes Sapolsky.

About 20% of the population will experience some form of anxiety disorder at least once in their lifetime. Studies show that law students and lawyers struggle with anxiety at twice that rate.

Anxiety and Depression

Stress went on too long in my life as a litigator. I had, indeed, entered the realm of anxiety. I felt like I had a coffee pot brewing 24/7 in my stomach. I became hypervigilant; each file on my desk was like a ticking time bomb about to go off. At some point, the anxiety made me dysfunctional, and I was unable to do as much as I had before. I felt ashamed of this. I denied it to myself and hid it from others, but the litigation mountain became harder and harder to climb as the anxiety persisted over a period of years.

Sapolsky writes, “If the chronic stress is insurmountable, it gives rise to helplessness. This response, like anxiety, can become generalized: A person can feel . . . at a loss, even in circumstances that [he or] she can actually master.” Helplessness is one pillar of a depressive disorder that becomes a major issue for lawyers because we think of ourselves as invulnerable superheroes who are the helpers, not the ones in need of help. Lawyers often don’t get help for their depression and feel ashamed if they do.

Many lawyers do not appreciate the connection between their stress and anxiety and their risk for developing clinical depression. But the occurrence of anxiety disorder with major depression is frequent; in fact, 60 percent of people with depression are also suffering from an anxiety disorder.

Maybe this connection helps explain studies that find such high rates of both anxiety and depression in the legal profession.

Depression “is stress that has gone on too long,” according to Dr. Richard O’Connor author of the book Undoing Perpetual Stress: The Missing Connection between Depression, Anxiety, and 21st Century Illness. Many people with depression have problems dealing with stress because they aren’t “stress resilient,” writes O’Connor. It’s not some central character flaw or weakness, but a complex interplay bewteen genetics and one’s experiences over a lifetime.

How our bodies and brains deal with stress and anxiety hasn’t changed much in the last 10,000 years. This wonderful defense mechanism, which is wired into our nervous system, is called the fight-or-flight response. When confronted with a threat – – whether real or perceived – – this response kicks in and initiates a sequence of nerve cell firing and chemicals like adrenaline, noradrenaline and cortisol that flood into our bloodstream and propel us into action to meet a threat. This was an essential survival device for our ancestors who lived in the jungle and would have to flee beasts or fight foes trying to kill them.

Lawyers don’t fact these types of real life-or-death threats. But they perceive life-or-death threats in their battles with opposing counsel while sitting in a deposition or sparring in the courtroom. Our bodies respond as if we were being chased by a hungry lion. Accordingly, the stress response can be set in motion by mere anticipation, and when humans chronically believe that a homeostatic challenge is imminent, they develop anxiety.

Over time, this chronic anxiety causes the release of too much fight-or-flight hormones. Research has shown that prolonged release of too much cortisol damages areas of the brain that have been implicated in depression: the hippocampus (involved in learning and memory) and the amygdala (a fear processing hub deep in the brain). Another area of the brain, the cingulate (an emotion-dampening center located near the front of the brain), in tandem with the amygdala, helps set the stage for depression.

Lawyers need to learn better ways to deal with stress and anxiety to avoid the multiple triggers that can cause or exacerbate clinical depression. Turning and facing those things that make us stressed and anxious, and doing something about it, gives us the best protection against depression.

Up

The cure for unhappiness is happiness, I don’t care what anyone says – Elizabeth McCraken

Most folks describe depression as a weight they carry around: dumbbells lodged in their pockets that drag them down body, mind and soul into a stinking swamp.

There’s no humor in this bayou; no levity, no sense of the sweet exuberance life can bring. Instead, there’s a collapsing inward, an inertia in which we can’t imagine . . . well . . . anything good happening to us.

We have a yearning to be free of depression; a deep desire to cut our losses and spit in its eye. It has cost us enough heartache – no more, we think. We pine for a way out of it, but sometimes don’t know the way.

But if we are to recover, we need to think about a different kind of life for ourselves. One where we take the “UP” to happiness escalator instead of the “DOWN” one to depression.

Imagining a Life without Depression

Envisioning freedom is part of the journey out of the dark woods. So often, depressives imagine a future with uninterrupted bouts of depression. This sorrow is what leads so many to a state of hopelessness. We need, with the help of wise others, to begin to imagine what our life would look like without depression and walk, step by step, that way.

I used to say to my therapist when depressed, “Why am I being punished?” It was as if I had done something “bad” and was a “bad person” (though I didn’t know and couldn’t articulate whatever that was) and now the Karmic Universe was going to dish out the punishment I thought I surely deserved.

As depression author Dorothy Rowe writes,“Depression is a prison where you are both the suffering prisoner and the cruel jailer.” Start to see, just a little bit at a time, that depression is not just happening to you. It’s an inside job too. This took me years to learn. Our thoughts and style of thinking help create and sustain depression. When we feed it with negative ruminations, it grows larger – like an algae plume. Withhold this noxious nourishment — and it can, slowly, wither away or at least become more manageable.

Happiness Skills Can Help

Before even imagine the promised land of happiness, however, we may need medication to lift the more onerous physical symptoms of depression to give us enough focus and energy. No doubt, antidepressants aren’t the only way to do this. Many have accomplished the same results with exercise, nutrition and/or psychotherapy.

In her book, The How of Happiness, Sonja Lyubomirsky, Ph.D., writes:

“Even the most the most severely depressed individuals can improve by doing a simple daily happiness-increasing exercise such as taking time to recall three things that went well each day. Although the exercises are not designed to ‘cure’ depression, if you are depressed, trying one or more of these activities affords a strong chance of lightening the burden and darkness of depression and producing positive feelings.”

We can also look back further than just what went right on a particular day to increase our sense of happiness. There is a powerful connection between how we view our past and present day happiness says Rick Nubert, Ph.D. In a study of 750 people, he found that highly extraverted people are happier with their lives because they tend to hold a positive, nostalgic view of the past and are less likely to have negative thoughts and regrets than their neurotic counterparts. Howell says that while it may be difficult to change one’s personality to being an extrovert, he found that savoring happy memories or reframing past painful experiences in a positive light could be effective ways for people to increase their life satisfaction.

Other ideas offered up by Dr. Lyubomirsky include avoiding overthinking – a big problem for lawyers: “Very happy people have the capacity – even during trying times – to absorb themselves in an engaging activity, stay busy, and have fun. To practice this strategy, pick a distracting, attention-grabbing activity that has compelled you in the past and do it when you notice yourself dwelling [on the bad stuff and your problems]”. Check out her other ideas in her blog.

You deserve to be happy. You don’t have to keep riding the down escalator. While going up to the second floor, just wink and wave at your depression as it goes down into the bargain basement.

My Desk, My Enemy: 6 Helpful Ways to Get Organized

I spend time – too much it – trying to keep my desk in check.

Like a taciturn child, it erupts with tantrums of disorganization. The fact that it’s a mess today seems unfair, as if a hole suddenly formed in the ceiling above me and dropped a cache of briefs, case opinions and half-used legal pads onto my workspace.

I shuffle the papers that lay before me. They look back at me. Ten minutes go by. I reshuffle everything all over again. Sound familiar?

Mind you, on the Clutter-o-Scale, my desk is only a 4 out of 10. If so, why the grief?

Some of my angst comes from having trouble finding things. But an equal measure comes from the sense that I should be more organized. We have made a religion out of organization in this country which has sprouted temples of crazed worship like The Container Store or Organize.com. Maybe this growth industry is in reaction to how much stuff/junk/information we like or have to obtain and perpetually reorganize. This mania has even spawned an inane reality T.V. show “Hoarders.”

Too many things compete for lawyers’ attention besides the usual culprits of returning phone calls, court appearances and last minute deadlines. When you add a messy desk to an already stressed-out life, well, it becomes the enemy.

Desks are the pedestals of our productivity. How we organize the stuff on them has a big effect on how well or if we get things done in a timely fashion. But just as important as these practical concerns is the impact it has on our mental health.

What is your Organizational Style?

According to Kelly Lynn Anders in her book The Organized Lawyer, “Not everyone prioritizes about what the eye needs to feel relaxed. Some ideas work for some and not for others. That’s why it’s important to know your type.” She identifies four types of organizers:

Stackers organize by topic in stacks. They are visual and tactile and like to give the appearance of order. The busier these people are, the more stacks they have.

Spreaders are visual like stackers, but must be able to see everything they’re working on.

Free Spirits keep very few personal belongings around the work area. They like new ideas and keep reports, books, articles and magazines near.

Pack Rats have emotional ties to things. They like the feeling of fullness around them and like to tell stories about what’s in the office.

Which type are you? She has a lot of useful suggestions, among them is color coding files. On her own desk, she keeps commonly used files close at hand. Because she identifies herself as a “stacker,” Anders avoids cabinets and other hidden spaces for her files. “The reason I don’t have a lot of hidden storage is stackers have a tendency to squirrel things away,” she said. Check out some of her other suggestions at her website.

A Contrarian Point of View

Einstein considered his cluttered desk a help rather than a hindrance to his prodigious creativity.

While we don’t have his brain’s elephantine computing power, it’s worth considering that your desk mess might not be so bad after all.

Dr. Jay Brand, a psychology professor, argues that a squeaky clean desk doesn’t always equate with a productive employee. It can actually hinder personal efficiency because a person’s desk is an extension of his/her mind. That’s because our human memory has a limited capacity, or finite ‘cells’ available for storage and since most people do multiple things at once they almost immediately ramp their working memory to capacity. They need a place to park some of the information from their working memory into the environment and what more logical place than their desks?

According to Dr. Brand, “these cluttered desks that people use to store information from their working memory are called ‘cognitive artifacts’, and they expand a person’s capacity to think and utilize the environment”. He argues that companies with clean desk policies waste time by requiring workers to clean up their cognitive artifacts every night and re-clutter them the next morning. He points out that everyone has a different working style and piles can be organized topically, chronologically, or according to an individual system. As long as the pile means something to the person who made it, it is effective.

I’ve known plenty lawyers in this group. But I ain’t one of them. Maybe it has to do with my own depression over the years. Or, as Kelly Anders suggests, it’s just my type that determines how I lay out the work space in front of me.

The Depressed Desk

When a lawyer has depression, motivation and organization are BIG problems. A lack of energy blunts motivation. We already know that it’s a good idea to keep our desk together, but there simply isn’t much neurochemical juice to get it done. But, time or a court’s scheduling order waits for no one. If we don’t keep the paperwork on the conveyor moving, we end up a casualty of our work days and add to the stress/anxiety/depression mix.

In her book Get it Done When You’re Depressed, Julie Fast writes:

“Many people equate depression with the inability to work. In reality, the problem is often the inability to feel like working. People who are depressed assume that their lack of motivation is a sign of weakness, and if they could just buck up a bit, they would be more productive. But waiting until you feel like doing something is the single biggest mistake you can make when you’re depressed and need to get things done.”

Yes, we need to start working in spite of our desire not to. Dr. John Preston, in the same book, elaborates further:

“Depressed people find it very hard to ignite this self-generated action due, in large part, to decreased metabolic functioning in the frontal lobes of their brain, which are responsible for initiating behavior. So if a person waits a long time and not only not accomplish the non-rewarding tasks but also miss out on the big projects that can bring big rewards.”

So it appears that folks who aren’t depressed and are motivated people have ramped up brain metabolism. I’m envious. Yet, there is something we can do about it. As I’ve written about before, consistent exercise helps boost the happy chemicals in our brains, jacks up metabolism and improves our motivation and focus. Moving is motivating.

We must outfox depression. It would have us do nothing. So we must do something. When I apply this simple wisdom to my day, I’m always pleasantly surprised at how my feelings catch up with my doing and how my doing affects my feelings.

My experience during bogged down moods, was that I’d get most things done, but it would take lots of energy. When I’d come home from work, I’d be spent.

Six Simple Solutions

I agree with an observation made by Leo Babauta on his blog Zen Habits: “The most important thing to remember is that you must have a system in place, and you must teach yourself to follow the system. Otherwise, you just clean your desk, and it gets messy again”.

Here are a couple of tried and true tips that have helped me:

1. Get rid of all those pens. Only keep three or four. More than that, and there’s too much ink in your work space. If you love pen, keep your stash at home. I often troll the pen aisle at Office Max — strange, but true. So I know how difficult it is to part with them.

2. Take home any books that you don’t use on a regular basis. It’s just more clutter and keeps you from easily putting your hands on the important stuff you need to do your job.

3. Hide cords – these are like a floating octopi with tenticles that seemingly go everywhere. Use twist-ties or coil your cords up.

4. Only keep on your desk what you need for that day. Then section off your desk and workspace so that everything has a specific space.

5. Have a dump day. Take everything off your desk and out of your drawer and then put it in a big pile. Then, sort through what is garbage and what you really need throughout the workday.

6. Schedule a date and time to clean your desk. Ideally, at the end of a workday. Weather permitting, do it on Friday’s around 4 so that I start my Monday fresh.

Darkness on the Edge of Town

The Eskimos had fifty-two names for snow because it was important to them: there ought to be as many for love – Margaret Atwood.

Last Sunday marked daylight savings time where we spin the clocks back one hour. While I enjoy the earlier light in the morning, there’s something about the darkness emerging earlier at the end of my day that makes me want to go to sleep earlier.

When my morning alarm clock rings, I ignore my body’s hibernatory cries for more slumber and paw my way out of bed. Jumping into my car after a shower and shave, I wheel out of my driveway and rocket to my local Starbucks to drink my daily joe.

Drinking my coffee, I look out the window. There is a distinctive pallor that comes over our world at this time of the year; the grey of the parking lot seems a lot greyer and people wandering into Starbucks this morning glummer. Folks in the northern climes with depression find this a trying time. The darkness seems to reflect a more woe-be-gone take on life.

I felt a wee bit flat as I labored under the din of fluorescent lights in my office yesterday. As I look up at these artificial bulbs, I imagined London Barristers of old working by whale oil lamps in white wigs trying to stay warm as logs burned in their stony hearths. No squinting like nowadays, but the fake lights bounce off my papers rather than illuminate them and add a shine to my bald head.

There is a form of depression, Seasonal Affective Disorder or “SAD,” which swoops down on many this time of year. It wreaks havoc with our circadian rhythms, our body’s internal clock, and knocks our sleep and brains off balance.

About 11 million people in the U.S. have a clinical form of this depression. Another 10 to 20 percent may have a mild SAD and it’s more common in ladies than gents. It’s also more likely to strike you – no surprise here – the farther north you live. Just great – I live in Buffalo, New York.

Dr. Norman Rosenthal, SAD expert and author of the excellent book Winter Blues, talks about SAD in this short video:

The specific cause of seasonal affective disorder remains unknown. It’s likely, as with many mental health conditions, that genetics, age and, perhaps most importantly, your body’s natural chemical makeup all play a role in developing the condition. A few specific factors that may come into play include:

Your biological clock (circadian rhythm). The reduced level of sunlight in fall and winter may disrupt your body’s internal clock, which lets you know when you should sleep or be awake. This disruption of your circadian rhythm may lead to feelings of depression.
Melatonin levels. The change in season can disrupt the balance of the natural hormone melatonin, which plays a role in sleep patterns and mood. Talk to your doctor to see whether taking melatonin supplements is a good option.
Serotonin levels. A drop in serotonin, a brain chemical (neurotransmitter) that affects mood, might play a role in Seasonal Affective Disorder. Reduced sunlight can cause a drop in serotonin, perhaps leading to depression.

Factors that may increase your risk of seasonal affective disorder include:

Being female. Some studies show that seasonal affective disorder is diagnosed more often in women than in men, but that men may have more severe symptoms.
Living far from the equator. Seasonal Affective Disorder appears to be more common among people who live far north or south of the equator. This may be due to decreased sunlight during the winter and the longer days of summer.
Family history. As with other types of depression, some studies have shown that people with a history of depression are more apt to have SAD.

There’s a bunch of recommended ways to deal with SAD; everything from antidepressants, fish oil supplements, light therapy and exercise. I have taken antidepressants for years, I have a cobwebbed lightbox in my basement (should use it more often) and I exercise. With the workout, I throw in 15 minutes in the sauna which raises my core temperature – I find that this helps a lot. After all, the folks in Finland know a lot about dealing with the cold.

Stay warm, lighten up and make sure that your sadness doesn’t turn into SADness.

By Daniel T. Lukasik, 2018

Nobody’s Perfect

Striving for excellence motivates you; striving for perfectionism is demoralizing — Harriet Braiker, Ph.D.

Nobody’s perfect – that’s why we have erasers. Yet nowhere on this sweet blue orb are there more people driven to perfection than attorneys.

It’s really not surprising, after all. We work with laws, rules and regulations: ancient tomes, incantations and idealizations about how our society expects folks to behave. When one acts outside the proscribed rules, one’s in violation, negligent or culpable. When this happens, people turn to a lawyer and expect him or her to get the job done – and flawlessly.

It’s easy to calm our fears with the wilted wisdom, “Well, everybody makes mistakes.” But things can and do go terribly wrong when we make mistakes – and we can and do make them. Things can go quickly awry despite our best efforts and work.

Lawyers are on edge because they feel if they’re not perfect, they’ll fall over the edge. Besides the inner stress, there is the outer pressure to keep a calm and cool façade lest our clients and colleagues lose faith in us.

I’m a perfectionist to the core. In a sense, it’s great because I take pride in my craft as a lawyer. I love the look and feel of good work well done. I can take it too far though – I can get so keyed up about churning out a masterpiece that I lose perspective; I lose sense of the possibly that the judge and his clerk might skip over seventy-five percent of my brilliant delineations of a statute’s historic origins, that the seventh draft of a motion isn’t always much better than the fourth and that there’s real value in not deliberating too much, but simply getting things done.

In a great piece in the A.B.A. Journal entitled, Three Deadly Ps: Perfectionism, Procrastination, and Paralysis, Rebecca Nerison, Ph.D. maps out why too many cracks at perfection can lead to procrastination and then paralysis, a veritable seizing up of our work motor:

Procrastination is an occupational hazard for lawyers. Procrastination robs lawyers of peace of mind. It’s difficult to feel happy, healthy, and successful when you are forever putting off what needs to be done. We procrastinate when we feel anxious about a task, when we’re bored with it, or when we’re tired. In any event, procrastination is about avoidance. Avoidance allows us to temporarily escape the fear, boredom, or fatigue we anticipate as we contemplate the task. We are immediately relieved from the unpleasant feeling. We get to feel good instead of bad.

A dilatory dodge of our work just leads to more problems down the road. We need to take stock and see perfectionism for what it is: avoidance behaviors that rob us of energy and a sense of competency that comes from getting things done. My psychologist, a wizard of the human psyche, once observed that it’s critically important to observe ourselves engaging in healthy behavior. We build a sort of healthy resume of concrete things we do on a daily basis so that we can confidently say to ourselves, “I’m a person who get things done.” Just as procrastination is a vicious circle, not procrastinating is a healthy one.

We really need to let perfection go and let our humanity seep into our daily work; a humanity that while imperfect, is full of good humor, irony and outright silliness.

When we ignore this essential truth, we press down too hard on the gas pedal and our – and our secretary’s lives – are made miserable. Anne Lamott, author of the wonderful book Plan B: Further Thoughts on Faith wrote:

Perfectionism is the voice of the oppressor, the enemy of the people. It will keep you cramped and insane your whole life and it is the main obstacle between you and a shitty first draft. I think perfectionism is based on the obsessive belief that if you run carefully enough, hitting each stepping-stone just right, you won’t have to die. The truth is that you will die anyway and that a lot of people who aren’t even looking at their feet are going to do a whole lot better than you, and have a lot more fun.

What would the opposite of perfect be? Maybe just human – and that’s humbling. When we try to be perfect, we are too locked into a view of ourselves as the center of the Universe.

We’re not gods, but in reality vulnerable creatures.

I wonder if God has a sense of humor. How could he not given this goofy planet. Even Jesus knew how to party when he turned water into wine at a wedding.

We lose perspective with depression – we forget to play. Richard O’Connor, Ph.D., once observed:

Most of us have to learn to take better care of ourselves. One way is by spending more time in play. The perfectionist, the depressive, the person who thinks he doesn’t deserve to feel pleasure, believes that he’d better never let his guard down, always busy, always productive. But it’s a joyless if all we care about is getting the work done. Something as simple as playing catch with the dog for a few minutes after work connects us with a part of ourselves we can lose only too easily – the child who can laugh, who can enjoy silliness, mindless physical activity. Tomfoolery is just as much a part of life as our lamentable laments. It’s uncomplicated, mischievous good fun that puts us into contact with our ageless inner child who wants to come out and play. He or she is there – if you just look inside. We need to open that door; we need to let some fresh air in.

William James once wrote “Common sense and a sense of humor are the same thing, moving at different speeds. A sense of humor is just common sense, dancing.”

So kick off those Oxford and Manolo Blahnik shoes . . . and start to rumba.

Three Skills for Overcoming Depression

“Courage is fear that has said its prayers.” Author, Regina Brett

The legal profession and those who shape it devote plenty of time to the practical side of being a lawyer; the nuts-and-bolts of how to do, for example, a Will and Estate. Precious little time, however, is spent on teaching lawyers how to maneuver skillfully through their lives not just as professionals, but as people.

Three years ago, when I first went public with my depression, I suggested to a Bar Association director that we put on a half-day Continuing Legal Education Seminar on Depression. She looked at me oddly — as if her face were about to crumble — and said “Who in the world is going to show up for that.” With some trepidation, I went forward expecting twenty people – over 125 showed up. Lawyers are hungry for meaning in their lives and want direction from other people in the business.

Ideally, every young lawyer should be paired with a mentor, a wise elder of the law. Lacking that, few lawyers have examples of how to deal with the profession in a healthy and meaningful manner. Is it any wonder then that lawyers suffer from depression at twice the rate of the average citizen?

We live in a profession where people endure a real pain, trauma and meaninglessness in the hope that it will get better “someday” in the indeterminate future. That someday may come sooner than later in the form of early retirement forced by burnout, unforeseen illness or some sort of divine intervention. I don’t see this as pessimistic, but as realistic. My goal is to wake lawyers up to the real costs of approaching their vocation with only nut-and-bolts in their tool chest. We are not crude machines in need of tune-ups. We are living beings in need of emotional and spiritual sustenance.

Depression is a type of half-living; we go to work, raise our children, sip lattes, do wheelies on our mountain bikes or grill steaks on the grill. But there is something vital within us always yearning just below the surface, something that seeks expression in our lives. Perhaps the situation wouldn’t be so dire for the legal profession if our time as lawyers were just okay – a manageable amount of stress, decent interactions with people and fair wages. But it isn’t okay; it’s completely out of balance: too much stress, combative interactions and wages, albeit much higher than the average American worker, that exacts a tremendous toll on our brains and bodies.

Is there any hope, any way out of this legal conundrum? I think there is because I have seen it happen in my own life, and in the lives of scores of other lawyers. For most – including me—the pain decibels have to be jacked up pretty high for us to conclude that change is better than living one’s life this way.

Carl Jung, a former protégé of Sigmund Freud, offers us a great deal of wisdom for dealing with our modern day psyche. He never preached a “top ten” ways to overcome depression, but some of his essential wisdom can be summarized for the modern reader. In dealing with melancholy, he said that there were three essential steps that we need to take – and no one else can take them for us.

In his book “Why Good People Do Bad Things,” James Hollis, a student of Jung, writes:

“To gain the positive values arising from the “landfill” we call the Shadow [i.e. to learn the painful lessons that depression is trying to teach us], we have to wrestle with Jung’s suggestion that to be a full , we have to know what we want, and do it. Knowing what we want, really, takes a lot of sorting. And living what we find, really, takes a lot of courage and endurance. In reflecting on the task of therapy, Jung once noted that it can only bring us insight. Then, he said, come the moral qualities of our character – courage to face what must be faced, and then to take the leap, and the endurance to stick it out until we arrive at the place intended for us from the beginning. So much of our lives have been lived through reflexive adaptations [unexamined emotional habits grounded in our past], so knowing what we really want is difficult, and then scary, but it feels right when we live it, as were meant to do.”

Here’s a great presentation by Dr. Hollis about finding a meaningful path in life.

Insight

Most of us are, at best, barely aware of things we do and why we do them. Many stuck in the muck of depression are doing things that actually encourage their distress without knowing they are doing so. As Richard O’Connor, Ph.D., points out, “Depressives keep doing the things they’ve always done because they don’t know how to do anything else.” They’ve become experts at “depressing.”

Insight means that we begin to see the causes of our distress and our role in perpetuating it. As Dr. O’Connor has said: “We aren’t to blame for depression, but we are responsible for getting better.” To fulfill that responsibility, we need to develop ideas of what and how to do things differently in our lives and we can only do that when we have some insight into why things are going so wrong. Absent this, we will continue to drift; to be a sort of unhappy ghost in the world.

We can become educated, in a dialogue with our therapist, about the origins of our depression and the old wounds that we will need to revisit in order to heal. It’s in the safety of a therapist’s office where we learn to stop blaming others and – perhaps a bigger problem for depressives – ourselves. Blaming ourselves is replaced by the recognition that bad things did happen to us as children that were not our fault. In fact, much of our negative thinking and painful emotions were learned and endured here. They don’t go away – we carry them into hood. Numerous studies have concluded that one of the major indicators for onset depression is trauma, neglect or abuse during childhood. Blaming others is replaced by the recognition that this just keeps us stuck and resentful.

We shouldn’t give ourselves license to remain stuck in our childhoods and abdicate our responsibility in the here and now to create a healthy life. Our responsibility is to find a way to empower ourselves so that we can get on with living a fulfilling –instead of futile—life.

Courage

Once we get insight, we need to then act on it. Jung suggests that this isn’t something a therapist can give you. It’s your job to leave that one hour session and go out into the world and experiment with your newly found knowledge. In short, you will need courage.

Too often, people achieve hard-fought insight, but then their recovery doesn’t go very far because they don’t put their wisdom into action. In my experience, action can be stressful because it involves stepping out of depression’s cave (a dark cave, yes, but also cozy in its own destructive sort of way) and risking new behaviors or feeling emotions long suppressed. We can even feel great shame – a sense of cowardice—if we don’t change because in some sense, we feel we now “know better.”

Pilot Amelia Earhart once wrote: “Courage is the price that life exacts for granting peace.” We are never at peace until we act in congruity with our inner truth.

I’ve have talked to hundreds of lawyers across the country who say that they “have to” stay a lawyer, as if it is a form of servitude that was somehow imposed on them. This seems to me a variation of depression’s theme that they are helpless. This is not to suggest and I’m unsympathetic or unrealistic about the very real impediments to change. What I am saying is that such impediments are given way too much power over our lives. They become heinous bogeymen that we’re afraid to confront. We give them so much power, that we remain stuck and depressed in our relationship to them. We think of our fears as “reality” and our dreams for a different life as flat-out .

The fact is it may not be your law job that is depressing; you may be bringing your depressive way of being into the job. It might be true that you’d be just as depressed if you were a librarian or sang in a country western band.

I am not suggesting any answers on this score. I am suggesting the living of questions to untangle this Gordian knot: Why am I choosing to remain in the job I am in? What behaviors support my depression while at work? Am I willing to take some chances, even small ones, to move my life in a different direction?

You will need courage, my friend, to act on the insights you’ve gained and not let these precious seeds die in the ground.

Sometimes music can get themes across when words aren’t enough. The other day, my ear inclined towards this powerful piece of bluesy jazz music by artist Lizz Wright. Watch this video of her belting out her song “You Can Fly”.

Endurance

Once we have got it together, it has to stay together. Episodic starts and stops just won’t do in the long run. We need to be determined for our recovery and personal growth to continue. We can get lazy or reckless about this. We just don’t want to put in the time to exercise, or think that it really doesn’t matter if we don’t go to therapy. It does my friend. I’ve learned the hard way. Everything counts.

We will all have peaks in valleys in this journey. The important part is not to stop. It took us a while to fall into depression, and it will take us a while to get out of it. By pressing on, we grow in stature because it is a courageous journey. Novelist William Faulkner once wrote: I believe that men and women will not merely endure. They will prevail. They are immortal, not because they alone among creatures have an inexhaustible voice, but because they have a soul, a spirit capable of compassion and sacrifice and endurance.”

Mindful On The Job

Work is about a search for daily meaning as well as daily bread, for recognition as well as cash, for astonishment rather than torpor; in short, for a sort of life rather than a Monday through Friday sort of dying – Studs Turkel, author

Sunday night rolls around all too quickly. The weekend, if we actually give ourselves a break from our jobs, can’t often prepare us for the frenzy of the week’s activity at the office that awaits us. If we like our jobs as lawyers – and granted there are alot of us who do – we still may feel it’s half-baked- “it still could be better” we think to ourselves.

Michael Carroll, author of the book, Awake at Work, was employed at such places as Shearson Lehman, American Express and The Walt Disney Company. More recently, he has been a consultant and coach to such companies as Starbucks and Proctor and Gamble. His comments, into what workers really want out of their jobs, is insightful to the lives of lawyers on the job:

“In my role as a business consultant, I regularly ask my clients to complete the following sentence with the first word that comes to mind:

At work, I want to be. . .

While my survey is not scientifically reliable, I can report there are some patterns to the responses. Here are the four most frequent answers:

Successful
Happy
Rewarded
Stress-free

Such responses come as no surprise. Given the demands, risks and relentless pace of our modern-day workplace, it is little wonder that most of us would like a little stress-free happiness on occasion. Rewards and success-isn’t that what we are all looking for at work?”

Who can’t relate to that take on the legal profession? Whether we are happy in our jobs or not, we all think about how we can embrace more of these intangibles while at the office.

Carroll, in addition to being in the business world for the past forty-four years, is a long-time meditator and proponent of mindfulness meditation. Here’s a great introduction to what Mindfulness is about:

You don’t have to be a Buddha sitting in a lotus garden to appreciate this fundamental and simple way of approaching your day. It’s not so much a different way of doing and accomplishing stuff; lawyers are great at that. Rather, it’s a different way of seeing at work. Moreover, seeing via a discipline of mindfulness meditation, seeks to plant our feet directly on the carpet. It’s not so much about being alert and wired to the swirling stimuli peppering us from every angle. It’s taking a time-out and leaning against the wall; it’s about letting the other half of our brain complement our eagerness to get things done.

Coming back to Michael Carroll’s survey about what people want out of their work, he opines that it’s not really success, happiness, being reward and a stress-free work-life:

“My survey indicates that most of us think we want to happy, successful, and to be stress-free at work, but we also know that such aspirations are wishful thinking. We all know work offers both success and failure; happiness and angst. We know that work, indeed all of life, unavoidably presents both rewards and penalties; joys and disappoints. So, while most of us wish to be happy and successful at work, what we really want, from my vantage point, is to be confident: confident that no matter what work offers up, we remain self-assured and at our ease.”

In my experience, truer words were never spoken. As lawyers, there is a wonderful sense we get about our craft when we achieve a certain level of competence and feel that we can handle whatever down the pike. We can acheive this sense of competence not just through the nuts and bolts of accomplishments in the courtroom, but through practice as sense of presence in our daily lives.

Explore how mindfulness meditation can help you at the office. Also, for those so inclined, check out the wonderful book, which I’ve previously raved about, The Mindfulway Through Depression. It’s not only for those with depression, but suitable for anyone who struggles with a sense of dissatisfaction and/or unhappiness at work.

A New Year to Kick the Depression habit

For last year’s words belong to last year’s language and next year’s words await another voice. And to make an end is to make a beginning – T.S. Eliot

With the New Year comes new choices; we can choose to leave behind ways of being in the world that cause and maintain our depression and embrace healthier and saner approaches to our days. Or we can simply do nothing.

Why do lawyers with depression keep repeating behaviors that prevent them from feeling good about themselves? Why do they relentlessly drive, isolate and unmercifully think of themselves as the biggest piece of crap this side of the Mississippi?

In his revised and updated book Undoing Depression: What Therapy Doesn’t Teach You and Medication Can’t Give You, Dr. Richard O’Connor offers this insight: “People persist in self-destructive behavior because they don’t know how to do anything else. I’m convinced that the major reason why people with depression stay depressed despite therapy, medication, and support from loved ones is that we are simply unable to imagine an alternative. We know how to ‘do’ depression. We are experts at it.”

Lawyers can’t envision healthier alternatives because depression shuts down their capacity to creatively imagine themselves productively engaged in the world. We simply have no reference point for that. So we stay in our offices with the doors closed looking out the window as the birds fly by and one season changes into another.

Our brains love habits — even when they stink and hurt us. It’s a more predictable way to go through life because we don’t have to rethink everything and change. We become used to depressive habits as we cruise through life on auto-pilot. Many lawyers with depression usually view their jobs as the sole source of their depression; surviving “it” becomes the focus of their lives. They use depression habits at their jobs that might work for awhile, but at a very high cost to their physical and emotional well-being. These aren’t stupid people; they just can’t imagine doing their jobs any differently. As educatior Parker Palmer once wrote about his depression, “It wasn’t so much that I was in the darkness as I became the darkness.”

Dr. O’Connor writes:

“We depressives become shaped by our disease as well; the skills that we develop with depression in a vain effort to save ourselves pain – skills like swallowing our anger, isolating ourselves, putting others first, being over-responsible – prevent our recovery. We have to give up the depressed habits that keep us down and make us vulnerable to relapse.”

Deepak Chopra wrote: “A habit is a frozen interpretation from the past that is applied to the present.” I think that’s why depression can have such a deadening sensation associated with it. In a sense, depression warps our perceptions about events happening in real time and pulls us under the frozen river of our past. People and events happening in real time trigger old interpretations of how life works. Since most people with depression come from dysfunctional or abusive childhoods, a current conflict with others becomes a ride back to their traumatic past.

For me, this distortion has often revolved around anger. I not alone on this one; how we handle anger is a big issue for most lawyers. As lawyer and psychologist Andy Benjamin wrote and studies have concluded, there is a strong connection between hostility and depression. Anger seems to be situational, while hostility is an overarching and aggressive approach to life. Anger that is repeatedly stuffed or inappropriately expressed becomes hostility. Many lawyers don’t want to be assholes, but feel they have to do so to survive in the shark tank of the law. Most lawyers I’ve known feel deeply conflicted about this and if they’ve had problems with depression, it just compounds it all.

In my childhood home, my alcoholic father had a volcanic temper – you knew to scram when you saw lava cresting at the rim. I learned that anger was painful, “bad” and always unjustified. As such, I used to avoid conflict and stuff my own anger because it was dangerous. Instead, I became a people pleaser. I developed exquisite antennae to read clients, colleagues, opposing counsel and judges’ reactions for any signs of aggression, anger or conflict. I molded my behavior to their behavior rather than living out of a core of my own reality. This distortion gave others too much power and myself too little. It is, as psychologist James Hollis once wrote, an emotional conclusion in which we tell ourselves “the world is big and I am small.” Most depressives think this way and feel overpowered by the events of their world and lapse into a state of helplessness.

As we enter a new year, let’s start leaving some depressive habits behind and embrace some new ones. This will take work on your part. No one is going to save you from your depression. While you are not to blame for your depression, you are responsible for getting better. Dr. O’Connor writes:

“Overcoming depression requires a new set of skills from us. But now we are recognizing happiness is a skill, willpower is a skill, health is a skill, successful relationships require skills, emotional intelligence is a skill. We know this because practice not only leads to improvement but also to changes in the brain. This is a much more empowering and adaptive way of understanding life than assuming that these qualities are doled out form birth in fixed quantities and that there’s nothing we can do to change our fate. The skills required to undo depression will permeate your entire life, and if you keep practicing, you can go far beyond mere recovery.”

Happy New Year!

The Remains of the Day

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“Then summer fades and passes and Fall comes. We’ll smell smoke then, and feel the unexpected sharpness, a thrill of nervousness, swift elation, a sense of sadness and departure.” – Thomas Wolfe

I felt like a tortilla a few days ago; you know, flat and doughy. There’s a realization that summer’s really gone, and that the chilling zaps of winter are on the horizon.

When I wake up now, it’s dark. While driving to get my coffee, the whole murkinessof the morning is compounded by the cold rain hitting my windshield. Long gone are the summer showers that can feel so refreshing. These drops are brooding; they cover everything like oatmeal coming out of the sky.

I’m looking out the window at my regular coffee haunt – Starbucks. I like the regularity of it as the seasons change in front of me. Everybody there knows my name – sort of like Norm from Cheers. I like this easy familiarity; especially the witty banter about the work day about to begin.

I start to read a book, but throw it back in my brief case. The shortening of our days and sunlight, in my experience, seems to make depression a bit worse. The dark dank seems to reflect our inner landscape. I know winter’s coming – sort of like I felt when I knew the Bar Exam was coming. Emily Dickinson captures the sense of the melancholic days of winter:

“There’s a certain Slant of light, Winter Afternoons – That oppresses, like the weight – Of cathedral tunes. Heavenly hurt, it gives us; we can find no scar – But internal difference – Where the meanings are.”

For those of you who don’t know – but I’m sure most of you do – science has chimed in and concluded that the lack of sunshine makes some of us feel pretty crummy. It’s called Seasonal Affective Disorder (“SAD”). The reduced level of sunlight seems to cause a disruption in our biological clock which let’s you know when you should sleep or be awake. It also can lower the levels of serotonin (a known culprit in depression) and melotonin which affects our sleep patterns. Click here to see a list of symptoms compiled by The Mayo Clinic to see if you suffer from SAD.

According to expert, Norman Rosenthal, author of the book, Winter Blues, there’s an estimated fourteen million Americans who suffer from SAD and another fourteen percent of the adult U.S. population estimated to suffer from the winter blues. Dr. Rosenthal states: “Though these people are not usually affected severely enough to seek medical attention they nevertheless feel less cheerful, energetic, creative, and productive during the dark winter days than at other times of the year.”

The Mayo Clinic lists a number of remedies to treat SAD including medication, lifestyle and home remedies and alternative medicine. Things that I’ve felt helpful are as follows:

The first is the purchase and use of a bright light. It’s a box that throws off a high concentration of light. You sit in front of it for thirty minutes to a hour and let these simulated sun rays soak into your brain. For more information about how these devices work and places to buy them, check out the companies Sun Box, Inc. and Full Spectrum Solutions, Inc.

Second, I’ve found that it’s very important to schedule my vacations in the winter. My family and I go to sunny locales and bask in the sun like tortoises.

Third, get warm anyway you can. I do this in two ways. I make regular trips to the sauna at my gym. There’s nothing like sitting around with a bunch of naked guys that you don’t know –some of them are pretty hairy – to work up a rejuvenating sweat. The only thing missing are feathered head dresses and peyote. This can also be accomplished with using the old hot tub. I also change to a “warming diet” when the cold winds blow. Click here to check out a series of great articles (just click again on the “Healthy Tips” button located on left side tool bar) from Dr Elson Hass, author of the best-selling book, Staying Healthy with the Seasons.

10 Ways to Deal with Depression

A lawyer with depression used to call me once a month. He would tell me about the emotional problems in his life. Many times, he cried. This went on for a year. I listened each time for about a hour and then the conversation would routinely end with, “catch you later.” Yet, nothing changed for him. At some point I said, “Bob, what are you willing to do to change your life?” He seemed surprised by the question. He never called back. Perhaps a good starting place for you to think about healing, is what old behaviors are you willing to change or what new behaviors are you willing to try to help you get better?

In her book, Listening to Depression: How Understanding Your Pain Can Heal Your Life , psychologist, Lara Honos-Webb, views depression not just as an “illness”, but as a wakeup call; a signal that we have been traveling down paths in our lives that have been unhealthy. She encourages us not to see depression as just a disease, but as an opportunity to change our lives. There is something in us, if we would only listen, that is telling us that we are killing ourselves.

We often don’t listen. So that voice turns up the volume until we get sick with anxiety and depression – or heart disease, hypertension and cancer.

As lawyers, we are experts at looking at problems from an analytical angle. When we turn that powerful lens on ourselves, seeking to “solve” our depression, it just doesn’t work. That’s because much of our distorted thoughts and strategies that got us into trouble with depression, can’t get us out.

After we have been diagnosed with depression, we can evade responsibility for our own recovery. Some time ago, I was in a great deal of pain. I told my therapist that my depression wasn’t going away despite my sincere efforts. I felt punished by my depression. He gently told me, “Dan, you haven’t done anything wrong. You’re doing it to yourself.”

This was a turning point for me in dealing with my depression. When I stopped letting depression victimize me, I began to take responsibility for getting better and started behaving and thinking in more constructive ways. That being said, what constructive steps can lawyers take to deal with their depression?

1. Get help

You can’t handle this by yourself. It’s not your fault. It is a problem bigger than any individual person. There are Lawyer Assistance Programs in most states that can get you started in the right direction, provide resources and help you with referrals. Click here to search by state for a program nearest you. While this advice sounds self-evident, believe me, it is not. Recent statistics reveal that eighty percent of Americans don’t get any help for their depression.

2. Maybe you have to take medication

That’s okay. You may have a chemical imbalance which you need to address. For many, psychotherapy won’t help until they quiet down there somatic complaints (e.g. extreme fatigue, sleep problems) so that they can have the energy and insight to work on their problems. However, “one size doesn’t fit all.” Medication can – and is – over proscribed. I also have a problem with family physician diagnosing depression and recommending antidepressants. Eighty percent of the scripts for antidepressants in this country are written by such doctors. Better idea: go to be evaluated by a well-regarded psychiatrist who specializes in mental health and doesn’t also treat stomach upset, fungus on the feet and the flu. For a fair and balanced review of the pros and cons of medication, check out HELPGUIDE.org, a not-for-profit organization.

3. Negative Thinking

Whether you will need medication or not, you will need to confront your negative thinking with a therapist. You really can’t do this effectively with friends or family alone. A lot of research suggests that cognitive behavioral therapy is a particularly effective form of treatment for depression. It teaches us that a large part of depression is made up of cognitive distortions. One example is the all-or-nothing thinking approach. Lawyers often think to themselves that they’re either “winners” or “losers” in the law. This is a distortion because the reality is that most lawyers both win and lose in their careers. Check out this excellent website article for a list of other cognitive distortions. I recommend interviewing a couple of therapists before you settle on one.

4. Exercise

The value of exercise is widely known: It’s is simply good for everybody. For a person with depression, it becomes not just about a healthy habit, but a critical choice. In his book, Spark: The Revolutionary New Science of Exercise and the Brain, Harvard psychiatrist, Dr. John Ratey devotes a whole chapter to the importance of exercise in treating depression. Please check this book out. Also check out this short article from the Mayo Clinic about how exercise can help with the symptoms of anxiety and depression.

5. Spirituality

If you have a spiritual practice, do it. If you don’t, think about starting one. This could include anything from a formal meditation practice, going to Mass or just taking a walk in the woods. A lot of research suggests that people who do have a spiritual practice do better with depression. If you believe in God or a higher power, you can avail yourself of help and support from Someone who is bigger than your depression. If you do not believe in God, maybe you believe in some other form of spirituality you can tap into. Spiritual growth and development, in my opinion, is an important pillar of recovery.

6. Join a support group

I started a lawyer support group in my community and it has been going strong for two years. Such groups can be invaluable in helping you to see that you are not alone and that others share in the very same struggle. Contact a Lawyers Assistance Program in your state. If you don’t feel comfortable being in a support group made up of lawyers, there are plenty of other routes to go. Check out the website run by The Depression and Bipolar Support Alliance. They run depression support groups meetings in all fifty states.

7. Get educated

Read some good books on the topic of depression. As part of your education, learn about the powerful connection between stress, anxiety and depression. I recommend you read Dr. Richard O’Connor’s, Undoing Perpetual Stress: The Missing Connection between Depression, Anxiety and 21^st Century Illness. Dr. O’Connor opines that depression is really about stress that has gone on too long. The constant hammering away of stress hormones on the brain changes its neurochemistry. This can and often does result in anxiety disorders and clinical depression. I list a number of other great books on my website at Lawyers With Depression. The site also offers guest articles, news, podcasts and helpful links for lawyers.

8. Build pleasure into your schedule

As busy lawyers, we have the “I will get to it later” mentality – especially when it comes to things that are healthy for us. We have to jettison that approach. We must begin to take time – NOW – to enjoy pleasurable things. A hallmark of depression is the failure to feel happiness or joy. We need to create the space where we experience and savor such feelings.

9. Restructure your law practice

Nobody likes changes. Lord knows, I don’t. Yet this pointer falls into the category of “what are you willing to do?” Maybe you will have to leave your job. Is this stressful? Yes. Is it the end of the world? No. Maybe you will have to change careers. I have spoken to many lawyers who haven’t been particularly happy with being a lawyer since day one. But they kept doing it because they didn’t know what else to do, the legal profession paid a good buck, they didn’t want to seem like a failure, they were in debt, etc. I am not trying to minimize these very real concerns. However, your good health (as I learned the hard way) has got to reestablish itself as a top priority in your life. I changed the nature and variety of my practice and am the better for it. I do less litigation. As a consequence, I have less stress which has been long known to be a powerful trigger for depression. It can be done.

10. Practice mindfulness in your daily life

A lot of attention has been focused on the use of mindfulness lately as a way to help depression. In mindfulness meditation, we sit quietly, pay attention to our breath and watch our thoughts float by in a stream of our consciousness. We habitually react to our thoughts (e.g. “I will never get this brief done”). In mindfulness meditation, we learn – slowly – to let the thoughts and feelings float by without reacting to them. If such an approach to depression seems far-fetched, read the compelling book, The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness, for an excellent primer on how you can incorporate mindfulness into your day. Check out this article written for my website by one of the book’s authors.

In closing, I often tell lawyers to remember to be kind to themselves. When I say this they usually look puzzled – like many a judge who has listened to my oral arguments. They’ve rarely, if ever, thought about it and don’t know how to be kind to themselves. I believe that it first begins with a conscious intention – “I am not going to treat myself poorly anymore.” Such a simple refrain can help us.

Depression is often built upon poor mental/emotional and physical habits. Our inner pain can bring us to the point where we have had enough. It begins to dawn on us that we are worthy of love from ourselves and others and that part of such love involves taking care of ourselves. I hope these suggestions help you on your path.

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