Listening to Depression: What It Might Be Trying to Tell Lawyers Who Suffer From It

This guest blog is from Dr. Lara Honos-Webb, a clinical psychologist and author of the book, “Listening to Depression: How Understanding Your Pain Can Heal Your Life.” I also write below about what listening to depression has meant in my own own life as a lawyer.

Why are lawyers so depressed these days?

The rates of depression and substance abuse problems are skyrocketing according to recent media reports and research. Can depression be seen as a break-down in the service of offering you an opportunity for a break-through? If depression offers corrective feedback to lawyers, what might it be telling you?

We only reflect on those things that break down in our life. For example, if life is going along smoothly you won’t spend time thinking about the meaning of life. You tend to think deeply about life when something is not working. When we identify a problem, we begin to reflect on what caused the problem and how to fix the problem. If you are disconnected from your deepest feelings and impulses you may still manage to get through life without realizing that your life is off track.

Depression makes it tough to function as a lawyer

One of the defining features of depression is that it results in impairment in social and professional functioning. You may feel blue, begin to lose interest in some aspects of your life, but this will not be diagnosed as depression unless a marked impairment in day-to-day functioning is evident. It is this aspect of depression, by definition an impairment, that seems on the face of it most difficult to reconcile with the idea that depression is a gift.

But if you begin to open to the possibility that there was something fundamentally wrong with your level of functioning before your depression, only then does the idea of depression as a gift begin to make sense. A bread-down can become a gift when it is in the service of increasing reflection on your life which will lead to ask the fundamentally important questions:

What is wrong with my life? What can I do to correct the problem?

When you listen to your depression, you can hear your life.

Depression’s Negative Thinking

Years ago, when I had just been told I had something called “depression,” I was having a tough time accepting it – after all, I was a litigator, a good-slinger extraordinaire.  The only thing that I thought could bring me down was a lucky pistol shot at High Noon.

During a talk with my therapist in the beginning of my recovery a decade ago, I told him all the negative thoughts I was having about my life. My counselor, a large, white -bearded older man with an Obi Wan Kenobi-like aura, gently told me, “Dan that is depression talking.” Somehow that got through to me; somehow I knew it was true.

My counselor, pillar of Jedi knowledge that he was, had helped me look through a sort of psychic telescope into the constellation that was my patterns of depressive thinking.  All people who have struggled with depression must do combat with their negative thoughts.  They must – usually with a therapist’s help – begin to see that THEY are thinking these thoughts and they’re not just HAPPENING to them.

Negative Thoughts – and Lots of Them

It has been estimated that we have anywhere from 25,000 to 50,000 thoughts a day. If your ideas about life are predominantly downbeat, imagine how many negative thoughts you are generating daily—thousands upon thousands.

In the magazine Psychology Today, Hara Estroff Marano writes:

“One of the features of depression is pessimistic thinking. The negative thinking is actually the depression speaking. It’s what depression sounds like. Depression in fact manifests in negative thinking before it creates negative affect. Most depressed people are not aware that the despair and hopelessness they feel are flowing from their negative thoughts. Thoughts are mistakenly seen as privileged, occupying a rarefied territory, immune to being affected by mood and feelings, and therefore representing some immutable truth.  

Compounding the matter is that negative thinking slips into the brain under the radar of conscious awareness and becomes one of the strongest of habit patterns. People generate negative thoughts so automatically they are unaware that it is happening; that it is actually a choice they are making.”

Lawyers are particularly prone to this type of pessimistic thinking which helps explain why their rates of depression are about twice that – twenty percent – of the general population.

In recent article in The Wall Street Journal wrote about this very topic:

“Martin E. P. Seligman, a psychologist and proponent of ‘positive psychology,’ observes that lawyers experience depression at rates that are 3.6 times as high as that of other employed people. They also abuse alcohol and illegal drugs at rates above what’s seen in non-lawyers. Why is this? In part, he says, the law selects people with a glass-half-empty attitude. His research has found that people who score low on an optimism test do better in law school. ‘Pessimism, he writes, ‘is seen as a plus among lawyers, because seeing troubles as pervasive and permanent is a component of what the law profession deems prudence.

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

The Big Ten

For us to start making different choices about what kind of thoughts we think, it’s important to see the patterns, the way these false thought patters take place over and over again.  Here are some examples of depressive thinking:

1.      False extremes – “the tendency to evaluate [one’s own] personal qualities in extreme, black-and-white categories; shades of gray do not exist.”

2.      False generalization “after experiencing one unpleasant event, we conclude that the same thing will happen to us again and again.”

3.      False filter “we tend to pick out the negative in every situation and think about it alone, to the exclusion of everything else.”

4.      False transformation “we transform neutral or positive experiences into negative ones.”

5.      False mind-reading “we may think we can tell what someone is thinking about us, that the person hates us or views us as stupid. But such negative conclusions usually are not supported by the facts.”

6.      False fortune-telling “we expect catastrophe and the expectation itself produces hopelessness and helplessness.”

7.      False lens “we view our fears, errors, or mistakes through a magnifying glass and deduce catastrophic consequences. Everything then is out of proportion.”

8.      False feelings-based reasoning depressed persons “tend to take their emotions as the truth. They let their feelings determine the facts.”

9.      False “shoulds” – “Our lives may be dominated by ‘shoulds’ or ‘oughts,’ applied to ourselves or others. This heaps pressure on us and others to reach unattainable standards.”

10.  False responsibility – “when we assume responsibility and blame ourselves for a negative outcome, even when there is no basis for this.”

A common theme running through much of this type of thinking is a self-judgment of inadequacy and, as a result, the depressed person notices negative, misfortunate circumstances but ignores positive, fortunate circumstances.

Overachievers and perfectionist that they are, depressed lawyers may frequently receive positive feedback concerning his or her performance at work. For example, a depressed lawyer may have a caseload of one hundred cases.  He might have the upper hand on 90%, but struggles with the 10%.   This lawyer sees his struggle with the handful of cases as confirming what a loser he or she is, incompetent and unable to keep up “like everyone else.” The many positive comments made by colleagues or staff are not even remembered.

Because of the belief that he or she is inadequate, and his or her tendency to only notice negative experiences, the future is viewed as certain to be gloomy, dismal, and painful: “I’ll never make partner,” “I suck as a lawyer.”

Negative thinking sounds, to the outside observer, to be obviously false or negatively skewed. If so, just why do depressives repeatedly think like this over and over again?  Are they idiots?

No, it’s because depressive thinking is “automatic.” It is not the result of thinking the situation through objectively – ironically enough, something lawyers are trained to do.

It just happens rapidly without any reflection.

So it’s the event itself that is sad, not life in general. And even if this thought or feeling arises, it is only temporary.

Depressive thinking leads to depression, leads to depressive thinking, leads to. . .

As we explain these thinking styles you will see how each helps to maintain depression, by altering how we perceive reality.

It’s these thinking styles that make it so hard to see an end to the depression, as they limit our possibilities of thought. Once these patterns take hold, the emotional arousal they cause begins to affect us physically.

If you are thinking now “Yeah, but you don’t know my life” – remember: there is nothing so awful that you can imagine that someone somewhere hasn’t survived without becoming depressed.

It is not your fault if you are depressed, but there are concrete, effective things you can do about it.

How to Kick Negative Thinking’s Butt

Again, Estroff Marrano offers some ways to combat negative thoughts:

  • Distract yourself. Engaging, pleasant activities, such as exercise or hanging out with friends, are best. Once you are feeling more positive, you will be better able to solve problems.
  • Stop that train of thought. Think or even tell yourself “Stop!” or “No!” when you start to ruminate.
  • Write it down. Tracking your ruminative thoughts in a journal can help you overcome depression by organizing those thoughts and relieving yourself of their burden.
  • Solve a problem. Even taking a small step toward solving one problem that is weighing you down will help with overcoming depression. Data show a strong link between goals you cannot achieve and depression-inducing ruminative thinking, so start problem solving.
  • Identify triggers. Figure out which places, times, situations, or people are most likely to cause a bout of rumination, and find ways to avoid those triggers or manage them better. Mornings and evenings are the times when ruminative thinking is most likely.
  • Meditate. Mindfulness techniques can help you get some distance from the thoughts that trouble you, while at the same time reducing stress.
  • Stop linking small goals to big goals. For example, you may need to challenge a belief that achieving big goals (such as happiness) completely depends on succeeding at smaller goals (such as losing five pounds).
  • Get therapy. Seek cognitive therapy techniques to help you question your thoughts and find alternative ways of viewing your situation.

Try, day by day, to chip away at the conclusion that depression just happens to you, or that it’s just a disease.  Try to remember, that whatever it’s causes, negative thinking is a powerful fuel to help it arise and keep it going.  Think about it.

 

 

 

The Triumph of the Human Spirit – Folks Dealing with Depression

A hero is an ordinary person who finds the strength to persevere and endure in spite of overwhelming obstacles – Christopher Reeve.

I want to tell others about all the remarkable people I’ve known who’ve struggled with depression.  While they’re not paladins that ride into medieval battle swinging swords atop snorting mares, they fight a different kind of battle.  And one no less heroic.

Many of the best people I’ve been privileged to know struggle with depression every day.  While they don’t have shiny medals pinned on their lapels, there is an unmistakable strength in them – even if they don’t see it.  I know it’s real because I see and feel it – just like when I am in a grove of giant and majestic pines during a walk in the forest that must withstand the fury of a winter’s storm in January.

A Hero Steps Forward

Take Bob Antonioni. Bob’s story appeared in Esperanza magazine’s regular column, “Everyday Heroes”.  He had a budding political career in the Massachusetts State Senate and a law practice. Despite holding such a public position, Bob took the courageous step to disclose that he suffered from clinical depression in the hope of letting others know it was okay – there wasn’t anything to be ashamed of:

“Telling his story has become another tool to chip away at stigma. Yet he remembers his trepidation when he disclosed the truth in a November 2003 interview with a local newspaper.
‘I had misgivings,’ he admits, ‘but I guess I didn’t give people enough credit. All I heard were thank yous —the complete opposite of what I expected.’ In fact, Antonioni was re-elected twice after that. He retired from public office in 2009 to have more time for himself and his family, but continues to practice law and pursue his advocacy work.”

To me, it says something wonderful about the human spirit that against such a formidable foe as depression, people keep fighting to get better. And many triumph. Just like Bob.

The Black Dog

A few weeks ago in Canada’s Globe and Mail newspaper, there was a great piece, Ill to Power.  The article was about Winston Churchill’s life-long battle with depression written by the author of the new book, A First-rate Madness.  Here, he describes Churchill’s struggles:

“There is no doubt that he had severe periods of depression; he was open about it – calling it, following Samuel Johnson, his ‘Black Dog.’ Apparently his most severe bout of depression came in 1910, when he was, at about age 35, Home Secretary. Later in his life, he told his doctor, ‘For two or three years the light faded from the picture. I sat in the House of Commons, but black depression settled on me.’ He had thoughts of killing himself. ‘I don’t like standing near the edge of the platform when an express train is passing through’.”

Like Churchill, Abraham Lincoln struggled with major bouts of depression.  In the book Lincoln’s Melancholy: How Depression Fueled a President to Greatness, Lincoln writes about a cloud over him that every bit matches Churchill’s darkness:

“I am now the most miserable man living.  If what I feel were felt by the whole human race, there would not be one cheerful face left on earth”.

Lincoln, who many say was one of this country’s greatest heroes, apparently did not feel like one all the time.

Hard to Feel Like a Hero

Most people depression — in some fundamental sense –feel broken.  This conclusion is fueled by the depression itself – both biological (sleep, appetite, energy levels) and psychological (e.g. “Nobody really cares about me”, “I stink at my job” or “My depression will never end”).  But this brokenness isn’t just an “inside job” – crummy stuff they tell themselves about themselves.  Other people or events in a depressive’s daily orbit serve-up damaging assessments and innuendos about a depressed person’s behavior or personhood.

Others may tell them that they are letting them down at the office or not contributing enough to family responsibilities – yes, loved ones can get fed up with the depressed person’s withdrawal from the family, the inability to do chores he/she used to do and the depressed person’s sourpuss.  Or, they deny the immensity of the suffering of the depressive by minimizing it:  “Don’t worry, things will get better.  You’re just in a slump.” 

We sense that their agenda isn’t so much about helping us get better, as it is about them their needs.  Why else would we feel so much crappier and lonely after such exchanges?  It isn’t as if their needs aren’t important, but shouldn’t our mental health be at least as important?

Then there is the cultural stigma – a cloud of ignorance, fear and misunderstanding – surrounding depression.  American culture tends to see depression as a moral or personal weakness; the “just-get-over-it” rants of a society that likes simplistic answers to complicated problems.  Dr. Richard O’Connor, in his book Undoing Depression, captures some the irony of how our society sees depression as different from – or maybe not as real as — other forms of illness:

“Where’s the big national foundation leading the battle against depression?  Where is the Jerry Lewis Telethon and the Annual Run for Depression? Little black ribbons for everyone to wear?  The obvious answer is the stigma associated with the disease. Too much of the public still views depression as a weakness or character flaw, and thinks we should pull ourselves up by our bootstraps. 

And all the hype about new antidepressant medications has only made things worse by suggesting that recovery is simply a matter of taking a pill.  Too many people with depression take the same attitude; we are ashamed of and embarrassed by having depression.  This is the cruelest part of the disease: we blame ourselves for being weak or lacking character instead of accepting that we have an illness, instead of realizing that our self-blame is a symptom of the disease.  And feeling that way, we don’t step forward and challenge unthinking people who reinforce those negative stereotypes.  So we stay hidden away, feeling miserable and yourselves for ourselves for our own misery”.

Renaming One’s Walk through Depression as Heroic

Why can’t we re-imagine our self-image in relationship to our depression in a more positive light?  Why can’t we think of our battles with depression as, in fact, heroic?  Instead of counting all of times that depression has gotten the better of us and knocked us to our knees, how about giving ourselves credit for all of the times that we have triumphed over depression (perhaps even in the simplest ways); the times that we have risen to the occasion in spite of our melancholy and the moments that we have looked depression in the eye and said, “no more.”  Make no mistake about it that takes gumption – lots of it!  And I’ve witnessed scores of people say “that’s enough.”  While talking back to depression isn’t a panacea, it may be a healtier way for us to cope rather than succumb to it.

Viewing yourself as a hero is a constructive and healing experience for people with depression.  It doesn’t deny that we struggle with it sometimes, but it more importantly doesn’t deny the power we actually do have over it and the courage it takes to deal with it to the best of our ability each day.

In his article “The Continuing Stigma of Depression” psychologist Jonathan Rottenberg writes about the stigma for those who have recovered from depression:

“My hunch is that the disease/defect model of depression, is unwittingly contributing to the ongoing stigma of depression.  Through the lens of the disease model, the legions of the formerly depressed are a “broken” people who need lifelong assistance.  I would like to see a more revolutionary public education approach, with campaigns that emphasize the unique strengths that are required to endure depression. Even if a person is helped by drugs or therapy, grappling with a severe depression requires enormous courage.  In many ways, a person who has emerged from the grip of depression has just passed the most severe of trials in the human experience.  If we acknowledge that surviving depression requires a special toughness, we will not see formerly depressed people as a broken legion, but as a resource who can teach us all something about overcoming adversity”. 

Things to Consider

 – Maybe we fall down 30 times a day, or maybe it’s just a stumble, but we have to regain our balance and get up.  As the old Zen saying goes, “fall down seven times — get up eight.”  That, my friends, is heroic. Just remember that when you fall and get up – YOU are that hero.

– We must remember that when we are in a depression, it isn’t easy to feel like a hero — just think of Honest Abe. But the depression will pass. So don’t be too hard on yourself if you don’t feel heroic all the time.

– We should not condemn ourselves when we are down, but pick ourselves up and remember that we are, truly, remarkable people. 

As writer Andrew Berstein once wrote:  “A hero has faced it all: he/she need not be undefeated, but he/she must be undaunted.”

 

The Suicide of a Lawyer with Depression — Ken’s Story

This is a guest blog by Cincinnati, Ohio attorney Tabitha M. Hochscheid, Esq., a partner at the law firm of Cohen, Todd, Kite & Stanford, LLC.  In this moving tribute, she writes about her law partner and dear friend Ken Jameson who committed suicide in May of 2011 after a battle with depression.

How well do we know those with whom we spend our work days with?  Is it possible to practice with someone and be there friend for years yet, not truly know that they are suffering from the depths of depression?  Being around other attorneys can give us the camaraderie and support we need to grow and build our practice.  But, often times, people keep their emotional health a secret and suffer from depression in silence.  By the time their colleagues realize what is going on, it can be too late to do anything about it. My partner and friend Ken Jameson was one of the people.  This is his story. 

Ken Jameson was, by outward appearances, successful, well liked, a loving husband and father, a friend to everyone and a dependable partner.  In fact, Ken was perhaps the epitome of the well liked, client centered and dedicated lawyer many of us envision when we think of how lawyers should behave. On the inside, however, Ken was struggling with the depression which eventually took his life.

I first met Ken in the summer of 2007 for breakfast to discuss my interest in joining Cohen, Todd, Kite and Stanford, LLC.  Ken was so easy to talk to and we instantly bonded because he too had left a small firm to find a place to grow and build his practice at Cohen, Todd, Kite & Stanford, LLC.   After I joined the firm in January 2008, Ken was always available to help and support me and we grew into friends, as well as, colleagues.

Like so many attorneys, Ken built a practice by creating a network of referrals, by giving his clients personal service and building long term relationships.  He was an attorney who facilitated resolutions and provided estate plans for people of all income levels.  Ken enjoyed his work.  After joining the firm himself in 2006, his practice thrived.  He became a trusted member of the firm and was on the management committee.   Ken shared is life outside of the office with his wife and best friend of 35 years, Betsy, and three adult children of whom he was most proud.

Ken was a universally well liked person.  He conducted himself professionally in such a way that he never seemed to have conflicts with others.  Ken cared about his firm family, he always checked in on people if they were sick or if he knew you were under stress.  He was active member in his Church.  Ken took care of his physical health by walking 5 miles a day, attending Pilates classes twice a week and maintaining a healthy diet.  By all outward appearances, Ken had success in his work, a happy home life and seemed content.

However, Ken had underlying mental health issues.  Like many attorneys he had trouble sleeping well.  Sleep is something that eludes most attorneys from time to time, but his type of sleep loss was chronic.   He would fall asleep and wake up in just a few hours and not be able to go back to sleep.  As long as I knew Ken, he had this issue.  He tried relaxation techniques to help him sleep better, he read books about stress management and attempted to delegate work to others.  Ultimately, Ken was a self confessed perfectionist and as such, had an inner critic who told him he had to be at work all the time.

Most lawyers struggle with the challenges of building a law practice, client demands and finding out how to have precious downtime.  Ken was doing all the right things, but he still wasn’t able to sleep.  In March of this year, he took time out of the office due to exhaustion.  He went to see his family doctor and was prescribed something for sleep.   He tried to come back to the office part time within a few weeks but was unable to sustain a schedule.   Ken represented to those of us at work that he was exhausted and initially did not tell others what was really going on.

In late April, he left the office again.  This time it was lack of sleep and a pinched a nerve in his back.   With this new medical issue, his depression worsened.  He spent sometime in the hospital to adjust to new medications and was scheduled for back surgery.  At this point, Ken began expressing worry about the office and felt as if he was letting the firm down.  Finally, Ken had back surgery for the pinched nerve in the middle of May.  After the surgery, Ken seemed to be doing better; everyone thought his return to the office was imminent.

Ken never returned to the office.  On Sunday, May 22, 2011, I received a call from our office manager.    She informed me that Ken’s depression had worsened and that he had taken his own life that morning.  As the next few days unfolded, details began to surface.  Ken underwent surgery on his back and in the days following the procedure, had checked in with people at the office and had seemed like his old self.  Ken also visited his mother and called his best friend.  All the while, Ken meticulously planned how to take his own life.

No one can answer the question of what was going through his head or why he was in such despair that he took his life.  The next five days were difficult at the office.  People were in a state of shock and disbelief.  His office door has remained open since Monday, May 23, 2011.   A memorial was held the Saturday following his death and it was standing room only.   Ken clearly touched the lives of thousands and his life was remembered in eulogies by his friends, his sister and his wife.  It was touching to see so many people who loved him, but the confusion as to what occurred actually increased for many.

Do you ever really know the people we practice law with?  Everyone at the office felt they had a personal relationship with Ken.  But, did anyone of us really know what was happening.  It is easy now to look back and see the signs of Ken’s illness (sleep deprivation, self criticism, feeling of letting others down, a search for answers and inability to allow others to help) and to wonder what if anything could have changed the outcome.  Time, however, does not give us this luxury and these questions will never be answered.  The best that can be done is to acknowledge that Ken’s illness, depression, can be deadly. 

It seems that our profession gives little in return for years of hard labor.  Learning a way to balance the demands of the business of being a lawyer with the need for downtime is essential to one’s mental and physical health.  Ken’s depression is an all too real downside of the practice of law.  His suicide is a tragedy to his family, our law firm and to the legal community.  He was one of the “good” guys and the profession needs more people like him.

For those of us left behind we struggle for understanding and to carry on in spite of the sadness we each feel.  Inevitably when speaking with others we are confronted with the questions of why?  Most people will ask the normal questions – were there money problems, did he have marital problems or health issues.  The answer to these questions is no and then people just cannot fathom why Ken chose to end his life.   I know in my heart that, as the minister said during his memorial, that Ken felt he was “fixing” the situation.  Ken was a fixer and this was his only choice left.

I’ll always miss Ken Jameson.  The courage and commitment he showed to his clients, his family and those of us in business with him is something I admire.   However, his suffering in silence has left me and his other colleagues with regrets as to what we could have done to help.  In the end, however, Ken could not give himself permission to be less than perfect and eventually, felt those in his life were better off without him.  It is truly a sad ending to a beautiful life that could have been prevented.  My hope in sharing Ken’s story is that there will be greater recognition of depression and the despair that can accompany and that it will help someone struggling with these issues.  As for Ken, I hope he has found the peace that life did not provide.

Editors note — If you or someone you know suffers from depression and may have thought about suicide, visit the website of the national organization The American Association of Suicidology which contains great information, resources and how to get help. Lawyers can also contact  Lawyer Assistance Programs in their legal community.  To locate a program near you, visit the ABA’s Commission on Lawyer Assistance Programs website.

Our Struggle with Depression

 

Everyone has had a taste of what depression feels like. Everyone feels the blues at times. Sadness, disappointment, fatigue are normal parts of life. There is a connection between the blues and clinical depression, but the difference is like the difference between the sniffles and pneumonia – Richard O’Connor, Ph.D.

Years ago:  I am walking down a Manhattan street on a grey day.  I am feeling so sad; beyond somber and without any external point of reference. I looked up at the grey buildings. I suddenly have the sense that I am a building; a tower with a cracked foundation slowly falling to the pavement below.

I step into a church I don’t know.  I try to pull myself together. “Please God. I need your help.” I have to be in Court shortly. I look at my watch. My suit feels tight against my skin. I struggle to make the sadness more manageable, more contained.  I leave because I must, not because I feel any better; but because I am an adult and have to move through my day, no matter the volume of pain ringing in my ears.

The sadness from that day would end.  I would feel better.    But a pattern was developing, even then.  A pattern of how I would respond to sadness in my life, both past and present.

The Struggle to Break Free   

Some folks have given up hope that depression will ever leave them alone. They’re just hoping for more good days than bad.  When it’s a relatively good day, when life is in flow and not stuck in the muck of melancholy, there is happiness, or perhaps, relief.  The depression gods’ hurtiling thunderbolts have missed them this day. But when they’re in the thick of it, they fight their sadness.  It’s as if they’re pressing on the gas trying to escape their pain while depression has its foot on the brake.

Sadness is not Depression – though they are cousins

First, let’s be clear: sadness is not depression, but it may manifest as persistent sadness that can be a symptom of clinical depression. When I developed depression ten years ago, my sadness was accompanied by lots of crying for no particular reason.

Paradoxically, Dr. O’Connor, in his book, Undoing Depression , wrote that depression is often the absence of despondency:

“We confuse depression, sadness, and grief.  However, the opposite of depression is not happiness, but vitality – the ability to experience the full range of emotions, including happiness, excitement, sadness, and grief.  It’s not sadness or grief, it’s an illness.”

Maybe this is why we don’t see – we don’t see how we react to our own sadness because we’re stuck in the vortex of depression where everything, like the perimeter of a tornado, is thrown together.

This relationship between sadness is troublesome for a depressive.  This is so not because there is anything wrong with sadness – it’s a normal part of the human experience and gives our lives depth and pitch.  It’s the bass tone you hear when B.B. King plays the Blues. In my experience, sadness has a bittersweet quality to it. As the great novelist Herman Hesse once penned, “It was if all of the happiness, all of magic of this blissful hour had flowed together into these stirring, bittersweet tones and flown away, becoming temporary and temporary once more.”

The Brain Knows How we React to Sadness

A recent study revealed that the brain’s response to sadness can predict a relapse into depression.  Faced with sadness, the relapsing patients showed more activity in a frontal region of the brain, known as the medial prefrontal gyrus.  These responses were linked to higher rumination: the tendency to think obsessively about negative events.  Patients who didn’t relapse showed more activity in the rear part of the brain, which is responsible for processing visual information and is linked to greater feelings of self-acceptance and non-judgment of experience. 

According to Norman Farb, Ph.D., who did the study:  “For a person with a history of depression, using the frontal brain’s ability to analyze and interpret sadness may actually be an unhealthy reaction that can perpetuate the chronic cycle of depression.  These at-risk individuals might be better served by trying to accept and notice their feelings rather than explain and analyze them.”

We keep trying to find the source of our sadness like squinting to find the bucket that has fallen in the deep well.  We circumambulate the hole, peering into the darkness, but don’t see the flashlight nearby that can help.  We can’t see that our attempt to break down and explain our sadness to ourselves isn’t helping – it’s hurting us.

A New Relationship to Our Sadness

In his book The Mindful Path to Self-Compassion, Christopher Germer, Ph.D., writes:

“This is an opportunity to move from mental work to heart work.  Self-compassion has a distinctly nonintellectual and non-effortful feel to it. If we can find ourselves in the midst of suffering and acknowledge the depth of our struggle, the heart begins to soften automatically. We stop trying to feel better and instead discover sympathy for ourselves. We stop trying to feel better and instead discover sympathy for ourselves. We start caring for ourselves because we’re suffering.”

Don’t always try to figure out your depression. Give yourself a breather from solving it, this boulder of sorrow. Instead, see that you – yes, you – are worthy of compassion from yourself because you suffer. If you don’t know how to feel this compassion for yourself, isn’t it about time to try?

 

 

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.

99 Things About Depression

  1. Depression sucks.
  2. You know this if you suffer from it.
  3. You know this if you’ve suffered from it before.
  4. If you have it, you’re not alone.
  5. If you’re in the legal profession, you’re really, really not alone.
  6. 10% of Americans struggle with depression.
  7. 20% of lawyers struggle with depression.
  8. Do the math – 200,000 out of 1 million lawyers have the big “D”.
  9. Grad school is tough.
  10. Apparently, tougher law students.
  11. 20 to 40% of law students will become depressed at some point.
  12. Do more math – 30,000 to 60,000 out of the 150,000 law students.
  13.  Ok, ok, we get it.  Depression is a BIG problem in the law.
  14. I’ve felt lonely when I’ve been depressed.
  15. I’ve been bone-tired when depressed, but couldn’t sleep.
  16. People who struggle with depression are my heroes.
  17. If there are so many depressed lawyers, why do they stay in the law?
  18. Money?  For sure, what else?
  19. Status?  Yes.
  20. Very often, they’ve drifted into it.
  21. But, maybe they’d be depressed in or out of the law. Maybe.
  22. Many wonder, “What else could I do with a law degree?”
  23. Not getting help?  Not a good idea.
  24. Getting help?  Much better idea.
  25. We are people who happen to be lawyers.
  26. We’re not lawyers who happen to be people.
  27. Remember this.  Don’t forget it.  Write it down someplace.
  28. Depression changes your brain chemistry.
  29. You may need medication.  Maybe not.
  30. You’ll need to talk to someone about it.
  31. A friend?  Good start.  A therapist?  Even better.
  32. You’ll need to make changes in your life to get better.
  33. And stay better.
  34. What combination of changes those are different for everyone.
  35. You can start to feel better.
  36. I care about you even though I’ve never met you.
  37. This is so because I’ve been there and understand.
  38. You need to find people like this to talk to.
  39. Be realistic – it might take a bit of time to feel better.
  40. How long? Nobody really knows.  Just keep going.
  41. Some say, “I feel like killing myself”.
  42. Don’t do that.  Though, I understand why you might feel this way.
  43. This painful impulse is depression talking – don’t listen.
  44. Talk with a therapist about this pain – immediately – and listen to them.
  45. Take a good look at how you see the world.
  46. Take a good look at how you see yourself.
  47.  The Buddha once said, You are what you think.
  48. Psychologists say that too.
  49. True, but you’re more than just your thoughts.
  50. You are a child of God, however you conceive of Him, Her or It.
  51. You are precious beyond measure.
  52. Exercise isn’t just about losing weight.  It’s also about good brain chemistry.
  53. Don’t listen to people who say “Toughen up.” Simple ignorance.
  54.  Don’t try to handle this by yourself.
  55. It’s an illness. You’re not a bad, weak person.
  56. Depression tends to run in families.
  57. Your drinking too much might really be about depression.
  58. It’s okay to be scared.  There are millions of others who feel this way too.
  59. There are different degrees of severity with depression.
  60. Just like coffee at Starbucks – mild, medium and bold.
  61. Depression isn’t just in our heads, it’s in our brains.
  62. Does your job feel meaningless?
  63. If so, it’s no surprise that you feel unhappy – maybe even depressed.
  64. Chances are you didn’t have a healthy childhood if you have depression.
  65. Many with depression didn’t.
  66. “Nobody cares about me.” That’s depression talking.
  67. What do you really want out of life?
  68. Has anyone ever asked you that question? And really listened to your response?
  69. Have you ever asked yourself that question? What would that life look like?
  70. Most people with depression also have a problem with anxiety – about 60%
  71. Are you just unhappy or depressed?  Important question.
  72. Maybe you’re both?  You should talk to an expert.
  73. Maybe the hardest part of depression is feeling hopeless.
  74. Depression is a vicious circle.
  75. We keep behaving in ways that keep us depressed.
  76.  We keep thinking in ways that keep us depressed.
  77. As such, we keep getting depressed.
  78. What’s your greatest passion in life?
  79. Do you do enough of it?  Why not?
  80. Small children can be great antidepressants.
  81. Serving others can be as well.
  82. Depression isn’t just a sign of illness.
  83. It is a sign that you need to change your life.
  84. You need to educate yourself about what depression is.
  85. You need to educate your significant other about it also.
  86. A good book would help.
  87. When you’re depressed, you don’t feel like doing anything.
  88. That’s why you need to do things.
  89. You can’t wait until you feel like doing things.
  90. If depression had its way, you’d never feel like doing anything.
  91. For most, depression isn’t happening all the time.
  92. Pay attention to that.
  93. Are there things, people that trigger it?
  94. Are there things that help bring it down a notch?
  95. I’m no expert.
  96. I don’t have all the answers.
  97. I hope I have a few.
  98. Thanks for reading this.
  99. Adios.

 

 

 

 

 

 

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