It’s Just Cancer – Get Over It.

 

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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.

Spiritual Hope – A Postscript

 

I have been listening to a wonderful audio interview with author/educator, Parker Palmer produced by a company called, Sounds True.  Check out their website.  Its catalog of authors address wellness, meditation, spirituality and personal growth is simply amazing.

Parker is currently 70 years old and a Quaker.  In the interview, he recounts the three major episodes of clinical depression he went through during his life. He said some insightful things to say about those experiences.  He doesn’t believe in “formulas” or “How-to-Lists” to cope with depression.  He speaks about depression in the context of his spirituality:

“Perhaps, the answer is that my ravaged mind rails against even the idea of God, but something deeper in me calls out as if God might answer.  ‘There are no 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 that one becomes the dark.  I have never been able to ‘do theology’ when I am in this state; the best I’ve been able to do is hang on.  Only later, in the light of day, am I able to understand that God walked with me in the darkness even though I could not feel God’s presence at the time.”

Later, he talks about how he survived his depression:  he “slogged through it.”  And maybe, sometimes, that’s all we can do.  While we may feel that a depression will never end, it’s important to remember that it always does and we can use that knowledge to slog through it.

A Spiritual Sense of Hope

 

bigstockphoto_Exulting_The_Sunset_300315In my previous Blog, I looked at hope from a psychological perspective. This writing will focus on the spiritual dimension of hope and the experience of depression.

Hopelessness is a common feature of depression. During the depths of my episodes, it was my constant companion.  I believe that hopelessness is strongly connected to a sense of helplessness:  no matter how sincere or noble our efforts to overcome depression, we don’t.  We hit a wall; a wall of spiritual darkness.  In this space, there is the sense that God doesn’t care about us, that he has abandoned us, or that he doesn’t even exist.  If he does exist, why would he allow me and others to suffer so?  It is the pointlessness of our suffering which seems so hard a cross to bear.

Barbara Crafton, minister and author of the book, “Jesus Wept,” captures this sense of sorrow:

“Religious people want there to be meaning in everything.  Randomness is hard on us:  that things just happen for no reason sometimes brings us closer than we want to be to the possibility that we’re not central to much of anything . . . .  And so we hope and expect the universe to have a message for us. Let there be something just for me, we pray and expect, something that will make it all make sense.  A plan.

And yet, the crushing weight of depression lies precisely in the meaninglessness that characterizes it.  A flat voice within contradicts every hopeful thought: live with it long enough, and the hopeful thoughts don’t even bother surfacing.  Muffled and parched, bereft of any vision that might ratify your journey or give it a reasonable goal, you trudge on and on for no particular reason other than that you know you’re supposed to.”

What is our spiritual response to this state of affairs?  As we drift out to sea, we long for a voice that will show us a way home.  We may go long periods of our lives with no such beacon.  And then, it happens.  We have a sense of God’s presence in the midst of our pain.  Jesus certainly understood such pain.  Contrary to the movement in some Christian circles to paint Him as a salesman of happiness, he was a man “well acquainted with sorrow.”   His life suggests that in a spiritual life we are not changed from some sad state into, necessarily, a happy one.  That’s not the point.  God doesn’t want some happy, well-adjusted and self-satisfied person per se.  He wants a real and authentic person.  Such authenticity often comes at a very high price.  We must walk through suffering.

The Twenty Third Psalm says:

Even though I walk

through the valley of the shadow of death,

I shall fear no evil,

for you are with me;

your rod and your staff,

they comfort me.

In one form or another, all humans most walk through “the valley of the shadow of death.”  There is simply no escaping the profound experience of suffering.  Depression is one such form of suffering.  It is a valley; a trench from which we so often feel there is viable exit.  During depression we stop walking through that valley.  We are immobilized by our pain and can’t step forward.  The “rod and staff” of God, however, tells us that depression is a “shadow”.  It doesn’t have the final say.  God does.  We must not stay stuck in the valley, but keep walking.

As we walk through our days, what are rods and the staffs that comfort us?  If they are the false sirens of success – of money, status symbols and power – they may temporarily satisfy us.  But they won’t sustain us.  At some point – it is hoped – we will recognize them for the phantoms that they are.

Whatever our spiritual orientation, chose a spiritual sustenance that isn’t borne of your small sense of self with its limited plans and agendas.  But rather a grander hope and vision of which we are intimately connected to.  A view of ourselves not distorted by depression, but by how God views us.  We are indeed precious in his sight, His children.  We can hope in his vision and plans for us.

In closing, sustenance for the day from Saint Ignatius Loyola:

O Christ Jesus,

when all is darkness

and we feel our weakness and helplessness,

give us the sense of Your presence,

Your love, and Your strength.

Help us to have perfect trust

in Your protecting love

and strengthening power,

so that nothing may frighten

or worry us,

for, living close to You,

we shall see Your hand,

Your purpose, Your will through all things.

 Amen.

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.

Zen and the Art of Lawyer Maintenance

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I grew up in the seventies; 1979 was the year of my high school graduation.  Next weekend, I will be going to my 30th high school reunion.  How time flies, no?  One book from the seventies that made a big impact on me was Zen and the Art of Motorcycle Maintenance by Robert M. Pirsig. 

The book is about the author and his young son’s 17-day motorcycle journey across the United States.  The trip is filled with a number of philosophical discussions by the author where he explores the meaning and concepts of quality.  His approach is that quality has to do with a non-intellectualizing, non-conceptualizing, Zen-like direct view of the universe.  Yet he also argues that Western rationality is just as important in seeking understanding.

I like Pirsig’s approach as it applies not only to the practice of law, but depression as well.  We need the approaches taken by Western rationality – medication, psychotherapy, etc.  But the legal profession would do well to heed some of the advice from the East and its approaches to depression.

In The Mindful Way through Depression:  Freeing Yourself From Chronic Unhappiness, four uniquely qualified experts explain why our usual attempts to “think” our way out of depression or “just snap out of it” lead us deeper into a downward spiral where depression only worsens.  Through insightful lessons (and an included CD with guided meditations) drawn from both Eastern meditative traditions and cognitive therapy, they demonstrate how to sidestep the mental habits that lead to depression, including rumination and self-blame, so that one can face life’s challenges with greater resilience. 

The authors explain how our trying to outthink depression is problematic:

“When depression starts to pull us down, we often react, for very understandable reasons, by trying to get rid of our feelings by suppressing them or by trying to think our way out of them.  In the process we dredge up past regrets and conjure up future worries.  In our heads, we try this solution and that solution, and it doesn’t take long for us to start feeling bad for failing to come up with a way to alleviate the painful emotions we’re feeling.  We get lost in comparisons of where we are versus where we want to be, soon living almost entirely in our heads”

Lawyers, by the nature of our work, are required to live in their heads a lot.  Not only that, our thinking habits are prone to pessimism –we look for problems everywhere and try to fix them.   We are the ultimate “fixers”.  This can get us into trouble, however, if we are prone to or suffer from depression.   The authors point this out:

“Once negative memories, thoughts, and feelings, reactivated by unhappy moods, have forced their way into our consciousness, they produce two major effects. First, naturally enough, they increase our unhappiness, depressing mood even further.  Second, they will bring with them a set of seemingly urgent priorities for what the mind has absolutely got to focus on – our deficiencies and what we can do about them.  It is these priorities that dominate the mind and make it difficult to switch attention to anything else.  Thus we find ourselves compulsively trying over and over to get to the bottom of what is wrong with us as people, or with the way we live our lives, and fix it.”

The author’s solution to this virtual swampland of depression:  mindfulness.  The practice of mindfulness is actually quite simply to do and involves sitting in silence and watching our feelings and thoughts float by the stream of our consciousness.  But instead of taking them literally – that such depressing thoughts and feelings are REALITY – we just detach from them and let them continue to float down the river.  We stop trying to react to these states by stopping our attempts to try to fix them.  We move from a “doing mode” to a “being mode.”  We pay attention to a neutral experience – the in and out sensation of our breath.  When we notice a thought or feeling flowing by and see that we are getting embroiled with it, we let it go and return to our breath.  Check out this great video, “Mindfulness with Jon Kabit-Zinn.”

 In “The Zen Path through Depression”, Philip Martin advises us to stop running away from our depression and face it.  It can even provide us with a unique type of experience:

“In depression our back is often against the wall.  Indeed, nothing describes depression so well as that feeling of having nowhere to turn, nothing left to do.  Yet such a place is incredibly ripe, filled with possibility.  It gives us the opportunity to really pay attention and just see what happens.  When we’ve done everything, when nothing we know and believe seems to fit, there is finally the opportunity to see things anew, to look differently at what has become stale and familiar to us.  Sometimes when our back is against the wall, the best thing to do is to sit down and be quiet.”

Part of the quality of our lives, of maintaining ourselves, is learning and growth.  The ongoing pain of our depression is a wakeup call that we need to think about how we typically respond to our depression and how we might respond differently – by moving from a doing to a being mode. This can be achieved with mindfulness meditation.

The Ladder of Success

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Many lawyers are consumed with the goal of becoming successful.  Often, traditional success means money, status and power.  According to veteran lawyer George W. Kaufman, author of the book, The Lawyers’ Guide to Balancing Life and Work, “For too many lawyers, the goal of success becomes the primary driver.  But surveys of working lawyers tell us that a great many of them are unhappy even when their planned goals are realized . . .”  This view was echoed by therapist, Alden Cass in an article on burnout in New York Magazine titled, Can’t Get No Satisfaction.  Cass, who treats Wall Street lawyers in New York City, says, “I can’t tell you how many people come into my office and ask, “How come I have this money and I can’t find happiness?”

Most lawyers are never taught about the problems and pitfalls of pursuing success without also combining it with the pursuit of meaning and purpose.  My parent’s only imperatives were that I go to college, get a good job and “be happy.”  I worked long hours, endured constant stress and moved up my old firm’s pecking order.  But somewhere along the way, I realized that something was terribly wrong with my life.  I wasn’t just unhappy; I was full of sorrow.  The great mythologist, professor and author, Joseph Campbell captured the irony of our common struggle for success: “You climb the ladder of success and when you get to the top you find it’s leaning against the wrong wall.” 

I fell off that ladder and into a well of depression.

I was never taught how to navigate the waters of difficult emotions.  When I looked around at my fellow lawyers, they all seemed so together — like a show room car that never got dented and was always polished.

Through my depression, I learned a lot about the darkness.  That it isn’t exactly an illness, but part of the human journey for all of us.  Educator and author, Parker Palmer, who went through and struggled with depression, wrote:

“Many young people today journey in the dark, as the young always have, and we elders do them a disservice when we withhold the shadowy parts of our lives.  When I was young, there were very few elders willing to talk about the darkness; most of them pretended that success was all they had ever known.  As the darkness began to descend on me in my early twenties, I thought I had developed a unique and terminal case of failure.  I did not realize that I had merely embarked on a journey toward joining the human race”.  Listen to a great podcast where Parker is interviewed for a show called, The Soul of Depression.

So much of the literature out there about success focuses on “work-life” balance.  The formula in many of these tomes is the same:  set limits, exercise and make time for family.  All of these are well and good, but seem to so often fail us.  There’s simply not enough gravity in them to keep us in orbit.  What’s lacking is a basic  truth:  Life is made up of struggles and losses and how we deal with them.  Such struggles can reach a crisis pitch in which we enter a sort of darkness.

In his book, Dark Night of the Soul:  A Guide to Finding Your Way through Life’s Ordeals, psychologist, Thomas Moore says: 

“A dark night may not feel like depression.  In a long illness or a troubled marriage you may be anxious, but not depressed.  On the other hand, a clinical depression might well qualify as a dark night.  Whatever you call it, the experience involves you as a person, someone with a history, a temperament, memories, emotions, and ideas.  Depression is a label and a syndrome, while the dark night is a meaningful event.  Depression is a psychological sickness; a dark night is a spiritual trial.

Many people think that the point of life is to solve their problems and be happy.  But happiness is usually a fleeting sensation, and you never get rid of the problems.  Your purpose in life may be to become more who you are and more engaged with the people and the life around you, to really live your life.  That may sound obvious, yet many people spend their time avoiding life.  They are afraid to let it flow through them, and so their vitality gets channeled into ambitions, addictions, and preoccupations that don’t give them anything worth having.  A dark night may appear, paradoxically, as a way to return to the living.  It pares life down to its essentials and helps you to get a new start”.

And maybe that’s what we all need – a new start.  To wake up to a new vision about what success really means to us and how we need to act in our lives as lawyers to meet that meaning.

I remember the words of Mother Teresa on the topic of success.  It’s worth mentioning that a book published in 2007, Come Be My Light – The Private Writings of the Saint of Calcutta,  says that Mother Teresa felt deep sorrow, despair and one could argue “depression” for the last fifty years of her life.  Yet, in the most profound sense –whether you are religious or not — wasn’t she a success?  She once said, “We are not called to be successful.  We are called to be faithful.”   In other words, we can’t control the outcomes.  But, we can live a life that is directed by our spirits.  And THAT is a life of success.

“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.”

The Dead Zone Of Depression

There is a zone in a depressed person’s life where nothing seems to happen — except the pain of the absence of everything. 

Such anguish is so overwhelming that every other concern is squashed in its wake.  Our capacity for willful actions seems to be gone; we can’t “figure it out.”  We are stuck.

I have learned a lot about the zone over the years and how to handle it.  It’s really like surfing a giant wave.  To handle these waves, you study them and prepare yourself for when the next big one rolls in.

When I feel I’m entering a Dead Zone, I start a deliberate and kind conversation with myself that is practiced and rehearsed.  I don’t let the toxic voice of depression drown me out.  It’s important to empower ourselves in whatever ways we can during these times because depression will lead you to falsely conclude that you’re helpless to lift your dark mood.  This conclusion is one of the central tenets of depression; one of its main “themes”.  We need to create – and we can – different and healthier themes for our lives.

Start with a three by five index card.  Use it to create your own deliberate and kind script of themes for yourself that day.  Here’s is an example of what I had written on one of my cards:

— This depression isn’t forever, it will pass.

— I have handled it in the past, I will handle it now.

— Get out of my head – don’t sit around and ruminate.

I usually write a new card out every morning.  When depression is absent (and there are long periods of time when it is), the theme of the card might be more celebratory or grateful:

— I appreciate all of the goodness in my life.

— Thank you God for all of the wonderful people you’ve put in my life.

— I am happy that I am not experiencing depression today.

Try this for awhile and see if it helps you. Don’t wait until you are in the zone of depression to construct the cards because your thinking during such times will be distorted.  Doing this is a healthy and self-empowering step that you can take today.

Father’s Day By the Sea

 

It’s Sunday night, still Father’s Day.  I’m on vacation with my family in Myrtle Beach, South Carolina.  The ocean’s waves are right outside my window reminding me of mysteries that I’ll never understand. And I am thinking of the man who was my father all those years ago.

My earliest memories of my dad are deeply troubling.  His life was defined by violence, alcoholism and neglect of his family.  I know that sounds morbid, even to me.   But, it’s just the plain truth.

When I look back on his life this day, I think about the time that he was dying in the hospital for a month.  One night, I stopped by after everyone else had gone.  Only the florescent light from the hallway made sense of the room.  My dad was tired and I told him just to sleep.  I pulled up a chair beside his bed.  My back was turned towards him and I was hunched over in the silence.  I thought he was asleep.  Minutes passed.

Then I felt his warm hand on my back.  He was rubbing it as he never had before.  We both said nothing.  Yet, there’s no doubt what it all meant in that moment.  He was saying that he was sorry and that he loved me.  He couldn’t say those words no more than he could say at AA meetings, “My name is Walter and I’m an alcoholic.”

I asked my sister and three brothers about their memories of Dad dying. My one brother, Tony, said, “Danny, I know that you’re trying to find good in Dad.  But really, he was just a big asshole.”  Yet, I’m not so sure that’s what I was trying to do; to find “good” in him.  What felt truer to me was the mystery of grief.  Such an experience seems a strange mix of sadness, loss and the weight of existence.  It’s a mystery that I can still touch today – especially today – when I think of him.

My sense of this is captured in Mary Oliver’s poem, “The Visitor.”

My father, for example,
who was young once
and blue-eyed,
returns
on the darkest of nights
to the porch and knocks
wildly at the door,
and if I answer
I must be prepared
for his waxy face,
for his lower lip
swollen with bitterness.
And so, for a long time,
I did not answer,
but slept fitfully
between his hours of rapping.

But finally there came the night
when I rose out of my sheets
and stumbled down the hall.
The door fell open
and I knew I was saved
and could bear him,
pathetic and hallow,
with even the least of his dreams
frozen inside him,
and the meanness gone.
And I greeted him and asked him
into the house,
and lit the lamp,
and looked into his blank eyes
in which at last
I saw what a child must love,
I saw what love might have done
had we loved in time.

When Is My Depression Going to End?

I find writing about depression for lawyers a delicate balancing act.  On one hand, I don’t want to pull any punches about just how awful depression is or how adversely it can affect your life and career.  On the other hand, I want to offer hope and encouragement to those who are in the trenches and deal with it every day.  I will try to do both today.

I have been encouraged by some to write only “positive” articles about dealing with depression. But I just can’t do that. To not deal with the more troubling aspects of depression seems to me a form of denial.  The other day, I was at my local bookstore checking out the Self-Help section for any new titles on depression.  Some of the titles seemed like they were being pitched by used car salesmen:  “Overcome Your Depression in 30 Days!”  This doesn’t help the conversation about depression because it sets up ludicrous expectations in the minds of those who suffer from it and their loved ones about the speed of recovery.  For many with depression, they’re in it for the long haul.

One of the hardest parts about dealing with depression on a daily basis is its seemingly unpredictable nature:  When is it going to start again and how long will it last?

Elizabeth Wurtzel, author of the best-selling book, Prozac Nation, gets it right when she wrote:

“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.  The fog is like a cage without a key”.

Many, many lawyers go into a mode of survival waiting for a depression to end.  To me, the degree to which such a depression can create catastrophe in our lives as lawyers seems driven by the episode’s severity:  is it a tropical depression or a full blown hurricane?

If it a low to medium grade depression, tools like Cognitive Behavioral Therapy (“CBT”) are very helpful.  With CBT, we work in therapy to replace destructive, depressing, negative self-talk with positive, healthy and realistic self-talk.  The efficacy of this approach has been studied and documented using PET scans of the human brain.  Such scans show that an area in the frontal cortex (the thinking part of our brain) is hyperactive in depressives before CBT and then calmed down after successful CBT treatment.  This same area of the brain is activated when people do self-referencing [relating external events, particularly negative ones, to the self] and depressives do too much of this.  They spin around in a cycle of negative thoughts and try to use the cerebral cortex to snap out of their depression.  With CBT, they learn to decrease their self-reference to the things that are negative.  It’s a form of rehabilitation of the cortex where depressives learn to turn the volume down.

This is a critical skill for lawyers to develop.  According to psychologist, Martin Seligman, author of the best-selling book, “Authentic Happiness,”  lawyers are pessimists.  They develop thinking habits which see problems as permanent and intractable.  They also feel an overdeveloped sense of ownership or responsibility for such problems.  Optimists, on the contrary, see problems as temporary, solveable and not necessarily their “fault”.  The important point here is that optimism is a skill that can be developed and practiced. Read Seligman’s chapter, “Why Are Lawyers So Unhappy?”

If it is a deeper depressive episode, more like a trough of despair, CBT won’t work very well.  During such an episode, there is the sense that it’s never going to end.  Yet, this is the distorted voice of depression talking because for the majority of people with depression, IT DOES END.  The trick is to learn how best to weather the storm.

I find that when I am in a deeper depression, I need to go outside my mind and get into my body.  Consistently, the things that helped me the most were the following:

1.   It’s virtually impossible to feel depressed while exercising and even for a good period of time thereafter.  The problem, as most of us know, is getting to the gym or the park.  Behavioral prompts can help.  Always have your gym gear in your car.  Also, be realistic.  Remember that it takes at least 21 days to form a habit.  So, those first 21 days won’t be the easiest ones.  Tell your family and friends about the importance of exercise to you and have them support and remind you about this on a daily basis.

2.   Cut off any unnecessary negative input in your life during these times.  Don’t listen to any sad music, watch violent T.V. shows or read somber books.  This isn’t a forever type of deal.  Think of it more as a “timeout”.  Some people stop reading the newspaper during an episode as well.  Also, the time you’re not doing these activities gives you the time that you’ll need to exercise.

3.   See a massage therapist.  Touch has a powerful effect on the human body and is known to cause the release of endorphins (the feel-good chemicals).  It doesn’t involve any thinking on your part.  For busy lawyers, it’s a time to relax and receive something positive for the day.

Remember to be kind to yourself today.

 

 

 

 

 

 

 

 

 

 

 

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