Paying Attention to Our Depression

Depression isn’t just an illness.  It’s a messenger.

In his book, Unstuck, James Gordon, M.D., writes:

“Depression is not a disease, the end point of a pathological process.  It is a sign that our lives are out of balance, that we’re stuck.  It’s a wake-up call and the start of a journey that can help us become whole and happy, a journey that can change and transform our lives.  Healing depression and overcoming unhappiness mean dealing more effectively with stress; recovering physical and psychological balance; reclaiming parts of ourselves that we’ve ignored or suppressed: and appreciating the wholeness that has somehow slipped away from us, or that we have never really known”.

If we would but listen, we might find that our depression is trying to tell us something; important insights about our lives and the ways we live it that might be keeping us mired in a soupy gloom.

We often don’t heed our inner wisdom, but keep going full-speed ahead in the wrong direction anyway. Richard O’Connor, Ph.D. observed, “Depression is a vicious circle and we keep doing these destructive patterns because “we don’t how to do anything else.”

When we think of depression only as an illness, we oversimplify its causes and remedies.  No doubt, it has profound effects on our brains and bodies.  Surely, it runs in families and likely has a genetic component. But if it were only that, a blue pill would solve the problem.  And it doesn’t.

The pain of depression may be an impetus for sufferers to live a more authentic life.  Often people who suffer from depression are living from a wounded place within themselves.  Along the way, they learned that they weren’t “good” enough or were “bad people”.  As a consequence, they learned to hide their true needs and wants and live an inauthentic life; a life that may not work, but they don’t know how to change.

In this vein, folks can come to think of depression as some sort of punishment:  a recompense of some unknown sins from an undefined past.  Or, maybe the very real wrongs they may have committed are magnified, as they are prone to be in the mind of a depressive, by the process of generalization: a known cognitive trick of depression where we take a negative incident (e.g. “I lost this case”) and turn it into “Why am I such a failure?”

Depression doesn’t just happen to anyone. Rather, it is the accumulation of a lifetime of varying degrees of psychic pain suffered during a lifetime, often starting in early childhood.  In our early years, many learned that it was dangerous to live from a space of our true selves because of a parent who was an alcoholic, abusive or in some way emotional abusive or absent.

Ellen McGrath, Ph.D., writes:

“Scientists know that traumatic experiences such as child abuse and neglect change the chemistry and even the structure of the brain.  They sensitize the stress response system so that those who are abused become overly responsive to environmental pressures.  They shape wiring patterns in the brain and reset the sensitivity level of the machinery.   Eventually, even small degrees of stress provoke an outpouring of stress hormones, and these hormones in turn act directly on multiple sites to produce the behavioral symptoms of depression. They push the brain’s fear center into overdrive, churning out negative emotions that steer the depression’s severity and add a twist of anxiety”.

Our parents, acting out of their own wounded souls, unconsciously played out their unresolved pain with us during our childhood.  They did so because of their distorted way of seeing the world; a place that they found threatening, its problems unsolvable and against them at every turn.  This hardened them and led them to fail in life’s most important vocation: the nurturance of their own children.

I recall my mom saying to me as a child, “Well, what are you going to do?”  While one could say this was the innocuous lament of a middle-aged mother of 5 kids, later in life I learned it was mom’s worldview that there weren’t really solutions to life’s fundamental problems, that we are, at our core, helpless in the face of life’s thorny challenges. 

My mom suffered from undiagnosed and untreated depression for most of her life.  I now see how this passive, victimized way of seeing the world took root in my psyche as a young man.  And how hard I had to work to overcome it over the years; how I had to struggle to listen less to the inner voice and critic of my parents and incline my ears toward my true self which was always there waiting to be heard.

In Listening to Depression, psychologist, Lara Honos-Webb writes that depression is trying to tell us something: that we are on the wrong track in life.  In this sense, depression can be a teacher if we would only listen to it.

How can we come to see depression as a teacher?  Honos-Webb writes:

“Depression can be seen as a break-down in the service of offering the person an opportunity for a break-through.  In this way, depression can be a corrective feedback to a life with little reflection.  We only reflect on those things that break down in life.  For example, if life is going along smoothly you won’t spend time thinking about the meaning of life.  We 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 it.”

I admit that it’s hard to see depression’s value when in the thick of it, the swamp through which we slog with little relief.  But there’s much to be said for seeing depression not just as a disease, but as a messenger that our lives need to change for us to heal.

 

 

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.

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.

Finding Our Way in the Law

It’s in the darkness of men’s eyes that  they get lost – Black Elk

Graduating from law school is both exciting and frightening at the same time.  There’s a real itch to put our knowledge into action, to be a bona fide “attorney at law” and to start making some dough instead of spending it on tuition and books. On the other hand, we really don’t know a lot about the application of legal theory to legal combat, may have a heap of debt and pray that our first stab at competency doesn’t land us face first on the courthouse steps. 

Beyond all of these pragmatic concerns is the meatier matter of living a life in the law that matters; a life in accord with our inner core of what we truly value in life.  As author Studs Turkel once wrote:

“Work is about a daily search for 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-to-Friday sort of dying.”

Lawyers, young and old alike, find it difficult to live out their values in the workplace, to search for “meaning as well as daily bread.”  There are challenges and compromises, some more difficult than others.  For example, we may really value spending time with our family.  But as the demands of our career mount, we become untethered from this life-giving sustenance as we spend more and more time toiling at the office.

Andrew Benjamin, Ph.D., J.D., a lead researcher in studies about the mental health of law students and lawyers, concludes that much of the dissatisfaction in the profession comes from a widening gap between the values we truly care about and the things we end up pursuing in in our jobs as lawyers.  This takes place over time and its effects are cumulative.  Many end up leaving the profession.  Or, if they stay, are mired in unhappiness, discontent and can’t see a way out.

Dr. Benjamin found that approximately 20% of lawyers – about twice the national average – aren’t just unhappy; they’re suffering from clinical anxiety or depression. We aren’t talking about everyday stress, sadness, blues or categorical grumpiness.  We’re talking rubber to the road clinical anxiety and depression; devastating diseases that cause breakdowns in every area of one’s life.  Put in perspective, Benjamin’s studies suggest that a whopping 200,000 of this nation’s 1 million lawyers are struggling – some very badly.

Certainly a gap between our values and the way we live as lawyers doesn’t cause depression.  But it’s one of many factors that include a history of depression in one’s family and emotional abuse and/or neglect during one’s formative years that make a person prone to depression. 

Lawyers also seem to have a particularly fearsome type of stress overload; a jacked central nervous system fueled by the adversarial nature of the trade.  Modern science now knows that there is a powerful connection between chronic and remitting stress and the development of clinical depression.  As I wrote in “How Stress and Anxiety Become Depression,” chronic stress and anxiety causes the release of too many fight-or-flight hormones such as cortisol which damages areas of the brain that have been implicated in depression: the hippocampus (involved in learning and memory) and the amygdala (involved in how we perceive fear).

The point of all this sobering news isn’t to rain on anyone’s parade.  Law can and should be a noble calling and a satisfying way to make a living.  Rather, these warnings are meant to impart some thorny wisdom: living out your values and dreams are just as important as – to quote my brother Wally’s favorite expression, “carving out a living”.  Or, as Studs Terkel earlier surmised:  “. . . to have a sort of life, rather than a Monday-to-Friday sort of dying.”

It’s scary when you sense that you’ve wasted a lot of time doing a type of law – or law at all – that fails to connect with your deeper values.  Part of the fear is driven by the growing sense as we age that we don’t have forever – we are finite beings.  When we don’t know the way, can’t find path to move our outer life closer to our inner life, we can experience a sort of existential terror.  We may be sitting in a classroom, at court or just wandering downtown during our lunch break and a visceral sense that we yearn for something else will hit us.  How many of us quickly dismiss such thoughts as minor meanderings that aren’t worth our time.  But, these thoughts may keep coming.  Listen to them.  If we don’t, we may risk greater peril.

Gregg Levoy, author of Callings: Finding and Following an Authentic Life, talks about the dangers of not following the murmurs coming from within us all:

“Of course, most people won’t follow a calling until the fear of doing so is finally exceeded by the pain of not doing so – pain that we appear to have an appalling high threshold for. Eventually the prospect of emotional and financial turmoil, the disapproval of others and the various conniptions of change, can begin to seem preferable to the psychological death you are experiencing by staying put.  Those who refuse their passions and purposes in life, though, who are afraid of becoming what they perhaps already are – unhappy – won’t of course experience the unrest (or the joy) that usually accompanies the embrace of a calling.  Having attempted nothing, they haven’t failed, and they console themselves that if none of their dreams come true then at least neither will their nightmares.”

So remember your values and where they are trying to lead you.  That’s realistic.  Our values are not set in granite; they can and will change over time.  Yet the only tuning fork you will ultimately have is trying to build a solid bridge between who you really are and what you are in the real world.  We can and will hit choppy waters as we sail our ships in our careers.  There will be many temptations – money, power.  This story has been played out for millennia.  As you go through your career, watch the currents and stir your ship bravely, with integrity and passion.

As Apple founder Steve Jobs wrote:

“Your time is limited, so don’t waste it living someone else’s life.  Don’t be trapped by dogma – which is living with the results of other people’s thinking.  Don’t let the noise of other’s grievances drown out your own inner voice; and most important, have the courage to follow your heart and intuition.  They somehow already know what you truly want to become.  Everything else is secondary.”

It’s About Time

Half our life is spent trying to find something to do with the time we’ve rushed through life trying to save – Will Rogers

Time is the enemy of our synapse challenged world.  This beast is always just a step behind us; we keep losing ground as it nips at our heels and bears its sharp fangs.  We tap on the brakes to try and slow down, but even the vacations and weekends aren’t always terribly relaxing.  We attempt to break apart our days into manageable segments or, as the poet T.S. Eliot once wrote, “Measure out our lives with coffee spoons.” 

We often experience time as a force outside of ourselves; as if the clicking clock on the wall or Timex on our wrist had its own personhood that nags at us: “Do this not that, wait, what about that other that?” There is the visceral sensation that everything – everything – must be done NOW. We spin like a top trying to take it all in. We labor to manage our time while our nervous systems overload, toasted to a crisp in the microwave of our modern times.

No doubt most folk dream of chucking it all; of hopping on a Jumbo 747 to Italy to sip Chianti in a verdant field near a Tuscan village – hence the popularity of the best-selling book and movie, “Eat, Pray, Love.”  But most of us will never go aerial; we soldier on and muddle our way through our lives as best we can.  This becomes all the more a sticky wicket when life’s engine seizes up in the throes of a murky anxiety and/or depression.  Trying to stop this pain moves to the top of our priority list; we hammer away at it, but sometimes it just won’t relent.

We feel that we must figure out our sorrow and mind-bending stress before time runs out and we find ourselves in a real pickle: “If only I didn’t feel stressed and depressed, I could get all this shit done!”

In his book, You Can Feel Better Again, Richard Carlson, Ph.D., writes:

When you feel down, depressed, or blue, there is a strong tendency to try to figure out why you are feeling the way you do and to try to do something about it.  The worse you feel, the stronger the urge.  Many times, particularly with regard to a ‘depressed’ person, this need to escape from the way you are feeling is ‘urgent’. One of the tricks to overcoming depression, or even extended low moods, is to learn to relax when you feel down – having faith that the low period will pass if you are able to leave it alone and do nothing.  The important point to remember is: The factor that keeps you feeling down is your reaction to the ‘urgency’ you feel.’

I love this psychological approach: I had never thought of my reaction to my depression as “urgent”, but so often it is.  Depression’s five alarm pain can burn down even our best laid plans. We think that the way to stop this unruly visitor is to squash it, when we might be better served by waiting it out. 

Today, walking up a leafy sidewalk thinking about past fall memories, I said to myself, “I accept where I am right now.”  And I really meant it.  It calmed me. I accepted all that lay in front of me today.  This gave me a sense of peace and rootedness.  I somehow felt a kinship with the blowing trees who so timelessly anchor themselves in the rich brown soil.

Take time for yourself today.  Take time to appreciate your daily bread – moment by moment – because it’s the only loaf of time you’ve got. There is much to be appreciated beyond depression’s grasp or the clatter of our anxiety. Depression, stress and anxiety do not last forever; there are gaps – some shorter or longer – between these turbulent emotional states.  Learn to see that this is so.

Sometimes, I catch myself.  I sense that I have let hours whizz by without having paid attention to neither my life nor a scintilla of the dear people and events that surround me.  I had lived too much in my head.  We all need to step out of the limitations of our own thoughts and through the portal of all the rich possibilities and blessings that lay both within and without in the time we’ve been given.

The $tress of Success

         

We avatars of the legal system, we hired guns who ride into town and shoot up saloons, measure our success by the notches on our dusty belts: Did I win or lose?  Or, perhaps more accurately, is it: Am I a winner or a loser? There is a thrill about winning and being successful, however we define it — but also a lot of stress.

Results, bottom-line bastards that they are, can spew toxic stress into our bodies like BP oil into the Gulf.  Many lawyers struggle to shut off their inner dialogue that pings between their ears as they lay awake at night and their family sleeps:  “Will I be successful tomorrow?  Will I bill enough hours this month?” We mash ourselves up like Idaho potatoes flopping around in our beds as the minutes click away on our L.E.D. alarm clocks.

 I wrote an article for Trial Magazine about the connection between stress, anxiety and depression.  Here’s a part of that article:

 “How our bodies and brains deal with stress and anxiety hasn’t changed much in the last 10,000 years.  A 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 floods our bodies with the powerful hormones cortisol and adrenaline, which propel us into action.  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 face 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 they were being chased by a hungry lion.  Over time, this chronic anxiety causes the release of too many fight-or-flight hormones.  Research has shown that prolonged release of cortisol damages areas of the brain that have been implicated in depression: the hippocampus (involved in learning and memory and the amydala (involved in how we perceive fear).”

Living in the jungle of our profession doesn’t involve warding off wooly mammoths, but it does involve a fight-or-flight from mental constructions in our heads:  the fear of missing a court ordered deadline can create panic in our nervous system every bit as real as a tangling with a beast that tried to kill our ancestors.

Lawyers are perfectionists and overachievers who are never content to give things their just their best try.  They believe in dumping large amounts of energy into each and every project. Such extraordinary efforts are stressful on our bodies and minds.  Yet, we know all of this, don’t we?  The truth is that many lawyers have already made the calculations in their heads and are willing to take the pounding for more dollars.  We come back to our abodes at the end of our days exhausted, peak at our mutual funds statements and turn on the T.V. too tired to think about the implications of living this type of life.

Lawyer Steve Keeva, in his piece Take Care of Yourself, wrote:

 “The dominant method of legal billing can, if you let it, subvert your ability ‘to claim a full and rich life   for yourself,’ as litigator John McShane put it.  Think about it. Billing by the hour is extraordinary in the way in which it so nakedly equates money with time.  It thereby offers no incentive at all to stop working. The taskmaster par excellence can reduce grown professionals to slavish piece workers.” 

When exploring the stress of success, we shouldn’t lose sight of the fact that depression happens in a context, a cultural milieu and a profession’s mores.  Too often, we put everything on the individual – her depressive thinking, his genetic makeup – as if depression in a person forms and takes place in a vacuum:  if it “takes a village to raise a child;” well, it takes a culture to create conditions for depression to develop.

We are social creatures that need support from our families, institutions and society.  These structures help mitigate stress and prevent depression.  Yet,  contemporary culture has largely failed us: the breakdown in families, the betrayal of cultural and political institutions, a grimy cynicism in people, vacuous and crass entertainment unmitigated consumerism and a legal profession which endorses the value of professionalism while lawyers say that levels of incivility between lawyers is at an all time high.  It’s become more of a business than a profession and calling, it’s become more mercenary in nature where lawyers forget that they are officers of the court and not just there to do the bidding of a well paying client.

Bruce Levine, Ph.D., author of the book Surviving America’s Depression Epidemic, writes about renowned psychoanalyst and social critic Eric Fromm’s commentary on the connection between our cultural values and depression.  Here is an excerpt from book about the dangers of a comsumerism driven culture:

“Fromm argued that the increase in depression in modern industrial societies is connected to their economic systems.  Financial success in modern in modern cultural societies is associated with heightened awareness of financial self-interest, resulting in greater self-absorption, which can increase the likelihood of depression; while a lack of financial interest in such an economic system results in deprivation and misery, which increases the likelihood for depression.  Thus, escaping depression in such a system means regularly taking actions based on financial self-interest while at the same time not drowning in self-absorption – no easy balancing act.

The idea that money and buying stuff and acquiring status = happiness isn’t treated for what it is – a paper thin myth.  Certainly, there’s nothing wrong with making money; buying things and wishing to obtain a certain level of success in our careers. It’s a healthy recognition of the limitations of our income and what it really can buy that makes all the difference and keeps us out of this downward spiral.

In the book The How of Happiness: A Scientific Approach to Getting the Life You Want, author Sonja Lyubomirsky, Ph.D., concludes:

 “One of the reasons for the failure of materialism to make us happier may be that even hen people finally attain their monetary goals; the achievement doesn’t translate into an increase into an increase in happiness. Also, materialism may distract people from relatively more meaningful and joyful aspects of their lives, such as nurturing their relationships with family and friends, enjoying the present, and contributing to their communities.  Finally, materialistic people have been found to hold unrealistically high expectations of what material things can do for them.  One father confided to me that he believed that purchasing a forty-tow-inch flat-panel TV would improve his relationship with his son.  It didn’t.

A more spiritual take on the issue was penned by famed author and Trappist monk Thomas Merton.  In his classic work, No Man Is an Island, he writes:

 “One of the chief obstacles to a sense of wholeness in life is the selfish anxiety to get the most out of everything, to be a brilliant success in our own eyes and in the eyes of other men. We can only get rid of this anxiety by being content to miss something in almost everything we do. We cannot master everything, taste everything, understand everything, drains every experience to its last dregs. But if we have the courage to let almost everything else go, we will probably be able to retain the one thing necessary for us -whatever it may be. If we are too eager to have everything, we will almost certainly miss even the one thing we need.

Happiness consists in finding out precisely what the ‘one thing necessary’ may be, in our lives, and in gladly relinquishing all the rest. For then, by a divine paradox, we find that everything else is given us together with the one thing we needed.”

For Merton, that one thing was God.  For some of us with depression, this may be our touchstone as well; a center around which to slow down the centrifugal force of our spinning lives.  For the others, it may be our family or friends.  But whatever it is, it must ground us and bring out, as Abraham Lincoln once said, “The better angels of our nature.”

To lessen the stress in your life, and the risk for developing or exacerbating your depression, try these tips from your friend Dan:

1.   Fast for a few days from the radio in your car, the newspapers or fooling around on your Blackberry.  Take a time out.  Think of it as an experiment.  Lawyers complain that they’re stressed out only to dump more information and stimulation into their craniums at every few moment they have.  Lawyers already read and think enough for a living – give your nervous system a break for crying out loud.

2.   Hand in hand with the above, incorporate some slice of silence into your life.  It doesn’t have to be a monastic experience.  I wear a runner’s watch and do a ten to fifteen minute period of silence a day.  If you don’t do something like this, you know what you’re stuck with – too much noise.

3.   Start asking yourself some questions.  What toll on your mental and physical health is your drive to succeed exacting on your life?  Make an actual list, take it out every day and read it.  The purpose is to try to become more conscious of the actual cost of your career to you.  People tell me they don’t have the time to do this, but then spend hours researching whether to buy a Lexus or Audi.  The irony of it all.We love accumulating things and experiences in our society.  Instead of adding something into your life, what can you drop out of it that would make you feel better? 

4.   Read something that would nurture you as a person and dump the rest of the crap.  Read only one thing at a time.  Maybe a book of poetry or the biography of a heroic person. 

5.   Reconnect with the humorous, whether highbrow or sophomoric.  Plug into it and have a gut-busting hoot.

6.   Remember, that life isn’t a dress rehearsal.  The time you’re spending at your job is a segment of finite time that you’re given.  Once it’s spent, it’s spent.  No one tells you how to spend it, despite what you might have gotten yourself around to believing.   Remember, you choose.  My priest once said that on every gravestone there are two dates:  the date we were born and the date we died.  We don’t get to choose those dates.  But between those dates, is a dash line: “—.” That dash is our life and what we have done with it.  Resolve to be a person whose dash is driven by substance and not solely by success.  As Mark Twain once wrote, “Let your life sing so that upon your death, even the undertaker will weep.”

7.   The notion of “quality time” for oneself or others is largely bullshit.  Richard O’Connor, Ph.D. once said that to overcome depression we need to start investing in ourselves like we’re worth it: exercising, sleeping enough, etc.   No matter how you slice it, there is no small amount of “quality time” in which you can achieve these basic self-care routines.  The reality is you will need to take whatever amount of time it takes because YOU are worth it.

8.   If you are locked in the success matrix as a lawyer, remember that it doesn’t have to stay that way forever.  Realistically, your life won’t probably change tomorrow.  But it can begin to change in small way that can lead you in a healthier direction.

A Place Called Hope

bigstockphoto_First_Light_Ray_Of_Hope__143636We must accept finite disappointment, but never lose infinite hope – Martin Luther King

As renowned pessimists, lawyers struggle to be hopeful.  One veteran litigator told me yesterday his definition of hope: getting up the next morning and, “hopefully,” having the energy to survive the day.  But this type of hope is more about avoidance; the draining sense of dread people feel when they are working at maximum capacity and just barely staying on top of all of it.  As lawyers, we need a more expansive sense of hope; of what hope is and how it can positively affect our lives as lawyers.

Hope, in its best sense, is a positive motivator in our lives.  Psychologist, C.S. Snyder, in his 1990’s book “The Psychology of Hope:  You Can Get There from Here,’ defined hope as a “motivational construct that let one believe in positive outcomes, conceive goals, develop strategies, and muster the motivation to implement them”.  He actually invented a measuring tool and test called the “Hope Scale.”  He discovered that “low hope” people have ambiguous goals and work towards them one at a time while “high hope” people often worked on five or six clear goals simultaneously.  Hopeful people had definite routes to their goals and alternate pathways in case of obstacles.  Low scorers did not.

More recently, psychologist Anthony Scioli expanded Snyder’s definition of hope and created his own “Hope Index.”  According to Scioli, hope has a powerful spiritual (and transpersonal) dimension.  From this perspective, hope includes patience, gratitude, charity, and faith.  In a previous article from Martin Seligman, Ph.D. posted on the Lawyers with Depression website, the issue of lawyer optimism/pessimism was discussed.  Scioli makes an interesting distinction between hope and optimism.  In an article from the magazine Spirituality & Health, he put it this way:

“Faith is the building block of hope.  Above all, it is based on relationships, on a collaborative connection with people as well as their higher power, as distinct form optimism, which is connected to self-confidence.  True hope also differs from denial, which is really false hope, an avoidance of reality.”

Scioli’s newest book, “Hope in the Age of Anxiety,” coming out in September of 2009, takes square aim at how hope helps us deal with anxiety on both a psychological and physiological level:

“Hope represents an adaptive ‘middle ground’ between the over-activated ‘stress response’ [also implicated in depression] and the disengaged ‘giving-up complex’.  At a physiological level, hopefulness can help to impart a balance of sympathetic and parasympathetic activity while assuring appropriate levels of neurotransmitters, hormones, lymphocytes, and other critical health-related substances.  Equally important, a hopeful attitude may permit an individual to sustain this healthy internal environment in the presence of enormous adversity.”

While Scioli’s research and writing is focused on the broader themes and benefits of hope, other psychologists have addressed how “hope therapy” can help those who suffer with depression.  In an article from MSN, psychologist, Jenniefer Cheavens said:

“We’re finding that hope is consistently associated with fewer symptoms of depression.  And the good news is that hope is something that can be taught, and can be developed in many of the people who need it.”  Hope has two components according to Cheaven – a map or pathway to get what you want, and the motivation and strength to follow that path.

In another article  fromWebMD, Cheaver notes how hope therapy is different from other more traditional forms of therapy: “. . . hope therapy seeks to build on strengths people have, or teach them how to develop those strengths.  We focus not on what is wrong, but on ways to help people live up to their potential.”  According to other researchers associated with the hope studies, people with high hope possess these “components of hope”: 

  • Goals:  They have long-and short-term meaningful goals.
  • Ways to reach those goals:  A plan or pathway to get there and the ability to seek alternative routes, if needed.
  • Positive self-talk, similar to the little red engine from the children’s book, telling themselves things like “I think I can.”

I have often thought of hope as something that just happens.  But this research suggests otherwise.  As lawyers who deal with adversity, stress and, all too often suffer from depression, it’s wise to ponder the role that hope plays in our days.  Consider where you fall on the “hope index.”  Learn more about how you can develop the skills of being a hopeful person.  For further reading, check out this great article by lawyer, Dave Shearon called, “Hope about Lawyer Happiness” and another article by Leland Beaumont called, “Hope: This Can All Turn Out for the Best.”

My next blog will look at the spiritual dimension of hope.

“Time” Management

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Graduates of law school shouldn’t be given diplomas – they should be handed crash helmets.  Our lives as lawyers can be bruising indeed.  It’s not only the emotional charge of situations that we are asked to face; it’s the sheer volume of them.  We are always running – running to beat time.  The humorist Will Rogers captured the irony of this approach to time when he wrote: “Half our life is spent trying to find something to do with time we have rushed through life trying to save.”

As a profession, we are obsessed with the slicing, dicing and crunching of the seconds, minutes and hours were allotted in this life.  In a recent search on Amazon, I found 26,864 books on time management alone.  Yes, it is true that our working moments as lawyers have a monetary dimension.  That’s just a fact of the profession.  But for us to have fulfilling lives, time must mean more than that.

We have impoverished ourselves by seeing time only as a commodity to be used and profited from.  There is a deep sadness in many lawyers over the use and quality of their time.  They resent that their jobs take too much of their time, that they can’t spend more of it with their families and things they enjoy doing. One survey asked lawyers to, “List the most significant fears you have about your practice as a lawyer.  Sixty-four percent said they fear spending too much time practicing law and not enough time living.

Too often there is a mindless, driven quality to our lives. Such a way of being is nothing short of deadening.  The great psychologist, Rollo May put it succinctly when he wrote:

“The more a person is able to direct his life consciously, the more he can use time for constructive benefits.  The more, however, he is conformist, unfree, undifferentiated, the more, that is, he works not by choice but by compulsion, the more he is then the object of quantitative time. . . .  The less alive a person is – “alive” here defined as having conscious direction of his life – the more is time for him the time of the clock.  The more alive he is, the more he lives by qualitative time.”

Try this day not to work so compulsively – to chase time.  Value it not just as a day of work to be endured, but for the qualitiy of the moments that you have been given to live.  Be humble and mindful of the love you bring to your work and how you use it.  As Mother Teresa once said, “We can do no great things, only small things with great love.”

A Lawyer’s Heart

I’ve felt plenty of anger over my twenty years as a litigator.  Sometimes, and thank God they were few and far between, I would blow up at opposing counsel or a client.  More often, my anger would sometimes simmer just below the surface.  This is an all too common reality for today’s lawyer.  “By definition, the adversarial system is conflict-ridden, and conflict creates certain types of emotions like anger, guilt and fear, which causes stress, says Amiram Elwork, Ph.D. author of the book, Stress Management for Lawyers

According to Chicago litigator, Shawn Wood, the “nature of civil litigation involves two lawyers (often Type A personalities) squaring off against one another under circumstances where there will be a winner and a loser, and part of each lawyers job will be to capitalize on any possible error in judgment that the other side makes.”  I really don’t buy into this completely.  Many lawyers that I know aren’t “Type A” personalities.  They are usually hard working and successful.  But, it can take a tremendous toll on their mental and physical health.  They struggle with the simmering variety of anger.

Anger turned outward is hostility.  Such hostility can express itself in a number of ways for lawyers.  Andy Benjamin, Ph.D., both a lawyer and psychologist who treats lawyers with stress, anxiety and depression, describes hostility as an “array” of the following thoughts and behaviors: 

  • Holding persistent negative, hostile, or cynical thoughts during relationship interactions;
  • Chronic impatience;
  • Frequent irritability
  • Disconnecting from others due to an empathetic deficit (for example, being rigid in relationship interactions);
  • Suffering continual fatigue.

You could say most people have these problems in our hectic, stressful world.  “But lawyers are particularly susceptible to stress-related illnesses because of the unique interplay of the legal profession and lawyer personality” says the ABA Journal.  A study that followed University of North Carolina law students as lawyers for 30 years suggested that those with significantly elevated levels of hostility were more likely to have died prematurely from cardiovascular disease.

According to Jesse Stewart, assistant professor of psychology at Purdue University, depression and hostility commonly occur together.  When a person is both depressed and hostile, the traits interact in a complex way to elevate inflammatory proteins in the body.  The combination of hostility plus depression appears to be as dangerous a risk factor for heart disease as high blood pressure or even smoking.

Edward C. Suarez, Ph.D., of Duke University, says a recent study, “. . . suggests the possibility that men who are . . . hostile and exhibit depressive symptoms, even in the mild to moderate range, are at heightened risk for cardiac events.”  This is so because of the release of adrenaline during times of stress.  According to Dr. Cleaves M. Bennet, clinical professor of medicine at UCLA Medical Center,  “Adrenaline is the growth hormone for the heart muscle.  On the one hand, its good to have a big, strong heart, but at the same time that the heart is getting bigger and stronger, the arteries are narrowing to protect the tissue.”

Given the clear connection between lawyer hostility, depression and the heightened risk for a cardiac event, what can lawyers do about it?

First and foremost, they need to educate themselves about the connection between depression, hostility and heart disease. Most people don’t see the correlation. But, there’s no denying the science which makes the links. 

Second, because hostility creates stress in the body (i.e. the release of adrenaline and cortisol when the body goes into the fight or flight mode), it’s critical to discharge the stress through some form of exercise.  When I go through a good workout after a confrontational day, it’s as if I am wiping the slate clean.  I am discharging the stress that is causing so much trouble in my body and bringing it back into some kind of balance.  Exercise is really just a formalized form of the flight response to stress.  Our bodies want to step on the gas.  Listen to your body and let it run.

Third, you need to find out where your hostility is coming from.  Is it from problems in your personal life that you bring into your daily life as a lawyer?  If so, these need to be met and addressed.  Or, is it the other way around?  Is it the daily grind and confrontation at the office that you bring home?  It’s important to figure this out.  If opposing counsel is a jerk and elicits a hostile reaction from you, it might be time to learn (and, yes, it is a skill you can learn) different ways of being assertive without harming your heart and increasing your risk for depression.  If it is problems at home, identify them and if need be, go for counseling.

Fourth, learn to tell the difference between being assertive and being aggressive. For further reading on this topic, check out this article “Are you Assertive – or Aggressive?” and the article “Assertive, Not Aggressive.”  To help evaluate your own levels of perceived stress and associated health risks, visit the University at Pittsburgh Center’s Healthy Lifestyle Program Web site.

Depression and our bodies

Working as a lawyer and struggling with clinical depression is a tough.  I know, because I deal with both every day.  In a peculiar sense, it is really like having two full-time jobs that absorb all of our time.  As we know, the daily demands and stress of our jobs as lawyers are often unremitting:  Deadlines to meet, phone calls to return, and that motion to argue in Court the next morning.  We often feel that others who aren’t lawyers really don’t understand us and our work because they haven’t “walked in my shoes.”

The “job” of being depressed seems to parallel my experience as a lawyer.  A common experience of feeling depressed is feeling alone and isolated.  When people who care about us reach out to help, there are times we push them away out of a sense of bitterness thinking:  “You really don’t know what it’s like to be a lawyer”.

Yet, there may come a time when we might want to begin seeing depression and our vocation as lawyers a little differently.  Not as two jobs, but really one.  The one job is finding a way to take care of ourselves.  Mother Teresa  once said that what God expects of humanity is that we be “a loving presence to one another.”  Taking that further, I would suggest what God equally expects is for us to be a loving presence to ourselves.

In any law firm, the barometric pressure of stress rises and falls frequently. Consequently, we often find it difficult to be a “loving presence” to ourselves:  to eat well, exercise, get enough sleep, and nurture a support structure of good friends.  The gale-force winds of stress, burnout and depression can begin blowing and disconnect us even from this basic agenda.  Yet, if we are to regain our health in the midst of depression, we must return to these basic concerns because depression afflicts our minds and our bodies.  Our physical state –our precious bodies – get hammered by the unremitting punishment that depression dishes out.  I have often described it to friends as “wet cement running through my veins.”

The biochemical imbalance that is so often a part of depression affects every part of our physical makeup: our eating, our weight, our energy level, and our ability to sleep.  How can we realistically hope to “feel better,” to regain the healthy ground that depression has knocked us off, if we don’t offer a loving presence to our tired and afflicted bodies left unbalanced, weak, and fatigued in depression’s wake?

Being a loving presence to our bodies is like being a loving parent.  We need to pause – and to have a support structure of people who remind us to pause – to ask ourselves what is good for our bodies.  My family doctor once told me that our bodies are like giant tape recorders that remember everything we have done to them.  Too little sleep, too much stress, not enough exercise tells our body that we simply don’t care and/or don’t have the time for it.  This pattern can have catastrophic consequences when depression hits because the body that we need to help us is not fully able to be our ally.  Because it has been ignored, it is of little help to fight depression and actually participates in it.  Anti-depressant medication can be a way, especially in the beginning, to begin to soothe our bodies, to calm our minds enough, so that we can begin thinking of how we are going to rebuild that loving relationship with our bodies.

One of my favorite parts of the Bible comes from the Old Testament, the Twenty Third Psalm.  To me, it speaks about the journey: “Yea, though I walk through the valley of the shadow of death, I will fear no evil; for You are with me; Your rod and Your staff, they comfort me.”  All humans must make this journey.  We must all “walk through the valley” of a life which is certain to have its victories and times of happiness, but also its stunning defeats and times of deep sorrow.  The shape of those victories and defeats take a particular form for lawyers.  Even more so for lawyers who struggle with  depression.  The valley can feel more like a deep trench with no way out.  Our bodies can feel buried in this trench with no light or air able to penetrate depression’s paralyzing weight.  Yet, there are steps each of us can take to begin our climb out of this hole.  In my experience, our bodies are like the ladders propped against the trench of depression.  The great Psalm tenderly says to us that we are not alone; God is there with us in the deepest darkness.  Yet, I would also suggest that our bodies are there for us also, waiting to assist us in our journey towards wholeness.

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