Is it Lawyer Sadness or Lawyer Depression?

I can spot sadness on a lawyer’s face like a good poker player can read dog-eared cards in a smoky, backroom bar.  To others, his or her expression may seem like a seasoned lawyer’s humorless and steely resolve. But, I know better.  There is something tragic in his or her gaze, his or her face a subtler shade of grey.  The repartee, if any, is deeply cynical and sarcastic. It is a tough life for many in this boat, and many dream of a different life.  “Every man has his secret,” wrote Tennyson, “which the world knows not; and often times we call a man cold when he is only sad.”

sad woman

Such sadness, however, does not necessarily equate with clinical depression. Like all humans that walk this earth, sadness is woven into the life of every lawyer.  One of the tougher aspects of their lives is that their demanding careers often leave little time to be with and enjoy their families.  Because sadness is often about the loss of people we care about and/or the time we spend with them, this one seems to be particularly piercing for lawyers. Too much sadness is the price they pay for too much time at work.

For most of us, sadness seems to be short-lived before we bounce back up.  When sadness goes on for a day or two, we might say that we have “the blues.”

It’s normal to feel the blues; a bittersweet type of sadness that colors our lives from time to time. Blues music is very popular given the universal nature of this experience.

But while sadness and the blues are inevitable parts of life, clinical depression is not.  The most significant difference between sadness and the blues is that someone that’s sad goes about their daily business without much trouble.  But depression involves impairment in one’s ability to carry out daily task at work and home.

Dr.Richard  O’Connor, in his deeply insightful book Undoing Depression, captures some of the difference between the two:

“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   depression, but the difference is like the difference between the sniffles and pneumonia.”

Other differences between the blues and depression include the length of time the sadness endures and whether or not there are other symptoms associated with depression which are tagging along with the perpetual sadness.

“I think the difference between just having the blues and depression lies in the symptoms,” writes Raymond Crowe, M.D., professor of psychiatry. “If the blues’ persist for more than a couple of weeks and are accompanied by trouble eating, difficulty sleeping, or suicidal thoughts, you should see a therapist or psychiatrist or your family doctor.”

depressed cave

Psychiatrist Peter Kramer, author of Against Depression, underscores the point that depression is a serious illness and not ordinary sadness:

For the psychiatrist, then, depression becomes an intimate.  It is poor company.  Depression destroys families. It ruins careers. It ages patients prematurely. It attacks their memories and their general health. For us – for me – the truth that depression is a disease is unqualified.  Depression is debilitating, progressive and relentless in its downhill course, as tough and worthy opponent as any doctor might choose to combat.”

It’s important to recognize the difference between lawyer sadness and depression because a suffering lawyer will not be able to resolve the depression by himself; talking it out with a group of workpals over some beers at lunch just won’t get to the heart of the problem.  This person will need a mental health professional to evaluate him or her and get him or her the serious help he or she needs.

Too frequently, the culture at large, and perhaps the legal profession in particular, mix up sadness, discontent, malaise, unhappiness and clinical depression.The titles of media and journal articles, while they may touch on depression, reflect this clumping together of unhappiness and depression.  I was interviewed for an article by The Wall Street Journal about depression in the legal profession.  While it was clear that the story was going to be about depression, the article’s title was Even Lawyers’ Get the Blues. A recent Law Journal article, which included a small section on depression, was titled How to Be a Happy, Healthy and Ethical Member of an Unhappy, Unhealthy and Unethical Profession.  Martin Seligman, the guru of the Positive Psychology movement, wrote a chapter in his book “Authentic Happiness” called, Why Are Lawyers So Unhappy? In the chapter, however, he wrote about both unhappiness and depression without attempting to differentiate the two.

This commingling of ordinary sadness, unhappiness and depression is confusing and misleading. And dangerous.  It is confusing because a sufferer and those around him may underestimate the gravity of the situation: “Bob is just sad, going through a tough patch at the law office.  He’ll get over it.”

But, Bob might not.  He may get worse.  The depression may deepen.  He may need medication that he’ll never get. He may need to talk to a therapist to address the distorted thinking that goes on during a depression. He may need medication to lift himself out of the darkness. Absent such help and hope, he may commit suicide.  As much as 80% of suicides are committed by those struggling with depression and lawyers have much higher suicide rates than the general population.

Others simply do not have a reference point for depression unless they have been through it before. Sadness? Yes. The deep psychic pain of depression? No. Misidentifying a person with depression as having the blues can have severe consequence because the more people do so in the life of the depressed person, the greater the isolation, the greater the pit of desolation the depressive falls into because no one understands. It causes them to queston themselves: “Why can’t I snap out of this?  What’s wrong with me?”

DSM

According to The Diagnostic Statistical Manual (DSM), the bible used by mental health workers, to be diagnosed with depression you need to have had a depressed mood or loss of interest or pleasure in daily activites for more than two weeks.  According to the National Institute of Mental Health, you also must have some, but not all, of the following symptoms:

  • Difficulty concentrating, remembering details, and making decisions
  • Fatigue and decreased energy
  • Feelings of guilt, worthlessness, and/or helplessness
  • Feelings of hopelessness and/or pessimism
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Overeating or appetite loss
  • Persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
  • Persistent sad, anxious, or “empty” feelings
  • Thoughts of suicide, suicide attempts

Do you think either you or someone you care about is suffering from depression?

Take this depression test to see if you or someone you care about might be suffering from depression.  If so, get help now.

 

 

 

Best Depression Quotes

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

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

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

The so-called ‘psychotically depressed’ person who tries to kill herself doesn’t do so out of quote ‘hopelessness’ or any abstract conviction that life’s assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire’s flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It’s not desiring the fall; it’s terror of the flames. And yet nobody down on the sidewalk, looking up and yelling ‘Don’t!’ and ‘Hang on!’ can understand the jump. Not really. You’d have to have personally been trapped and felt flames to really understand a terror way beyond falling.  David Foster Wallace

The term clinical depression finds its way into too many conversations these days.  One has the sense that a catastrophe has occurred in the psychic landscape. Leonard Cohen

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

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

Depression presents itself as a realism regarding the rottenness of the world in general and the rottenness of your life in particular. But the realism is merely a mask for depression’s actual essence, which is an overwhelming estrangement from humanity. The more persuaded you are of your unique access to the rottenness, the more afraid you become of engaging with the world; and the less you engage with the world, the more perfidiously happy-faced the rest of humanity seems for continuing to engage with it.  Jonathan Franzen, How to Be Alone

I’m here. I love you. I don’t care if you need to stay up crying all night long, I will stay with you. There’s nothing you can ever do to lose my love. I will protect you until you die, and after your death I will still protect you. I am stronger than Depression and I am braver than Loneliness and nothing will ever exhaust me.  Elizabeth Gilbert, Eat, Pray, Love

Choking with dry tears and raging, raging, raging at the absolute indifference of nature and the world to the death of love, the death of hope and the death of beauty, I remember sitting on the end of my bed, collecting these pills and capsules together and wondering why, why when I felt I had so much to offer, so much love, such outpourings of love and energy to spend on the world, I was incapable of being offered love, giving it or summoning the energy with which I knew I could transform myself and everything around me.  Stephen Fry, Moab Is My Washpot

I didn’t want to wake up. I was having a much better time asleep. And that’s really sad. It was almost like a reverse nightmare, like when you wake up from a nightmare you’re so relieved. I woke up into a nightmare.  Ned Vizzini, It’s Kind of a Funny Story

I thought the most beautiful thing in the world must be shadow, the million moving shapes and cul-de-sacs of shadow. There was shadow in bureau drawers and closets and suitcases, and shadow under houses and trees and stones, and shadow at the back of people’s eyes and smiles, and shadow, miles and miles and miles of it, on the night side of the earth.  Sylvia Plath, The Bell Jar

No amount of love can cure madness or unblacken one’s dark moods. Love can help, it can make the pain more tolerable, but, always, one is beholden to medication that may or may not always work and may or may not be bearable.  Kay Redfield Jamison, Night Falls Fast

Depression is melancholy minus its charm.  Susan Sontag

You are constantly told in depression that your judgment is compromised, but a part of depression is that it touches cognition. That you are having a breakdown does not mean that your life isn’t a mess. If there are issues you have successfully skirted or avoided for years, they come cropping back up and stare you full in the face, and one aspect of depression is a deep knowledge that the comforting doctors who assure you that your judgment is bad are wrong. You are in touch with the real terribleness of your life. You can accept rationally that later, after the medication sets in, you will be better able to deal with the terribleness, but you will not be free of it. When you are depressed, the past and future are absorbed entirely by the present moment, as in the world of a three-year-old. You cannot remember a time when you felt better, at least not clearly; and you certainly cannot imagine a future time when you will feel better.  Andrew Solomon, The Noonday Demon

Depression is the most unpleasant thing I have ever experienced. . . . It is that absence of being able to envisage that you will ever be cheerful again. The absence of hope. That very deadened feeling, which is so very different from feeling sad. Sad hurts but it’s a healthy feeling. It is a necessary thing to feel. Depression is very different.   J.K. Rowling

Do not abandon yourselves to despair. We are the Easter people and hallelujah is our song.  Pope John Paul II

The absolute worst part of being depressed is the food. A person’s relationship with food is one of their most important relationships. I don’t think your relationship with your parents is that important. Some people never know their parents. I don’t think your relationship with your friends are important. But your relationship with air-that’s key. You can’t break up with air. You’re kind of stuck together. Only slightly less crucial is water. And then food. You can’t be dropping food to hang with someone else. You need to strike up an agreement with it.  Ned Vizzini, It’s Kind of a Funny Story

Depression is the flaw in love. To be creatures who love, we must be creatures who can despair at what we lose, and depression is the mechanism of that despair.  Andrew Solomon, The Noonday Demon: An Atlas of Depression

And an inky-colored despair of rejection enveloped me like the black tortilla of depression around a pain burrito.  Christopher Moore, Bite Me

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

So why am I depressed? That’s the million-dollar question, baby, the Tootsie Roll question; not even the owl knows the answer to that one. I don’t know either. All I know is the chronology. Ned Vizzini, It’s Kind of a Funny Story

Music can lift us out of depression or move us to tears – it is a remedy, a tonic, orange juice for the ear. But for many of my neurological patients, music is even more – it can provide access, even when no medication can, to movement, to speech, to life. For them, music is not a luxury, but a necessity.  Oliver Sacks

Grief is depression in proportion to circumstance; depression is grief out of proportion to circumstance.  Andrew Solomon, The Noonday Demon

We don’t have a great war in our generation, or a great depression, but we do, we have a great war of the spirit. We have a great revolution against the culture. The great depression is our lives. We have a spiritual depression.   Chuck Palahniuk, Fight Club

I didn’t want to wake up. I was having a much better time asleep. And that’s really sad. It was almost like a reverse nightmare, like when you wake up from a nightmare you’re so relieved. I woke up into a nightmare.  Ned Vizzini, It’s Kind of a Funny Story

Killing oneself is, anyway, a misnomer. We don’t kill ourselves. We are simply defeated by the long, hard struggle to stay alive. When somebody dies after a long illness, people are apt to say, with a note of approval, “He fought so hard.” And they are inclined to think, about a suicide, that no fight was involved, that somebody simply gave up. This is quite wrong.  Sally Brampton, Shoot the Damn Dog: A Memoir Of Depression

It’s so hard to talk when you want to kill yourself. That’s above and beyond everything else, and it’s not a mental complaint-it’s a physical thing, like it’s physically hard to open your mouth and make the words come out. They don’t come out smooth and in conjunction with your brain the way normal people’s words do; they come out in chunks as if from a crushed-ice dispenser; you stumble on them as they gather behind your lower lip. So you just keep quiet.”  Ned Vizzini, It’s Kind of a Funny Story

A loss of focus can be the most debilitating of depressive symptoms, rendering a person unable to work effectively or plan for the future, which seems desolate, devoid of the possibility of redemption.  John Nelson, M.D.

The depressed person is constantly chewing on himself.  He needs to find something else to chew on. The form of diversion is not important, but the act of diversion is.  Penelope Russianoff, When Am I Going to Be Happy?

Depression is not only an experience in the mind; it is also an affliction of the body.  There is a lack of energy, a painful heaviness; sadness and a grief that permeate to our marrow. Philip Martin, The Zen Way through Depression

In an age of hope men looked up at the night sky and saw “the heavens.” In an age of hopelessness they call it simply “space”.   Peter Kreeft

The opposite of depression is not happiness, but vitality – the ability to experience a full range of emotions, including happiness, excitement, sadness, and grief. Depression is not an emotion itself; it’s the loss of feelings, a big heavy blanket that insulates you from the world yet hurts at the same time. It’s not sadness or grief, it’s an illness.  Richard O’Connor, Ph.D., Undoing Depression

Depression can be set off by a variety of stressors: sexual abuse, housing problems, illness in one’s child, and the other common problems you might imagine. To suggest that depression arises from loss is to skew the argument in the direction of the metaphor . . . , the one that likens apparent depression to ordinary bereavement. Likewise, “sadness” does not capture the essence of depression, which is a marked disruption of brain and mind characterized by painful apathy. Not only in degree but also in quality, sadness and depression are different.  Peter Kramer, M.D., Against Depression

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.  Hara Estroff Marano

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.  Abraham Lincoln

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.  Jonathan Rottenberg, Ph.D.

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.   Richard O’Connor, Ph.D., Undoing Depression

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.  James Gordon, M.D., Unstuck

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.  Ellen McGrath, Ph.D.

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.  Lara Honos-Webb, Listening to Depression

The opposite of depression is not happiness, but vitality – the ability to experience a full range of emotions, including happiness, excitement, sadness, and grief. Depression is not an emotion itself; it’s the loss of feelings, a big heaving blanket that insulates you from the world yet hurts at the same time. It’s not sadness or grief, it’s an illness. Richard O’Connor, Ph.D., Undoing Depression

When we ruminate, we become fruitlessly preoccupied with the fact that we are unhappy and with the causes, meanings, and consequences of our unhappiness. Research has repeatedly shown that if we have tended to react to our sadness or depressed moods in these ways in the past, then we are likely to find the same strategy volunteering to ‘help’ again and again when our moods start to slide. And it will have the same effect: we’ll get stuck in the very mood from which we are trying to escape. As a consequence, we are at even higher risk of experiencing repeated bouts of unhappinessMark Williams, The Mindful Way through Depression

Perhaps all the dragons of our lives we fear are princes and princesses who are only waiting to see us once beautiful and brave. Perhaps everything terrible is in its deepest being something helpless that wants us to help.  Rainer Maria Rilke

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 your 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.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 breakdown can become a gift when it is in the service of increasing reflection on your life which will lead you 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 heal your life.  Lara Honos-Webb, Ph.D., Listening to Depression

Depression has a mind of its own. When you are depressed, you think in generalizations (nothing works out), you don’t give yourself credit (I can’t do anything right), and you label yourself in the most negative terms (loser, ashamed, humiliated). You set demanding standards that you will never live up to. You may think you need to get everyone’s approval, or excel at everything you do, or know for sure something will work out before you try it. Your thinking keeps you trapped in self-criticism, indecisiveness, and inertia. Robert Leahy, Ph.D., How to Beat the Blues

Depression is the inability to construct a future.  Rollo May, Ph.D.

Every time a person gets depressed, the connections in the brain between mood, thoughts, the body, and behavior get stronger, making it easier for depression to be triggered again. At the earliest stages in which mood starts spiraling downward, it is not the mood that does the damage, but how we react to it. Mark Williams, The Mindful Way through Depression

The Failure of Will theory is popular with people who are not depressed.  Get out and take your mind off yourself, they say. You’re too self-absorbed.  This is just the stupidest thing you can say to a depressed person, and it is said every day to depressed people all over this country.  And if it isn’t that, it’s, ‘Shut up and take your Prozac.’ These attitudes are contradictory. Conquer Your Depression and Everything Can Be Fixed by the Miracle of Science presuppose opposite explanations of the problem. One blames character, the other neurotransmitters.  They are often thrown at the sufferer in sequence: ‘Get out and do something, and if that doesn’t work, take pills.’ Sometimes they’re used simultaneously: ‘You won’t take those pills because you don’t WANT to do anything about your depression, i.e. Failure of Will. Susanna Kaysen, Unholy Ghosts: Writers on Depression

Perhaps, the answer is that my ravaged mind rails against the idea of God, but something deeper in me calls out as if God might answer. ‘There are not foxholes,’ I guess, and depression is the deepest and deadliest foxhole I’ve been in. It may be the ‘dark night of the soul’ that the mystics talk about but in depression it is not so much that one becomes lost in the dark as one becomes the dark.  Parker Palmer

Depression can seem worse than terminal cancer, because most cancer patients feel loved and they have hope and self-esteem.  David D. Burns, Ph.D.

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

One description of depression is that it is like the shapeless sagging of a rubber band that has been kept too taunt for too long. When feelings have been strong, stressed, unprocessed, or held captive over a period of time, we just stop feeling altogether. Persons and events no longer have the power to enliven us; we operate on a low level cruise control.  Usually we keep functioning, but there is no positive or creative affect toward persons and things, and even less toward ourselves.  We basically stop living our only life.  Ron Rohr

All of us feel shamed by life.  All of us consider ourselves failures of some kind, screw ups in something really important to us. Notice how shame, consciously or unconsciously pulls us away from risk, ratifies our negative sense of worth through self-sabotage or compels us into frenetic efforts of overcompensation or yearning for the validation from others that never comes; how much each of us needs to remember one definition of grace as accepting the fact that we are accepted despite the fact that we are unacceptable   James Hollis, Ph.D., What Matters Most

Everyone knows 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., Undoing Depression

While direct-to-consumer advertising has likely fostered an easier acceptance of these pills, most of the people I interviewed who suffer from major depression embark on a psychiatric career with great reluctance.  Typically my respondents turn to medications only when desperation leaves them without alternatives.  This is understandable in terms of the identity line that one crosses by seeing a doctor, or seeing a diagnosis of depression and filling the prescription for anti-depressants.  One person poignantly expressed her identity dilemma by saying that, ‘When I swallowed that first pill I swallowed my will.’ Beginning a regimen of psychiatric medications is part of the traumatic transformation from person to patient; from being merely a troubled person to someone who has mental illness.   Daniel Karp, Speaking of Sadness

Mysteriously and in ways that are totally remote from natural experience, the grey drizzle of horror induced by depression takes on the quality of physical pain.  William Styron, Darkness Visible

 

 

 

 

It’s Just Cancer – Get Over It.

 

bigstockphoto_Man_In_Depression_5432510 

 

 

 

 

 

I arrived in New York City’s JFK Airport yesterday.  My family and I are visiting friends over the weekend.  While walking through the terminal, I saw a large advertisement from the Depression Is Real Coaliation. If you haven’t heard of this organization, check out their website.  The ad read as follows:

YOU’D NEVER SAY, “IT’S JUST CANCER, GET OVER IT”.  So why do some say that about depression?

When I first developed depression over seven years ago, at least five people told me to “get over” or “snap out of” it.  Get over or snap out of “what” I often thought.  I searched my mind for some frame of reference.

When people are too preoccupied with themselves and their problems, we have all thought or told them to end their narcissistic nonsense.  “Life isn’t so bad.  So stop complaining,” is our common refrain.   We judge them to be selfish, inconsiderate or even burdensome. Yet, were such people suffering from a physical illness – say cancer, diabetes or heart disease – we would never imagine saying such a thing for fear of being thought cruel, rude or simply ignorant. 

Sadly, all too often, people treat people with depression as if they don’t have an illness, but a problem of self-absorbtion.   And for people who have experienced the Black Dog, they know exactly what I am talking about. Such comments make us doubt ourselves:  “maybe I am just a complainer,” or “I’m just selfish.”  But deep down, we may sense otherwise.  If we do, we know that something is seriously amiss.    

Critical comments from others made me feel like the accused.  I imagined what must have been going through their minds:  “You’re faking it.  Now let’s get back to the business of practicing law.” They just didn’t seem to believe me.  That didn’t believe that I had a chemical imbalance in my brain, that it wasn’t my fault and that this had made me sick – very sick.

In the beginning of my journey, I wanted everyone to understand me.  I wanted them to just say, “It is okay, Dan.  You have a medical illness and need treatment.”  Sometimes this happened and sometimes it didn’t.  When it didn’t, I felt hurt and even angry.  I thought, “Just step in my shoes for an hour and you’ll know that what I’m experiencing is true.”  We need to be careful who we choose to expect sympathy from.  Make no mistake about it, we need allies when we are in a depression.  Most often, it will come from other depressives who have “walked the walk,” people who have known and loved others with depression, or just big-hearted, everyday people.

In his book, Against Depression, psychiatrist, Peter Kramer, M.D., takes an unflinching account of the illness that is depression.  Check out his Blog.  Kramer cites a number of scientific studies linking depressive symptoms with abnormalities in the hippocampus and prefrontal cortex of the brain.  Kramer also emphasizes that depression is more than a brain disease.  “It is a neurologic, hematologic and cardiovascular disease.  Overactivation of stress pathways causes a liability to clots and [heart] arrhythmias – and along or together, they predispose to heart attacks, silent strokes, disturbed mood and sudden death”, he wrote.  Listen here to Dr. Kramer being interviewed by National Public Radio.

Richard O’Connor, Ph.D., author of the best-selling book, Undoing Depression: What Therapy Doesn’t Teach You and Medication Can’t Give You, makes clear why depression should be likened to other major medical illnesses:

“Heart disease is a good analogy to major depression.  Heart disease is “caused” by a complex of factors, including a genetic predisposition, emotional factors like how we handle stress, and habits like diet and exercise.  You don’t catch heart disease from an infection.  You develop it gradually, over time, as plaque builds up in your arteries.  Once you cross an invisible threshold marked by standards of blood pressure and cholesterol levels, you have heart disease . . . . Depression may be a similar threshold disease – genetic and biochemical factors may determine a different level of stress for each of us that, once reached, puts us over the edge into depression.”

It is critical to remember that depression isn’t your “fault.”  However, it’s equally important to remember that it’s your responsibility.  We must take responsibility to get better and stay that way.  Yes, the critical judgments of others hurt. That’s why it is imperative to not go through this alone.  Join a depression support group.  They have also dealt with the judgments of others.  There truly is strength in numbers.

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