Is it Lawyer Sadness or Lawyer Depression?

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

sad woman

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

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

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

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

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

“Everyone has had a taste of what depression feels like.  Everyone feels the blues at times.  Sadness, disappointment, fatigue are normal parts of life.  There is a connection between the blues and   depression, but the difference is like the difference between the sniffles and pneumonia.”

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

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

depressed cave

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

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

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

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

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

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

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

DSM

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

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

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

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

 

 

 

Separating Sadness From Depression

Sad movies are popular. People read sad novels and get in touch with the feeling. However, in our daily lives, sadness is a bittersweet memory of what once was.

This normal and natural emotion accompanies a loss of something or someone you value. It can be brief. It can linger. Sadness can reappear on the date of a loss, from looking at a picture, a situation, a passing thought—practically anything that you associate with the loss that holds meaning for you.

It is because we form attachments with people, with animals, and with ideals and places, that sadness carries through our lives. The size of the loss doesn’t matter. A child who experiences the loss of a goldfish weeps at a loss that others might find trivial. It’s not trivial. This loss is as real as any other is.

Losses come in different ways at different times. The loss of a tradition can evoke sadness. You may miss and feel sad when your children grow to adulthood and leave home to live on their own. The death of a close friend may leave you with a lingering feeling of loss. All sad. All inevitable.

When my childhood friend Al’s teen-aged daughter died, I saw my six-foot-five, 350-pound friend collapse in sadness and despair. He asked, “How will I ever get through this?” There was no answer. There was only time. I supported him as best I could. I wrote a poem in her memory. I wished I could have done more.

Within the year of his daughter’s death, Al died from cancer. I felt a great loss. Sadness still awakens within me when I think of happier times. When I visit his grave, I bury an old coin in the ground. Silly? Perhaps. Al loved to collect old coins. There is nothing wrong with feeling sentimental.

Sadness is a tribute. If there were no meaning to our relationships, there would be no sad feelings. There are sad times because there were once happy times, cherished times, and valued attachments.

Sadness reminds us that we are human. It is part of our biology and our heritage. If you accept that reality, you may find that you don’t go through phases of denial, anger, and resignation following a major loss. You may avoid depression. Acceptance of sadness is enough. Meanwhile, write poetry. Organize a march to raise money for a cause. Paint. Walk. Solve a problem.

Loss. Sadness. Time to grieve. Time to heal. Time. Time. Time. It can go so slowly. There is acceptance. There is allowance. There is working through the process of loss. However, in situations where the loss came from a tragedy that is followed by depressive thinking and depression, it can take considerable time and work to come to grips with the experience.

Bob’s fiancée, Jane, died hours before their wedding. It was a tragic automobile accident. Bob felt numbed and grief stricken. Three years after this tragic event, Bob continued to feel great guilt and depression. He told himself, “If only I had phoned Jane before she left, she would have gone through the intersection at another time.” He told himself, “I can’t live without her.” He believed, “I will never find anyone like Jane.” A cloud of hopelessness covered his life, and his depressed mood was both deep and painful.

Bob stopped doing what he once enjoyed. An avid tennis player, Bob let his racquet gather dust. There were no more dinners with his friends. As he drew within himself, he withdrew from his family. Previously a successful accountant, Bob quit. Thereafter, he mostly did odd jobs, such as buffing automobiles.

Bob felt overwhelmed by the details of daily living. His mood was despondent. He awakened in the middle of the night with a frightening image of the accident that took Jane’s life. He compounded his profound sadness with defeatism, pessimism, and self-loathing.

As he learned to defuse the negativity in his thoughts, and to accept his lack of control over Jane’s tragic death, Bob’s inner turmoil softened to sadness. Months later, he resumed his accounting career. At the time of this writing, he is happily married with three children. His family is a source of great joy. Has he forgotten about Jane? Jane lives on as a cherished memory.

Loss is inevitable. Sadness is inevitable. But, depression is not inevitable. Sadness, you accept. You deal with depression.

When sadness changes to depressive darkness, it’s time to look for a flashlight.

By Bill Knauss, Ph.D.

Singin’ the Blues

Depression isn’t about feeling sad and blues music isn’t about depression.  A great piece by lawyer turned therapist Will Meyerhofer.  Read the Blog

Depression: Tragically Misunderstood

From psychologist and best-selling author Dr. Steven Iliardi, a piece that distinguishes sadness from depression and why such a distinction is important not only for others who care about depressives and want to help, but for the depressive’s own understanding about such a confusing illness. Read the Blog

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