Attorneys Grapple with High Rates of Stress, Burnout

Business West reports, “Lawyers say they entered the legal field to help people with their problems — often very difficult, serious problems. The danger is internalizing those problems and making client stress a permanent part of one’s psyche. That pitfall, and other stressors common to lawyers, from time pressures to sometimes-adversarial work relationships, contribute to unusually high levels of burnout, depression, substance abuse, and even suicide in the legal field. One challenge, experts say, is to recognize those dangers before they take root.” Read the News

 

Holiday Survival Guide for Lawyers with Depression

From The Anxious Lawyer website, “Unfortunately, for all too many people, and particularly for all too many lawyers, the holiday season is a time filled with sadness, self-reflection, loneliness and anxiety. It is a season that comes with a “holiday depression” of its own which can affect anyone, whether it be due to time pressures, family issues, financial worries, memories of past holidays or just loneliness.” Read the Blog

Why I’m Speaking Up About Lawyers and Depression

From The Mighty, “Lawyers aren’t supposed to have problems; we’re supposed to fix them. Most male lawyers I know would rather drop dead than admit they have problem with depression. I guess the exception to this observation is when the wheels have fallen off. Then, and only then, do they recognize (hopefully) they are experiencing depression.” Read the Blog

Ketamine and Depression: Too Much, Too Soon?

Any new drug that might work faster and have fewer side effects is jumped on by researchers and clinicians alike. The latest drug, heralded by some as a new wonder drug for depression, is ketamine.  But should we roll out it out as a fix for depression?  Read the News

“Plop, Plop, Fizz, Fizz” – Oh, What a Relief it is? Our Relationship with Antidepressants

Alkaseltzer

Most folks with depression have a complicated relationship with their antidepressant medications.

I certainly do.

While these pills saved my life years ago when major depression struck, years later, I often wonder if I still need to take them, or, if they’re still effective.

If I feel tired and flat on a particular afternoon, is it depression, the side effects of my meds or a jumble of both? Or maybe, it’s just my persistently pensive nature?

I think about this a lot these days – and maybe you do as well.

While the one-two punch of Cymbalta and Lamictal have kept me out of the dungeon of major depression for years, its comes with a cost. I have interludes of passivity, numbness, and fatigue. Maybe a low-grade depression at times, as well. If I ditch the drugs, maybe I will feel more “alive,” I think. I fantasize that cutting my ties with meds could lessen the days lost to the deadening grayness of a medically induced sense of normalcy I sometimes go through.

But I also feel anxiety. If I went cold turkey and lived medication-free, would it end, well, in disaster? A return to the swampland of depression? A deadman’s land if ever there was one. Can I take that chance? Should I?

There’s scary research that suggests once you stop antidepressants that work (or sort-of-work) for you and try to go back on the same ones because being off of them caused your depression to return (or you just couldn’t tolerate the horrible side effects that can come with discontinuation), there’s a good chance they won’t be as effective.

So, what’s a depressed person supposed to do? What should I do?

There are two camps that offer some guidance on this issue. Both have persuasive arguments about why those afflicted should or shouldn’t stay on meds.

The Stay on the Meds Camp

If depression is an “illness,” like diabetes or heart disease, I need these meds to balance out my of whacky neurochemistry. Given my risk factors: a family history of depression (genetics), a crazy childhood with a nutty, abusive and alcoholic father, and a high-pressure job with too much stress, I should stay on the pills.

IMG_6260

In his insightful essay in the New York Times, In Defense of Antidepressants, psychiatrist, Peter Kramer, author of the best-selling books, Listening to Prozac and Against Depression, suggest that studies show this: for mild or moderate depression, talk-therapy is as or more effective that medication. But for the Moby Dick sized sucker called Major Depression? Medications are warranted, and, indeed, lifesavers. They help many to function and live productive lives, albeit with a range of mild to more severe side effects.

The Get off the Meds Camp

Some people (including psychiatrists) see meds as the devil’s handiwork: supposed chemical solutions to emotional problems that flat-out don’t work. Many psychiatrists’ (and family doctors who write the overwhelming majority of scripts for these drugs in the U.S.), they maintain, are “pill pushers” who do the bidding of “BigPharma”, a multi-billion dollar industry in this country. Antidepressants aren’t so much a cure as a curse.

Irving Kirsh, Ph.D., author of The Emperor’s New Drugs: Exploding the Antidepressant Myth, writes:

“Putting all [the research] together leads to the conclusion that the relatively small difference between drugs and placebos might not be a real drug effect at all. Instead, it might be an enhanced placebo effect, produced by the fact that some patients have broken [the] blind and have come to realize whether they were given drug or placebo. If this is the case, then there is no real antidepressant drug effect at all. Rather than comparing placebo to drug, we have been comparing ‘regular’ placebos to ‘extra-strength’ placebos.”

The remedy from this group? Psychotherapy. They see depression as the result of off-kiltered, negative thinking patterns. The way out of these ruminative, pessimistic thoughts involves working with a therapist who uses, most often, Cognitive Behavioral Therapy, to challenge and encourage patients to replace such thoughts with more realistic and positive ones.

In his book Undoing Depression: What Therapy Doesn’t Teach You and Medication Can’t Give You, Richard O’Connor, Ph.D. argues that both therapy and medication are effective, but limited in certain respects.  He advocates an additional factor often overlooked in depression recovery: our own habits. Unwittingly we get good at depression. We learn how to hide it, how to work around it. We may even achieve great things, but with constant struggle rather than satisfaction. Relying on these methods to make it through each day, we deprive ourselves of true recovery, of deep joy and healthy emotion.

The book teaches us how to replace depressive patterns with a new and more effective set of skills. We already know how to “do” depression-and we can learn how to undo it.

Some Recent News on the Meds and Therapy Conundum

The New York Times reports that a large, multicenter study by Dr. Charles Nemeroff, then a professor of psychiatry at Emory and now at the University of Miami, found that for depressed adults without a history of abuse, there was a clear ranking order of treatment efficacy: Combined psychotherapy (using a form of cognitive behavior therapy) and an antidepressant (in this case, Serzone) was superior to either treatment alone. But for those who had a history of childhood trauma, the results were strikingly different: 48 percent of these patients achieved remission with psychotherapy alone, but only 33 percent of these patients responded to an antidepressant alone. The combination of psychotherapy and a drug was not significantly better than psychotherapy alone.

So what’s a depressed person supposed to do?

I don’t know, really.

We’re in a pickle, aren’t we?

Maybe there’ll be a soon-to-be discovered test that can guide us on precisely what to do. But for now, many of us will stay-the-course and, for better or worse, stick to the “plop, plop, fizz, fix”.

I see myself somewhere in the middle of all this. I’ve never been hospitalized or tried to commit suicide. But I have known depression’s scorching winds, gales that have torn the flesh from my body. I will never forget this pain. It’s scarred me. And I never want to return to it.

If you’re thinking of discontinuing your meds, here’s a great article on how to do it safely.

I welcome your comments about your depression journey with or without medicaton.

Copyright, 2017

by Daniel T. Lukasik

How Vulnerable Are You to Relapse

Blogger Carol Richard writes in Esperanza magazine writes about depression relapse: “As solid as mine or anyone’s recovery may be, it doesn’t stop the illness from trying to get out & start taking over our lives again. It’s the nature of chronic health issues – why we can only MANAGE our health, not CONTROL it. Great ideas here. Read the Blog

Lawyers, Don’t Let Perfectionism Ruin Your Health

Duke University Law grad, Jennifer Alvey explores why lawyers have such poor mental and physical health: “Part of the answer lies in lawyers’ predisposition toward perfectionism. I often encounter lawyers who can only envision doing something if they can be all in. Doing something less-than-perfectly is seen as failure. When it comes to exercise and diet, this kind of thinking can set anyone up for failure because they will try to make big, grand changes at once, be unable to sustain them, and quickly quit in disgust.”  Read the rest of her Blog

Built by Staple Creative