One Therapist’s Take on Lawyer Addiction & Mental Health

This is a guest blog by Nicole Roder, LCSW-C, a bilingual DBT therapist in Bethesda, MD, certified by the DBT-Linehan Board of Certification. She is intensively trained in DBT, DBT prolonged exposure for PTSD, DBT for parents, couples, and families, and DBT for substance use disorders. In her practice, she treats adults and adolescents with BPD, PTSD, DMDD, SUD, and related disorders.

As a therapist who treats addictions, I have seen many people who use alcohol to cope with high-stress jobs. I have also seen people suffer terrible losses when that coping mechanism becomes an addiction. Fortunately, there are well-researched treatments that can help attorneys overcome addiction. Let’s take a look at the data on addiction among lawyers, the consequences of addiction, and some resources that might help overcome the problem.

Unpacking Depression: An Interview with Psychologist Dr. Margaret Wehrenberg

Today’s guest is Dr. Margaret Wehrenberg. Dr. Wehrenberg is a clinical psychologist in Naperville, Illinois. She is the author of six books on the treatment of anxiety and depression published by W.W. Norton, including, “The Ten Best-Ever Depression Management Techniques: Understanding How Your Brain Makes You Depressed and What You Can Do to Change It” and “Anxiety + Depression: Effective Treatment of the Big Two Co-Occurring Disorders.” An international trainer of mental health professionals, Dr. Wehrenberg coaches people with anxiety via the internet and phone. She’s a frequent contributor to the award-winning magazine, Psychotherapy Networker and she blogs on depression for the magazine Psychology Today.

Dan:

What is the difference between sadness and depression and why do people confuse the two so often?

Dr. Wehrenberg:

Because depression comprises sadness. Sadness is a response to a specific situation in which we usually have some kind of loss. The loss of a self-esteem, a loss of a loved one, the loss of a desired goal. Depression is really more about the energy – whether it’s mental energy or physical energy – to make an effective response. So, sadness is an appropriate and transient emotion, but depression sticks around and affects all of our daily behaviors and interactions.

The Twin Pillars of Depression

“Once you choose hope, anything is possible.” – Christopher Reeve

There are two pillars upon which depression rests.

Helplessness

When in the grip of depression, we feel helpless despite our efforts to pull out. The more we struggle, the more exhausted we become. In her book Eat, Pray, Love, Elizabeth Gilbert writes, “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.”

Hopelessness

Helplessness often leads to profound hopelessness about the future. In her book Prozac Nation, Elizabeth Wurtzel writes, “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 compounds daily that it’s impossible to ever see the end.”

What I have learned over the past twenty years of living with depression is we need to chisel away at these twin pillars. I began to discover helplessness and hopelessness are disempowering: I had no choice but to live my days under this rock of sadness. My healing involved learning that I did have options in how I related to life when depressed. And I found this power to choose empowering and life-affirming.

How did I leave helplessness and hopelessness behind?

Putting Pen to Paper: Writers on Depression

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

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: Young and Depressed in America

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: A Memoir of Madness

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

The Depression Journey: Walking the Rocky Trail With a Therapist

 

Diagnosed with major depression by a psychiatrist when I was forty years old, I had to find a therapist who could help me. The physical side of the illness pounded me: sleeplessness, fatigue, and the inability to concentrate and be productive at my job as a lawyer. But also the psychological dimension: feelings of low self-worth, chronic sadness, and negative thoughts about my ability to recover and be happy again.

A friend recommended me to the man who would become my therapist for the next twenty years. Jerry was a psychology professor at a local university. From the Bronx, he has a wonderful, salty sense of humor. Not only was he brilliant, but he was also warm and engaging. I felt at home, and we quickly bonded.

During this dark time in my life, I felt isolated. More often than not, I felt lonely and didn’t know anyone with depression that could understand what I was going through. Jerry did. He became my closest ally, who was with me every step of the way as I dug my way out of the dark cellar of depression. It took time. And patience that was tough to come by as I slogged through depression for years. But his strong and kind presence saw me through. He gave me insight into what depression was and the ruminative, distorted thinking that the disease would churn out. Jerry called this “crooked thinking.” I learned to recognize such thoughts as not part of who I truly was but as part of the illness. It gave me a distance from them and made it easier not to identify with them. This opened up the possibility – and hope – that I could let go of these destructive thoughts and embrace more realistic, positive ones.

The Dark Side of Success: A Psychiatrist’s Exploration of Depression in the Legal Profession

By Joann Mundin, M.D.

There are significant effects of depression in the legal profession that are pervasive. Lawyer depression can have terrible personal and professional ripple effects for attorneys but also impacts clients, business partners, employees, and staff.

The general population is significantly affected by depression, with 17.3 million persons, or 7.1% of all adults in the US, reporting having experienced a major depressive episode in 2017. But, the proportion of depression among attorneys is considerably higher: according to ALM’s Mental Health and Substance Abuse Survey from 2020, 31.2% of the more than 3,800 respondents report having a depressive disorder. This indicates that compared to the ordinary US adult, lawyers have an approximately three-fold higher risk of developing depression.

Nevertheless, the stigma associated with mental illness keeps lawyers from getting help immediately. This can cause excessive and prolonged distress, making the problem worse over time.

Managing Depression: Podcast Interview with Dr. Margaret Wehrenberg, Author of “The Ten

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Today’s guest is Dr. Margaret Wehrenberg. Dr. Wehrenberg is a clinical psychologist in Naperville, Illinois. She is the author of six books on the treatment of anxiety and depression published by W.W. Norton, including, “The Ten Best-Ever Depression Management Techniques: Understanding How Your Brain Makes You Depressed and What You Can Do to Change It” and “Anxiety + Depression: Effective Treatment of the Big Two Co-Occurring Disorders.” An international trainer of mental health professionals, Dr. Wehrenberg coaches people with anxiety via the internet and phone. She’s a frequent contributor to the award-winning magazine, Psychotherapy Networker and she blogs on depression for the magazine Psychology Today.

Dan:

What is the difference between sadness and depression and why do people confuse the two so often?

Dr. Wehrenberg:

Because depression comprises sadness. Sadness is a response to a specific situation in which we usually have some kind of loss. The loss of a self-esteem, a loss of a loved one, the loss of a desired goal. Depression is really more about the energy – whether it’s mental energy or physical energy – to make an effective response. So, sadness is an appropriate and transient emotion, but depression sticks around and affects all of our daily behaviors and interactions.

Podcast Interview With Mary Cregan, Author of “The Scar: A Personal History of Depression and Recovery”

Dan:

I’m Dan Lukasik. Today’s guest is Mary Cregan, author of the book The Scar: A Personal History of Depression and Recovery. Mary received her PhD from Columbia University and is a lecturer in English literature at Barnard College in New York City, where she lives with her husband and son. Welcome to the show, Mary.

Mary:

Thank you, Dan.

Dan: Mary, where does the title of the book come from?

Mary:

The title is the origin of the story, really. I have a scar from a suicide attempt I made in the very intense depressive episode that followed the death of my first child. That was when I was first diagnosed with major depression. The story that I tell in the book goes back to that scar which, of course, is with me always and is a kind of memory on my body of that experience. Because of the scar I try to return to that time to tell the story of my depression and the larger history of depression.

Wired: Anxiety Strikes at Harvard Law School

Freud was of the opinion that in fear a person is responding to a specific and immediate threat to physical safety while in anxiety a person is responding to a threat that is objectless, directionless, and located somewhere far off in the future—ruination, for example, or humiliation, or decay. Daniel Smith, Monkey Mind: A Memoir of Anxiety

I spoke at Harvard Law about the challenges of living with depression and the epidemic of poor mental health in the legal profession. It was a memorable event.

Days before I am scheduled to talk, my sleep goes cuckoo. I become incredibly anxious about my speech. What if I fall flat on my face? I graduated from some third-tier law school, after all. I don’t belong lecturing at Harvard.  My churning nighttime ruminations now seep into my days as the event gets closer.

You Don’t Have to Go It Alone: Finding Support When You’re Depressed

 

Strong, supportive relationships are one of the best safeguards against depression. In fact, studies have found that good social support helps to protect both our psychological and physical health.  Sharing our lives with others is pleasurable and helps us feel better at times when we feel down. The process of talking about our problems and being listened to by someone who cares can be healing by itself.

Friends provide us with many important things such as emotional support, practical assistance and information, a different perspective on our problems, a sense of personal worth and belonging, and ideas for solving problems.

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