One Nation Under Medication

Clinical depression’s analogy to illnesses like heart disease or diabetes has been helpful to de-stigmatize it in our society.  It is a physical illness, regardless of its causes, and requires medical care and treatment.  But, in a very real sense, it’s much more than that.

Heart disease and diabetes do not affect our minds, personalities and emotional worlds like clinical depression.  Taking antidepressant medication, unlike other meds to open sinus congestion or plaque-filled arteries, changes how we see ourselves as well as how others see us.

Much about what drives how we feel about taking medication is driven by stigma; the dark cloud of shame which says that we’re weak or somehow “bad” for taking such drugs.  This nonsense continues despite the fact that 350 million people suffer from depression worldwide and that it’s the leading cause of disability on the planet.

In the book Undoing Depression, Dr. Richard O’Connor captures some of the irony of stigma:

“If [all of the statistics] are true, if depression is as dangerous and prevalent as I’m saying, you may well ask: Where’s the big national foundation leading the battle against depression?  Where’s the Jerry Lewis Telethon and the Annual Run for Depression?  Little black ribbons for everyone to wear?”

Looking back on my journey with medication, it was a rough ride but one in which I am glad I took.  I have been on medication for the past eight years and it controls my depression.  I don’t think that it’s the only reason why I’ve gotten better; I’ve done a lot of healthy stuff to recover too (e.g. psychotherapy, exercise and change in my diet).  But, at least for me, medication brought about a profound stability that I might not have otherwise achieved.

The fact that medication helped me and continues to do so doesn’t mean I don’t have my fair share of ambivalence about taking them; on the contrary.  Besides the unknown long-term effects on our brains from using these potent concoctions, there is also a change of identity that takes place when we start using them.

I sometimes miss the old, pre-antidepressant Dan that was wired and edgy.  When anxiety and depression really lit up  my nervous system, it was as if too much wattage was flowing through the power grid of my body.  The medication seemed to calm things down and even things out.  As I grew calmer, I was able to think through things more clearly – especially my depressive thought habits.  But there’s a struggle which waxes and wanes within me, even as I give the medication its due, about whether becoming a medicated person has been a good thing entirely. 

In his book, “Is It Me or My Meds?” Boston College Professor, David A. Karp writes:

“[P]eople’s self-esteem and sense of integrity are deeply connected to their ability to control their personal problems  The people I spoke with had difficulty accepting the idea that emotional illnesses are no different from physiological problems such as heart disease or diabetes.  It may be comforting to hear that antidepressant medications correct chemical imbalances in the brain just as insulin controls diabetes.  But most of those I interviewed assigned different meanings to mental and physical conditions. When asked directly, they affirmed that psychiatric drugs are far more likely than other medications to make them feel bad about themselves . . . .”

There is no doubt in my mind that we become different people on these drugs; there is the pre-antidepressant person and the post-antidepressant person.

In an article Dr. Karp wrote for the Lawyers With Depression website, he writes:

“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 drug 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 a merely troubled person to someone who has mental illness.  Crossing that boundary is hardly an easy step to take.”

I think Dr. Karp captures a good deal of the angst that goes along with taking meds.  Most people I know who take them can identify with what he says.  There is often a sense of shame attached with taking medication because we feel that we should be able to kick depression’s ass all by our sweet old selves.  What that blows up and we are left stumbling on depression’s playing field, we often turn to medication.  In my own life, I felt shame for a period of time.  But as my understanding of depression grew, I knew I didn’t have anything to be ashamed of.  It wasn’t my fault that I had depression, but it was my responsibility to get better.  Medication was part of that for me.

A New Year to Kick the Depression habit


For last year’s words belong to last year’s language and next year’s words await another voice.  And to make an end is to make a beginning – T.S. Eliot

With the New Year comes new choices; we can choose to leave behind ways of being in the world that cause and maintain our depression and embrace healthier and saner approaches to our days.  Or we can simply do nothing.

Why do lawyers with depression keep repeating behaviors that prevent them from feeling good about themselves? Why do they relentlessly drive, isolate and unmercifully think of themselves as the biggest piece of crap this side of the Mississippi? 

In his revised and updated book Undoing Depression: What Therapy Doesn’t Teach You and Medication Can’t Give You, Dr. Richard O’Connor offers this insight:  “People persist in self-destructive behavior because they don’t know how to do anything else. I’m convinced that the major reason why people with depression stay depressed despite therapy, medication, and support from loved ones is that we are simply unable to imagine an alternative.  We know how to ‘do’ depression.  We are experts at it.”

Lawyers can’t envision healthier alternatives because depression shuts down their capacity to creatively imagine themselves productively engaged in the world.  We simply have no reference point for that.  So we stay in our offices with the doors closed looking out the window as the birds fly by and one season changes into another.

Our brains love habits — even when they stink and hurt us.  It’s a more predictable way to go through life because we don’t have to rethink everything and change.  We become used to depressive habits as we cruise through life on auto-pilot.  Many lawyers with depression usually view their jobs as the sole source of their depression; surviving “it” becomes the focus of their lives.  They use depression habits at their jobs that might work for awhile, but at a very high cost to their physical and emotional well-being.  These aren’t stupid people; they just can’t imagine doing their jobs any differently.  As educatior Parker Palmer once wrote about his depression, “It wasn’t so much that I was in the darkness as I became the darkness.”

Dr. O’Connor writes:

 “We depressives become shaped by our disease as well; the skills that we develop with depression in a vain effort to save ourselves pain – skills like swallowing our anger, isolating ourselves, putting others first, being over-responsible – prevent our recovery.  We have to give up the depressed habits that keep us down and make us vulnerable to relapse.”

Deepak Chopra wrote: “A habit is a frozen interpretation from the past that is applied to the present.”  I think that’s why depression can have such a deadening sensation associated with it.  In a sense, depression warps our perceptions about events happening in real time and pulls us under the frozen river of our past.  People and events happening in real time trigger old interpretations of how life works.  Since most people with depression come from dysfunctional or abusive childhoods, a current conflict with others becomes a ride back to their traumatic past.

For me, this distortion has often revolved around anger.  I not alone on this one; how we handle anger is a big issue for most lawyers. As lawyer and psychologist Andy Benjamin wrote and studies have concluded, there is a strong connection between hostility and depression.  Anger seems to be situational, while hostility is an overarching and aggressive approach to life.  Anger that is repeatedly stuffed or inappropriately expressed becomes hostility.  Many lawyers don’t want to be assholes, but feel they have to do so to survive in the shark tank of the law.  Most lawyers I’ve known feel deeply conflicted about this and if they’ve had problems with depression, it just compounds it all.

In my childhood home, my alcoholic father had a volcanic temper – you knew to scram when you saw lava cresting at the rim.  I learned that anger was painful, “bad” and always unjustified.  As such, I used to avoid conflict and stuff my own anger because it was dangerous.  Instead, I became a people pleaser.  I developed exquisite antennae to read clients, colleagues, opposing counsel and judges’ reactions for any signs of aggression, anger or conflict.   I molded my behavior to their behavior rather than living out of a core of my own reality.  This distortion gave others too much power and myself too little.  It is, as psychologist James Hollis once wrote, an emotional conclusion in which we tell ourselves “the world is big and I am small.”  Most depressives think this way and feel overpowered by the events of their world and lapse into a state of helplessness.

As we enter a new year, let’s start leaving some depressive habits behind and embrace some new ones.  This will take work on your part.  No one is going to save you from your depression.  While you are not to blame for your depression, you are responsible for getting better.  Dr. O’Connor writes:

“Overcoming depression requires a new set of skills from us.  But now we are recognizing happiness is a skill, willpower is a skill, health is a skill, successful relationships require skills, emotional intelligence is a skill.  We know this because practice not only leads to improvement but also to changes in the brain.  This is a much more empowering and adaptive way of understanding life than assuming that these qualities are doled out form birth in fixed quantities and that there’s nothing we can do to change our fate.  The skills required to undo depression will permeate your entire life, and if you keep practicing, you can go far beyond mere recovery.”

Happy New Year!

A Christmas Blessing




The people who walk in darkness will see a great light.  For those who live in a land of deep darkness, a light will shine – Isaiah 9:2

Christmas is, for most of us, a mixed experience.   There are celebrations, music, a sense of holiness and community.  However, there is also the loneliness, the unresolved grievances and a gnawing sense that we should be happier than we are at this time of the year.  God knows this about His people who “walk in darkness” and He sends a “great light” who, for those that believe, is Jesus.

In the mix and mud of our depression, we still need to find a way to give thanks to God for who He is.  Giving thanks encourages a feeling of contentment; a sense that we’re appreciative of what we’ve been given in our lives and that we don’t need more to be at peace.  At this time of year, we give thanks for God’s greatest gift – Jesus.

In the book “The Breath of the Soul” by Sister Joan Chittister, she writes:

“Gratitude is not only the posture of praise but it is also the basic element of real belief in God.  When we bow our heads in gratitude, we acknowledge that the works of God are good.  We recognize that we cannot, of ourselves, save ourselves.  We proclaim that our existence and all its goods come not from our own devices but are part of the works of God.  Gratitude is the alleluia to existence, the praise that thunders through the universe as tribute to the ongoing presence of God with us even now.  Without doubt, unstinting gratitude saves us from the sense of self-sufficiency that leads to forgetfulness of God.  Praise is not an idle virtue in life.  It says to us, ‘Remember to whom you are indebted.  If you never know need, you will come to know neither who God is nor who you yourself are.’ Need is what tests our trust.  It gives us the opportunity to allow others to hold us up in our weakness, to realize that only God in the end is the measure of our success.”

The other aspect of gratefulness is an appreciation of the goodness within us that God has placed there.  For those who suffer from depression, it’s sometimes hard to experience this if at all.  But just as the sun has not expired when it’s behind the clouds, we as children of God can’t extinguish this essential goodness in us.  As the great contemplative monk Thomas Keating  wrote, “The fundamental goodness of human nature . . . is an essential element of Christian faith.  Our basic core of goodness is our true Self.  Its center of gravity is God.”  He goes onto say, “The acceptance of our basic goodness is a quantum leap in the spiritual journey.”

Beyond the crowded malls, the smoke coming off our credit cards and the mindless consumerism that can overtake us all at this time of year, it’s the basic love of God and the goodness always within us that we can be most thankful for.  Take a “quantum leap”, if only for a short while, and experience the profound holiness which is really what Christmas is all about.

As the author Taylor Caldwell once wrote, “I am not alone at all, I thought.  I was never alone at all.  And that, of course, is the message of Christmas.  We are never alone.  Not when the night is darkest, the wind coldest, the world seemingly most indifferent.  For this is still the time God chooses.”

God bless you all.

Heroes Can Help Lawyers Overcome Depression


The ultimate measure of a person is not where they stand in moments of comfort and convenience, but where they stand at times of challenge and controversy  – Dr. Martin Luther King

I have talked to hundreds of lawyers across the country about depression in the legal profession. One of the common themes in these conversations is how the legal community fosters depression. There are many forms this can take: a “winner-take-all” outlook, a lack of civility and too much emphasis on money and power as a barometer of success. There is something profoundly dispiriting about this approach to life and it can contribute to one’s depression as a lawyer.

I think it’s important to be inspired as a lawyer; to develop our own sense of purpose and passion. One way to do this is to look to the luminaries of our profession; people of high moral character, bravery and basic decency. In the November 2, 2009 edition of Time Magazine, there was a touching tribute written by attorney, Morris Dees (one of my heroes), about one of his heroes, Judge William Wayne Justice. Rather than attempt to pen something else about this great man, here’s what attorney Dees wrote:

“Judge William Wayne Justice was a hero of mine. He set the pace for so-called activist judges and in the process became the most despised man in Texas. When Wayne was appointed a federal district judge in 1968, the South was not through fighting the Civil War. The most unpopular people were those, like Wayne, who enforced desegregation in schools.

It would have been easier to just go along, as so many judges did. But Wayne, who died October 31 at 89, didn’t wink at the law. After receiving handwritten letters from prison inmates describing awful conditions and brutal treatment, he appointed a lawyer to handle the case, a decision that lead to an overhaul of the state’s prisons. While most people in Texas were glad to use migrant laborers as indentured slaves, Wayne helped their children get an education in the state’s public school system.

When I found out that Wayne had been selected to receive an award in my name in 2006, I was actually embarrassed. I would have been honored to get an award in his name, and I called him to tell him so. He couldn’t have been more gracious. He really was a saint with a briefcase and a gavel.”

We need more saints in the legal profession. But, they’re out there. Find them and let them guide and inspire you. Then become a hero yourself. As the modern sage Bruce Springsteen once said “At some point a person has to stop thinking about the person they want to be and be the person they want to be.”

Let’s all move in this direction.

Another Way For Lawyers to Think About Time Management

Law students, lawyers and judges are always pursuing time.  Watches on our wrists act more like compasses than time keepers as they point us in directions we must march.  A search on Amazon for “Time Management” books resulted in 632 titles.  The wizards of time who penned these templates for success cover familiar ground: organization, prioritization and scheduling. 

Yet much about the practice of law is fear driven: dire consequences will follow should we fail to get things done.  Perhaps that’s why there are over six hundred books on the subject, many purchased by lawyers, and scores of articles on the topic for lawyers on the run. 

“That’s just the way things are” is the legal profession’s anthem to the status quo of fear driven law. Time management isn’t embraced so much as an empowering experience, but more as a life preserver. I’m not going to offer any “solutions” to time management, at least in the traditional sense.  If you need the more “how to” remedies, check out these books: “Time Management In an Instant: 60 Ways to Make the Most of Your Day” and “The Time Trap: The Classic Book on Time Management.”  Here are some  helpful articles on time management for lawyers:  “How to Use Effective Time Management” and “Do You Have Time? A Few Thoughts about Time Management for Attorneys.”  There is also a website devoted to time management for lawyers called “Time Management for Lawyers.”  On the site you’ll find plenty of articles on this topic.

We often don’t think of time management as a reflection of our self-worth, but it is.  Psychiatrist M. Scott Peck, M.D., author of The Road Less Travelled, once wrote: “Until you value yourself, you will not value your time.  Until you value your time, you will not do anything with it.”

How much, we must ask, do lawyers value themselves as they slug through the ten hours a day or more they spend at their jobs?  If it’s primarily about the money, the danger is that they can become defined by the almighty $ and all it can buy.  That’s dispiriting and depressing, yet so often a reality for lawyers.  By frittering away their days not fully and passionately engaged in what they are doing, lawyers are devaluing the totality of who they are.

Lawyers lose the perspective that all of us only have 1440 minutes in a day and when they’re gone, baby they’re really gone.  As the novelist Annie Dillard once wrote, “How we spend our days is, of course, how we spend our lives.” We all have financial obligations of one sort of another.  But if we funnel all of our energy and time into meeting this one aspect of reality, sorrow will surely follow.  At the end of our lives, do we want to look back and think that our lives have been spent managing our time to gain more status, power and money?  To do so doesn’t necessarily make us “bad” people. I would suggest that it reflects a lifetime of little awareness; an inability or difficulty to separate the trivial from the truly important events of our lives.  Henry David Thoreau once wrote: “As if you could kill time without injuring eternity.”

Getting things done moves us through our days. But, we have to make time to savor these experiences both large and small. Making the resolution to do so is a noble. But the degree to which we adhere to this goal often waxes and wanes – as do our earnest plans to watch less T.V., eat better and exercise after our morning coffee.  The waning could because we are discouraged, tell ourselves that we’re not particularly well disciplined or some other plausible excuse.

I have come to believe that the reason we don’t savor our legal experiences is because we have defined success too narrowly. We tend to buy into the clearly defined and conventional ideas of success offered up by the legal establishment.  For too many lawyers this involves waiting for successful moments to happen and trudging through their days.  As Supreme Court Justice Oliver Wendell Holmes warned, “Many people die with the music still in them.  Why is this so?  Too often it is because they are getting ready to live.  Before they know it, time runs out.”

Living the music in you involves learning to be more process than product driven; as equally concerned with the journey as the destination.

We shouldn’t think of time management as just a good skill to develop, but also as something we are going to do because we value ourselves. Many “how to” books on time management fail to make us better at managing our affairs because some lawyers don’t like what they’re required to do to keep their jobs. How then do you “manage” work that you’re not crazy about doing in the first place? 

To be honest, I don’t think you can over the long haul.  Whether we recognize it or not, there will be a steep price for us to pay if we go down this path.  We can’t keep doing things over a long period of time driven by fear and anxiety with impunity.  The bill always comes due.  Our bodies and minds keep a tally of how we have treated them.  If we have ignored their carnal needs for love, affection, rest, exercise and purpose, in a sense we have betrayed them.  The result is often exhaustion, stress related illnesses, anxiety disorders and depression.

Let’s begin anew.  A New Year is around the corner.  Let’s start to think of time management as not just something to make us more productive, but as a way to learn to take care of ourselves.  Built into our time management must be time for ourselves.  I created my own personalized “Self-Care Tool Kit”.  Each of you should have one of these in your emotional garage.  When I felt helpless in my depression, I would pull out my lists of things I could act on to help me feel better.   Acting on these things was also a way to demonstrate to myself that I wasn’t helpless, a common cognitive distortion with depression. 

Try not to think about time management as getting things done so much as getting you going.  It can be enormously difficult for people with depression to finish projects.  In my experience, however, it is even more difficult for them to begin.  They often have a sense of being lost and not knowing how to start a task.  I would sit at my desk and look out the window waiting for the angels to move my fingers on my keyboard.   I viewed all tasks as an all or nothing proposition – another cognitive whammy that depression throws at us.  Against the steep benchmark of getting everything done during a depression, I would do nothing.

I learned to retool my approach.  The only thing that worked was to become very concrete and deliberate about work.  I began to pay attention and make an inventory of what did and didn’t help me get things done.  Sitting at my desk pounding out a brief for three hours didn’t work when I first experienced depression.  Working on the same brief for a half hour, stopping to return two phone calls and then a 10 minute coffee break did.  This sounds simplistic, but it’s a testament to how small changes in our behavior can change the character of our days.

Make a list of ways in which you currently work.  What are the obstacles?  Some of those problems are pragmatic; some of them are more existential. See time management as another way to value yourself.  You’re going to manage your time because you need to practice valuing yourself.

Climbing Out of the Well of Depression

Depression feels like falling into a well.  We’re trapped at the bottom with no way out. We look up and see light at the well’s entrance, but it’s so far away.  It turns the soupy darkness surrounding us into a sluggish grey.

We long to feel the sun’s vitality again, a sense of motion in the rhythm of life.  It becomes clear that we won’t get out of the well by our own efforts. We’ll need help – serious help.

Out of the darkness above, a ladder appears.  Others might not see it, but we do.  It’s a ladder meant only for us, as if it were crafted with knowing hands.  Its railings and steps bring hope, a passage to another place above us.  Yet, we must climb each step ourselves, one at a time.

God drops ladders into our wells all the time, but we’re often not aware of them.  Sometimes they’re big, sometimes they’re small.  Sometimes they’re a new medication that brings solace to our pained bodies; sometimes they’re  in moments of mercy like when we share the shy smile of a stranger on the street.

We often can’t see these ladders because we’re on our hands and knees looking for a key to get us out.  But a key won’t work.  We don’t need to turn a lock so much as to rise from our knees. We can surrender our sadness, our weight as we go aloft.  “Come to me all you who are burdened and I will give you rest” said Jesus.  And in the depths of our depressed souls, that’s what we deeply thirst for – rest.

People with depression feel like it’s their constant companion.  In such a relationship, and it’s a relationship of sorts, we need not destroy depression.  We need to transcend it.  We do so by letting go of our relationship with depression and embracing another sort of relationship.

Yesterday, I went to Mass.  Often, I feel like such a dullard in those worn wooden pews.  I understand some of the readings, but much of it I don’t.  But, I often feel a quality of peace.  Maybe, on occasion, even a peace that “passeth understanding.”  I can’t explain this experience, but I appreciate it.  It’s a Mystery which calls to all of us by name. It seeks to give us a new identity and loosen our grip on an old one.  It asks us to let go of all the ways we limit our daily lives because of depression.

Jesus once asked Peter, as he asks each one of us, “Who do you say I am?”  I always understood this question one way: it doesn’t matter what others say about “who” Jesus is; it only matters who we say he is to us.

I now see another way of understanding this passage.

It’s just as important for us to ask Jesus, “Who do you say I am?”

For those suffering from depression, the illness usually responds to this question. It tries to tell us who we are: worthless, weak and undeserving. 

Are we willing to turn away from depression’s voice? Can we surrender it to find our true value as seen through the eyes of God?  He sees us as worthy and precious beyond measure. 

Are we willing to trade the noxious tirades of depression for the soothing and life offering voice of God?

As we climb the ladder, let’s leave the voice of depression at the bottom of the well.  It’s voice becomes faint as we leave it behind.  As we near the light, it infuses us with a true sense of our true value.  We are precious in His sight.  We can finally rest.

When we leave the well of depression behind, perhaps we find a different sort of well and a different kind of falling.  Sister Joan Chittister, a Benedictine nun and author of the little book, “The Breath of the Soul: Reflections on Prayer”, writes:

“The purpose of prayer is the process of falling into God.  As the mystics say, we are beginning to learn that God alone is enough.  The truth is that none of us really knows where we are going and must never take it for granted that we do.  We can plan our lives but we cannot guarantee them.

When our prayers are not answered, we know one thing for sure:  The challenge of life now is to live it differently.  And it will be through prayer that we discover how to do that.  Seeing Jesus being driven out of town, we come to understand that we cannot expect more.  Seeing Jesus depressed is not the loss of faith, it is the moment of faith.  Seeing Jesus lose favor with the authorities, we learn that authorities are not the final measure of our lives.

Then we come to prayer free of the desires that bind us, free to live life in God, free to choose trust over certainty — which really means free to choose God over self.

Our Relationship With Our Therapist










If you have ever suffered from clinical depression, chances are that you have undergone psychotherapy.  Today, my musings will focus on the mysterious, intimate relationship between therapists and their clients in dealing with depression.

I guess you could say that I’m a veteran of therapy.  I first started going during my last year of law school.  This fledging attempt at “getting better” didn’t go so well.  At the time, my therapist was focused on helping me to recover from being raised by an alcoholic father.  Depression wasn’t even part of the conversation.  I was high achieving, but broken in some fundamental sense.  I really didn’t know who I was or how to be myself in the real world.  So, I pretended a lot. 

I pretended by learning how to please others.  Certainly, getting good grades was part of this basic formula. My mother and professors were certainly pleased.  I loved learning, but getting good grades was more than that.  I began to envision myself as a “success” and needed high grades to build on that identity.  Good grades would take me places, I thought. They eventually took me to law school and my new identity, after passing the Bar Exam, as a member of the legal profession.  I wasn’t just Dan, I was a “LAWYER”; an Esq. par excellence.

After becoming an attorney, I saw a therapist off and on.  They helped, but not in any enduring way. Years went by and I still felt that same sense of brokenness that I had when I first began therapy over twenty years ago.  I would bash myself with these critical questions:  “Why can’t I get myself together after all these years of therapy?  Why can’t I figure all this out?”  These questions would haunt me for a long time. Little did I know that most people with depression struggled with the same misguided ruminations.

Psychologist James Hollis once said that the quality of our lives is driven by the quality of questions we ask ourselves.  Depression warps this questioning process.  The questions our melancholy ask of us are dead ends even though we don’t see them as such while we are engaged in such self-assessments.  A common lament: “What’s wrong with me?”  What good comes of this question for someone with depression?   Its focus is actually part of the illness and not a legitimate route out of it. It often compels us to make up a list of “Things to Do to Fix Myself” never realizing that we don’t need to fix ourselves so much as compassionately face ourselves.

I’ve had the same psychologist for the past three years.  His name is Jerry and he bears some resemblance to Freud with his grey beard, don’t you think? 

 He’s an Italian guy from the Bronx and a professor of psychology at one of our local universities.  I often waffle about how much can be accomplished from seeing a psychologist once every week or two.  But I am often surprised by the sustenance that I draw from Jerry, often in unexpected ways.

In my own depression, I found that I would often try to run away from the suffering of it all.  Alternatively, I would perpetuate it with negative thinking and unskillful behavior; I would literally step on the melancholy gas pedal. 

The famous psychoanalyst Carl Jung once wrote:  “The principle aim of psychotherapy is not to transport one to an impossible state of happiness, but to help the client acquire steadfastness and patience in the face of suffering.” We need to face our depression and perhaps learn that it won’t destroy us; we need to learn (yes, it is a skill you can learn) not to run from it or keep feeding it.  Jung’s wisdom was echoed by another renowned analyst, Helen Luke:  “The only valid cure for depression is the acceptance of real suffering.  To climb out of it any other way is simply laying the foundation for the next depression.”

Recently, I went through a painful episode in my life.  I was telling Jerry about my best friend, Steve, and said, “He told me that he will always be by my side 24-7.”  Jerry sat across from me with his wise eyes and paused.  He then said, with a sense of weighted authenticity, “Dan, I too will stand beside you and be with you at all times.”  The intimacy between us during that 10 second exchange was profound and stayed with me for a long time.  Can someone you see for 1 hour truly care about you in such an intimate way?  Yes. 

It can’t be faked, however. Maybe that’s part of the chemistry of having the right therapist and it’s a different equation for everyone.  I believe that it’s critical to have a therapist as our ally in our recovery from and management of depression on a consistent basis.  I believe consistency is important because people with depression often come from families where consistency was sorely lacking; they may not even have much it in their present lives.  Even if they do, it most likely needs shoring up.

In a loving way, let go of the questions that only lead you down depression’s dead ends.  Therapy is not only a questioning of negative habits that fuel depression, but a replacement with questions worthy of you.  In short, they are nothing short of the Great Questions:  “How can I bring more meaning in my life?  What are my greatest passions in life?”  It is only by facing and being present to the pain of our depression that we can learn to let it go and live out the great questions of our lives.

Chipping Away at The Iceberg of Depression








     James Hollis, Ph.D., the noted psychologist, once said that we spend the first half of our lives accumulating accolades for our resumes.  These same achievements, he opines, then become the biggest impediments to our making real and healthy changes in our lives.  It’s as if we are at an existential crossroad:  we look back –north for the sake of this analogy – and see what we have accomplished. We then look forward – south – and see an unknown and scary future as yet undefined.   “The past is who I am”, we think.  It offers us a sense of stability, a history and a comfortable life.  Nothing bad in and of itself.  Yet, we may be deeply unhappy and unhealthy.  We may even be suffering from depression because of the stress involved in accumulating these accomplishments.

     The prospect of real change is frightening.  We worry: “What if I make these changes in my life and things don’t get better.  Maybe they’ll even make my depression worse!” Yet, depression is a terrible liar; its voice drips with a corrosive inner directed sarcasm that seeks to undermine any meaningful recovery from it.  It disempowers us from seeking a way out of its meaningless labyrinth.  Its sole agenda is to keep perpetuating itself.

     In some real sense, we must stand up to our depression.  We must disassemble it piece by piece and try to understand what we are dealing with.  We must know its ways and how it manifests in our daily lives.  There are things that we do that propagate it; other things that let it wither on the vine.  

     I used to unwittingly feed my depression with my pensive nature.  In some dreamy sense, I thought I had some dramatic and sad existential take on the human condition.  Sort of like a modern day Tolstoy.  The problem, as I see it now, is that this propensity was not constructive and helpful.  It could, when fueled by the various conniptions of life, be overly dramatic.

     As I’ve previously blogged, pessimistic or distorted thinking is a hallmark of depression.  While I don’t think existential musings make one depressed, I do believe that when we take such thoughts too far or too seriously, we fuel depression. 

     I often think of depression as an iceberg.  We envision these monoliths as permanent, imposing and unshakable.  Yet, we know that they really aren’t.  An increase in temperature (e.g. think global warming) causes chunks of ice to start falling away from the iceberg’s hefty girth.  By standing up to depression, parts of it too begin to fall away.

     We don’t have to take our depression on all at one time, but take it on we must. I like to think of it as a kind of vow we make to ourselves .  Mahatma Gandhi once wrote:  “A vow is fixed and unalterable determination to do a thing, when such a determination is related to something noble which can only uplift the person who makes the resolve.” 

     Standing up to our depression is ennobling and courageous.  Rather than being a victim of depression – and there are sure to be times we feel that way – we can take a vow to stand up to it.

     Please try to be one of the thousands of people who stand up to depression everyday. I have been privledged to know some of these everyday heroes and it always reaffirms my faith in humanity.

Missing The Point


I recently read a tragic article about a young man at New York University who jumped to his death at the school’s library the other day.  One of the school’s spokesman said, “It’s a very competitive school that stresses people out. This sort of stuff happens at places like this”.  Sort of like a variation of “shit happens,” don’t you think?  I think this misses the point.

Some months ago, I wrote a blog article called, “The Death of a Law Student.” A brilliant young man – I’m sure much like the man who killed himself this past week – from Fordham Law School, David Nee, killed himself shortly before graduation.  While there may be no concrete answers to these tragedies, I feel that there are lessons to be learned.

First, when reporting these stories, there is usually no mention of the victim’s psychological history.  Neither is there in most news accounts of the 30,000 people who kill themselves every year in this country. 

That’s okay, because everyone has a right, as does their surviving family, to privacy.  Yet, I am sure if we were to know the whole story about these victims, we’d find that the majority of them had been suffering from depression for some time.  It wasn’t just “stress” or a “competitive academic environment” or a job loss which caused these deaths.  Perhaps, it was the latest in a series of emotional struggles; inner battles which that person fought valiantly but ultimately lost.

Second, I think these suicides underscore just how painful depression really is. Dr. Kay Redfield Jamison (click here to read an interview with her), author of the recent and definitive book, Night Falls Fast, captures this sense of pain:

“Depression paralyzes all the otherwise vital forces that make us human, leaving instead a bleak, despairing, and deadened state.  It is barren, fatiguing, and agitated condition:  one without hope or capacity.  All bearings are lost; all things dark and drained of feeling.  The slippage into futility is first gradual, then utter. Thought, which is pervasively affected by depression as mood, is morbid and confused.  The body is bone-weary; there is no will; nothing that is not an effort, and nothing that at all seems worth it.  Sleep is fragmented, elusive, or all-consuming.  Like an unstable gas, an irritable exhaustion seeps into every crevice of thought and action.”

It is so painful, in fact, that some sufferers would prefer death to the ongoing agony of dealing with depression for the rest of their lives.  They often conclude that the noonday demon will be with them forever because of their inner battle and many failures to overcome or contain it which have been going on for some time.  Seeing no progress or hope on the horizon, people take their lives.  They experience a sort of “combat fatigue.”  They just can’t get out of their foxholes.  It feels like a dead end.

It’s very difficult for suicidal people to think about anything but the pain they’re in.  It is hard for them to connect to the very real pain – emotional devastation really – that loved ones would feel were they to take their life.  It’s as if they’ve become unmoored from all those who care about them and can only hear the siren of depression’s screaming wail.

I have been encouraged by others who have never experienced depression not to blog about the “grim topic” of suicide.  To me, that’s like saying let’s not talk about cigarette smoking and cancer. Untreated depression – like smoking packs of cigarettes everyday- can and often does lead to death.

In a real sense, I don’t give a damn what others think.  I want to reach those people out there who are suffering with depression and need someone, for Christ’s sake, to tell them that they understand and they’re not crazy to feel this way – even when it comes to having suicidal thoughts.

People who have suicidal thoughts should seek help right away.  Click here for immediate help, a toll free number and additional resources. There were plenty of times during my deepest depressions that I felt like I couldn’t take it anymore.  And there was no hiding place; nowhere that I could go to escape the clutches of depression. It covered me like a wet wool jacket as I stumbled through my days.  I always reached out for help and it saved me.

I think that people who experience depression are very brave people.  They must cope with something very painful.  Often, they don’t feel supported. Often, even when they are really supported, they don’t think so because their depression tells them otherwise.  It’s the voice of depression giving them the old screw job every which way they turn. 

Had we broken arms or legs, it would be so simple.  Loved ones would respond – maybe with flowers and chocolates and a puffing up of our favorite pillow – with love and care.

Sometime ago, I was trying to tell my mother and older sister about my depression.  They weren’t terribly moved and I got angry.  I said, “Maybe, if my head were falling off and I was spouting blood, you would believe me then.  You would give me a damn ounce of compassion.”  Looking back on it, I really don’t think they were being selfish bastards.  I think that they just didn’t know.  They didn’t have any frame of reference for what depression is or just how painful it can get.

This really doesn’t make it any easier for the depressed person.  They feel misunderstood at a time when they feel broken.  They’re reaching out to people beyond their therapist and psychiatrists and hoping to find friendly souls to assuage some of their anguish.  “Surely, people will understand me and care about this,” they often think.  But others are often frightened and minimize the problem:  “Just get the hell over it” they preach from the pulpit.  All the while, we stand there, crying inside and feel all alone in a veritable wasteland. 

A few times, in the worst of times, I even thought that maybe if I really did kill myself, then others would take my pain seriously.  But what a supreme tragedy such an act would be; it doesn’t solve anything and would only leaves a cosmic trail of pain in its wake forever.  I am so grateful that I never acted on any of these impulses.

We all want so much to connect at a time when depression has disconnected us.  We feel ourselves falling with no parachute.  Yesterday, I give a presentation to thirty undergraduate students on the topic of depression.  After my talk, I fielded many questions.  One young woman asked, “what do you think helped you most in getting over your depression?”  First, I said that I hadn’t gotten over it; I would have it – in some form- probably for the rest of my life.  I told her that it was contained and manageable, not cured.  I also said: “Probably, what helped me the most was time.” My depression and who I am has changed over time.  It didn’t kill me.  I survived and continue to work at it like a miner digging for coal.  I have learned creative and effective ways to cope with it.  It doesn’t rule my days – most of the time.

After hearing my answer, she exclaimed, “How brave you are.”  I responded: “I really don’t feel brave at all.  What I do feel is determined”.  I feel determined to fight my depression in all of its manifestations.  I feel determined to not let it define me and my life.

It is such determination, over time, that helps us recover from depression.  It gives us hope because we can actually witness ourselves not giving into our melancholy.   We don’t need to keep being victimized by it.  Sure, there will be days when it might get the better of us.  But, as the old Zen saying goes, “fall down seven times, get up eight.”  Keep getting up.

The CEO of Depression











I’ve read lots of books and articles about depression. What’s strikes me about most of them is how redundant they are. It’s as if there is a place called “Depression Town” where a lot of these authors live and reach consensus about what should be in these books

Most of the books I’ve read didn’t particularly help, some did.  Yet, I felt compelled to keep buying them.  I would show up on a regular basis at my neighborhood Barnes & Noble looking for new self-help titles or troll Amazon hoping –just hoping – that there would be a depression book written especially for me.  During the worst of my depressions, I didn’t read the books so much as use them as emotional tourniquets.

The titles would usually be great – “10 Was to Stamp out Depression for Good”; the content not so much.  Many of the books were boring.  How could this be true, I thought?  How could they be writing about depression – one of the most God-awful experiences you can imagine – and bore me? Most of the authors seemed never to have suffered from depression. If they had, they didn’t say.  If they had, I wished that they had told me so.  Maybe I would have felt a greater connection to what they were trying to say.

I think it’s easy to get lost in so much advice. And we’re all seeking pearls of wisdom; nuggets of truth that we can take back to our nest and ponder.  I think the best wisdom not only deals with the particulars of depression, but also connects us to the larger human condition and all humans search for meaning within suffering.

Sister Kathryn James Hermes, author of the book, “A Contemplative Approach to Depression”, writes that prayer and contemplation help us to deal with depression in a larger spiritual context:

“Both of these practices lead to vulnerability – the learned powerlessness of the truly powerful who can simply be: simply wait, simply be present, simply wonder, simply trust that much larger hands are holding us and knows for whom we work in view of a much larger plan that we cannot as yet understand.”

Absent this, I think many of our efforts to get better may fall flat.  Without such nurturance, advice becomes just another self-improvement project.  Not much really changes.  Oh, it might for a short while.  We feel better, and then one of the wheels of our lives starts to wobble as we try to traverse our days.  We feel like that is something about ourselves that needs fixing, and we get to it. Yet, there’s something very isolating and lonely about these Oprah-like projects to remake ourselves.  Often, it involves rejection of some important element of who we really are. 

That being said, we may come to the conclusion that depression is bigger than us, but it’s not bigger than God. A God –however you define Him/Her, who “holds us in His/Her much larger hands.”

When the turbines of depression were really churning in my life, dealing with it felt like a full time job.  I had two jobs really – working as a lawyer and trying to get better.  This often, in retrospect, would take on a grim earnestness that wasn’t very constructive.  Sometimes, or so it seemed, God would drop these moments into my life to remind me not to take myself or my depression too seriously.

My then 5 year daughter would say, “Daddy works for the Depression Company.”  As I tucked her into bed at night, and looked into those magical eyes that all small children possess, I said, “That’s right honey.  And I’m the CEO.”


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