Clinical studies show that regular aerobic exercise is effective as antidepressants in reducing mild to moderate depression. In fact, exercise causes the same structural changes to the brain as antidepressants do and is a treatment option that is not recommended enough and is underutilized in the United States. Read more here.
Running From The Pain
How Exercise May Help the Brain Grow Stronger
The New York Times reports that a new study with mice fills in one piece of that puzzle. It shows that, in rodents at least, strenuous exercise seems to beneficially change how certain genes work inside the brain. Though the study was in mice, and not people, there are encouraging hints that similar things may be going on inside our own skulls. Read the News
Meditation, Aerobic Exercise Combo Cuts Depression by 40 Percent
A new study has found that following two sessions combining meditation and aerobic exercise per week for two months can reduce the symptoms of depression by 40 percent. Read the News
Scans Suggest Recurrent Depression May Take Toll on the Brain
The area of the brain involved in forming new memories, known as the hippocampus, seems to shrink in people with recurring depression, a new study shows. Read the News
Six Ways to Cope with the Limitations of Depression
Blogger Therese Borchard writes, “Living with chronic depression demands an acceptance of one’s condition and a willingness to learn to live around lasting symtoms”. Find out her six tips about how to do just that. Read the Blog
Depression and Fatigue: A Vicious Cycle
Learn how depression affects fatigue, and vice-versa. Find out what you can do to help treat both. Read the Blog
Gunslingers: How Lawyers Can Better Handle Stress
We avatars of the legal system, we hired guns who ride into town and shoot up saloons, measure our success by the notches on our dusty belts: Did I win or lose? Or, perhaps more accurately, is it: Am I a winner or a loser? There is a thrill about winning and being successful, however we define it — but also a lot of stress.
Results, bottom-line bastards that they are, can spew toxic stress into our bodies like BP oil into the Gulf. Many lawyers struggle to shut off their inner dialogue that pings between their ears as they lay awake at night and their family sleeps: “Will I be successful tomorrow? Will I bill enough hours this month?” We mash ourselves up like Idaho potatoes flopping around in our beds as the minutes click away on our L.E.D. alarm clocks.
I wrote an article for Trial Magazine about the connection between stress, anxiety and depression. Here’s a part of that article:
”How our bodies and brains deal with stress and anxiety hasn’t changed much in the last 10,000 years. A wonderful defense mechanism, which is wired into our nervous system, is called the fight-or-flight response. When confronted with a threat – whether real or perceived – this response kicks in and floods our bodies with the powerful hormones cortisol and adrenaline, which propel us into action. This was an essential survival device for our ancestors who lived in the jungle and would have to flee beasts or fight foes trying to kill them.
Lawyers don’t face these types of real life-or-death threats. But they perceive life-or-death threats in their battles with opposing counsel while sitting in a deposition or sparring in the courtroom. Our bodies respond as if they were being chased by a hungry lion. Over time, this chronic anxiety causes the release of too many fight-or-flight hormones. Research has shown that prolonged release of cortisol damages areas of the brain that have been implicated in depression: the hippocampus (involved in learning and memory and the amydala (involved in how we perceive fear).”
Living in the jungle of our profession doesn’t involve warding off wooly mammoths, but it does involve a fight-or-flight from mental constructions in our heads: the fear of missing a court ordered deadline can create panic in our nervous system every bit as real as a tangling with a beast that tried to kill our ancestors.
Lawyers are perfectionists and overachievers who are never content to give things their just their best try. They believe in dumping large amounts of energy into each and every project. Such extraordinary efforts are stressful on our bodies and minds. Yet, we know all of this, don’t we? The truth is that many lawyers have already made the calculations in their heads and are willing to take the pounding for more dollars. We come back to our abodes at the end of our days exhausted, peak at our mutual funds statements and turn on the T.V. too tired to think about the implications of living this type of life.
Lawyer Steve Keeva, in his piece Take Care of Yourself, wrote:
”The dominant method of legal billing can, if you let it, subvert your ability ‘to claim a full and rich life for yourself,’ as litigator John McShane put it. Think about it. Billing by the hour is extraordinary in the way in which it so nakedly equates money with time. It thereby offers no incentive at all to stop working. The taskmaster par excellence can reduce grown professionals to slavish piece workers.”
When exploring the stress of success, we shouldn’t lose sight of the fact that depression happens in a context, a cultural milieu and a profession’s mores. Too often, we put everything on the individual – her depressive thinking, his genetic makeup – as if depression in a person forms and takes place in a vacuum: if it “takes a village to raise a child;” well, it takes a culture to create conditions for depression to develop.
We are social creatures that need support from our families, institutions and society. These structures help mitigate stress and prevent depression. Yet, contemporary culture has largely failed us: the breakdown in families, the betrayal of cultural and political institutions, a grimy cynicism in people, vacuous and crass entertainment unmitigated consumerism and a legal profession which endorses the value of professionalism while lawyers say that levels of incivility between lawyers is at an all time high. It’s become more of a business than a profession and calling, it’s become more mercenary in nature where lawyers forget that they are officers of the court and not just there to do the bidding of a well paying client.
Bruce Levine, Ph.D., author of the book Surviving America’s Depression Epidemic, writes about renowned psychoanalyst and social critic Eric Fromm’s commentary on the connection between our cultural values and depression. Here is an excerpt from book about the dangers of a consumerism driven culture:
“Fromm argued that the increase in depression in modern industrial societies is connected to their economic systems. Financial success in modern in modern cultural societies is associated with heightened awareness of financial self-interest, resulting in greater self-absorption, which can increase the likelihood of depression; while a lack of financial interest in such an economic system results in deprivation and misery, which increases the likelihood for depression. Thus, escaping depression in such a system means regularly taking actions based on financial self-interest while at the same time not drowning in self-absorption – no easy balancing act.
The idea that money and buying stuff and acquiring status = happiness isn’t treated for what it is – a paper thin myth. Certainly, there’s nothing wrong with making money; buying things and wishing to obtain a certain level of success in our careers. It’s a healthy recognition of the limitations of our income and what it really can buy that makes all the difference and keeps us out of this downward spiral.
In the book The How of Happiness: A Scientific Approach to Getting the Life You Want, author Sonja Lyubomirsky, Ph.D., concludes:
”One of the reasons for the failure of materialism to make us happier may be that even hen people finally attain their monetary goals; the achievement doesn’t translate into an increase into an increase in happiness. Also, materialism may distract people from relatively more meaningful and joyful aspects of their lives, such as nurturing their relationships with family and friends, enjoying the present, and contributing to their communities. Finally, materialistic people have been found to hold unrealistically high expectations of what material things can do for them. One father confided to me that he believed that purchasing a forty-tow-inch flat-panel TV would improve his relationship with his son. It didn’t.
A more spiritual take on the issue was penned by famed author and Trappist monk Thomas Merton. In his classic work, No Man Is an Island, he writes:
”One of the chief obstacles to a sense of wholeness in life is the selfish anxiety to get the most out of everything, to be a brilliant success in our own eyes and in the eyes of other men. We can only get rid of this anxiety by being content to miss something in almost everything we do. We cannot master everything, taste everything, understand everything, drains every experience to its last dregs. But if we have the courage to let almost everything else go, we will probably be able to retain the one thing necessary for us -whatever it may be. If we are too eager to have everything, we will almost certainly miss even the one thing we need.
Happiness consists in finding out precisely what the ‘one thing necessary’ may be, in our lives, and in gladly relinquishing all the rest. For then, by a divine paradox, we find that everything else is given us together with the one thing we needed.”
For Merton, that one thing was God. For some of us with depression, this may be our touchstone as well; a center around which to slow down the centrifugal force of our spinning lives. For the others, it may be our family or friends. But whatever it is, it must ground us and bring out, as Abraham Lincoln once said, “The better angels of our nature.”
To lessen the stress in your life, and the risk for developing or exacerbating your depression, try these tips from your friend Dan:
- Fast for a few days from the radio in your car, the newspapers or fooling around on your Blackberry. Take a time out. Think of it as an experiment. Lawyers complain that they’re stressed out only to dump more information and stimulation into their craniums at every few moment they have. Lawyers already read and think enough for a living – give your nervous system a break for crying out loud.
- Hand in hand with the above, incorporate some slice of silence into your life. It doesn’t have to be a monastic experience. I wear a runner’s watch and do a ten to fifteen minute period of silence a day. If you don’t do something like this, you know what you’re stuck with – too much noise.
- Start asking yourself some questions. What toll on your mental and physical health is your drive to succeed exacting on your life? Make an actual list, take it out every day and read it. The purpose is to try to become more conscious of the actual cost of your career to you. People tell me they don’t have the time to do this, but then spend hours researching whether to buy a Lexus or Audi. The irony of it all. We love accumulating things and experiences in our society. Instead of adding something into your life, what can you drop out of it that would make you feel better?
- Read something that would nurture you as a person and dump the rest of the crap. Read only one thing at a time. Maybe a book of poetry or the biography of a heroic person.
- Reconnect with the humorous, whether highbrow or sophomoric. Plug into it and have a gut-busting hoot.
- Remember, that life isn’t a dress rehearsal. The time you’re spending at your job is a segment of finite time that you’re given. Once it’s spent, it’s spent. No one tells you how to spend it, despite what you might have gotten yourself around to believing. Remember, you choose. My priest once said that on every gravestone there are two dates: the date we were born and the date we died. We don’t get to choose those dates. But between those dates, is a dash line: “—.” That dash is our life and what we have done with it. Resolve to be a person whose dash is driven by substance and not solely by success. As Mark Twain once wrote, “Let your life sing so that upon your death, even the undertaker will weep.”
- The notion of “quality time” for oneself or others is largely bullshit. Richard O’Connor, Ph.D. once said that to overcome depression we need to start investing in ourselves like we’re worth it: exercising, sleeping enough, etc. No matter how you slice it, there is no small amount of “quality time” in which you can achieve these basic self-care routines. The reality is you will need to take whatever amount of time it takes because YOU are worth it.
- If you are locked in the success matrix as a lawyer, remember that it doesn’t have to stay that way forever. Realistically, your life won’t probably change tomorrow. But it can begin to change in small way that can lead you in a healthier direction.
Copyright, 2014. All rights reserved by Daniel T. Lukasik
Lawyer Fight-Or-Flight And Its Connection To Depression
Lawyers are control freaks. Okay, maybe they have to be. There’s is so much going on that they actually do have to control things to be good at their jobs. But it creates a grind of perpetual stress; every day, all-out stress seizures to control of events and people that are all too often uncontrollable leaving them depleted by the constant firing of their bodies’ fight-or-flight reaction.
We all learned in high school biology about the fight-or-flight response; a binary system of survival that kept our hairy, grunting ancestors alive in prehistoric times when meandering about the Sarengeti plains. This lighting quick response evolved to make us scamper from threats we could outrun and brawl with ones we couldn’t.
Today’s’ lawyers are embedded with the same nervous system their Neanderthal ancestors had 30,000 years ago. When they’re threatened on the job, their heart rate fires, breathing becomes shallower to divert oxygen to muscles and stress chemicals are dumped into their bodies. This all happens automatically, before they’ve even had a chance to think about it. And it happens even when they’re not being chased by a ravenous cougar or fighting a loin clothed adversary.
When our body’s stress response is triggered, it does not know the difference between true physical threats to our physical survival and psychological threats to our sense of self. Think about how much our hearts pounds in a contentious deposition, for example. Our bodies, unable to actually physically run or fist fight in the office, surge with stress hormones as if we were in a bloody life-or-death battle for control of that deposition with a dastardly adversary.
For lawyers prone to anxiety and depression, the daily surges of the stress hormone cortisol are particularly troublesome because of its impact on the hippocampus and the amygdala in the brain.
The hippocampus is that part of the brain that remembers details and helps you put incoming information into context. It is without emotions, registering and storing details of events, functioning like a Joe Friday from Dragnet: “Just the facts, mam.”
The amygdala is the brain’s early warning system and is a major cause in genetically depressed moods and negative thinking. It acts as an importance meter, registering tone and intensity and tells your brain instantly if it should prepare for trouble. It scans the environment looking for danger.
Too much cortisol, over too long a period of a time, can cause depression and result in actual changes to the brain.
Physician John Ratey writes in his best-selling book Spark:
“Chronic depression causes structural changes to the brain. Research has showed that depressed patients had measurable changes in the amygdala and the hippocampus, crucial players in the stress response. We knew the amygdala was central to our emotional life, but they also found that the memory center was also involved in stress and depression. High levels of the stress hormone cortisol kill neurons in the hippocampus. If you put a neuron in a petri dish and flood it with cortisol, its vital connections to other cells retract. Fewer synapses develop and the dendrites wither. This causes a communication breakdown, which, in the hippocampus of a depressed brain, could partly explain why it gets locked into thinking negative thoughts – it’s recycling a negative memory, perhaps because it can’t branch out to form alternative connections. At the same time, MRI shows that new nerve cells are born every day in the hippocampus and possibly the prefrontal cortex – two areas shriveled in depression. Now we see depression as a physical alteration of the brain’s emotional circuitry.
Norepinephrine, dopamine, and serotonin are essential messengers that ferry information across the synapse, but without enough good connections in place, these neurotransmitters can only do so much. As far as the brain is concerned, its job is to transfer information and constantly rewire itself to help us adapt and survive. In depression, it seems that in certain areas, the brain’s ability to adapt grinds to a halt. The shutdown in depression is a shutdown of learning at the cellular level. Not only is the brain locked into a negative loop of self-hate, but it all loses the flexibility to work its way out of the hole.”
In the privacy of their offices or in anonymous phone calls, I’ve heard many lawyers with depression tell me they hate themselves. They hate themselves because they’re stuck in depression and spinning their wheels. Rather than see this predicament as something that can be explained as an illness going on in their brain, they mercilessly punish themselves and feel they’re weak and lazy.
In his book Undoing Perpetual Stress: The Missing Connection between Depression, Anxiety, and 21st Century Illness, Dr Richard O’Connor writes:
“For an overwhelming number of people today, the result of the vicious circle of perpetual stress is a state of permanent malfunction: dissatisfied, irritable, overwhelmed and hopeless, out of control, frightened, physically run down and in pain. For want of a better term, this is what I call the “Perpetual Stress Response.” Overwhelmed by too many stress hormones in our system, our cells close down receptor sites to try to compensate; but that just makes the endocrine system pump out even more stress hormones. Continually bathed in neurotransmitters telling us there is constant danger. And our brains become rewired by stress, our neural circuitry restricted to firing along preconditioned pathways, so that we are literally unable to think of new solutions, unable to come up with creative responses.”
Anxiety and depression are terrible coping mechanisms. If so, why do lawyers in such large numbers suffer from these maladies? Because they don’t know what else to do and don’t realize the damage they’re doing to their bodies and minds by living with the fight-or-flight furnace turned on high all day long.
So what is a depressed lawyer to make of all of this? Like recovery from any illness, awareness goes along way. For many with depression, it will take a long time and periods of suffering, to see, to truly see, that anxiety and depression don’t work as coping mechanisms and that they have to learn better ways in which to run their lives to help their brains.
In my next blog, I’ll explore what we can do about this situation.
Finding Our Way in the Law
It’s in the darkness of men’s eyes that they get lost – Black Elk
Graduating from law school is both exciting and frightening at the same time. There’s a real itch to put our knowledge into action, to be a bona fide “attorney at law” and to start making some dough instead of spending it on tuition and books. On the other hand, we really don’t know a lot about the application of legal theory to legal combat, may have a heap of debt and pray that our first stab at competency doesn’t land us face first on the courthouse steps.
Beyond all of these pragmatic concerns is the meatier matter of living a life in the law that matters; a life in accord with our inner core of what we truly value in life. As author Studs Turkel once wrote:
“Work is about a daily search for meaning as well as daily bread, for recognition as well as cash, for astonishment rather than torpor, in short for a sort of life, rather than a Monday-to-Friday sort of dying.”
Lawyers, young and old alike, find it difficult to live out their values in the workplace, to search for “meaning as well as daily bread.” There are challenges and compromises, some more difficult than others. For example, we may really value spending time with our family. But as the demands of our career mount, we become untethered from this life-giving sustenance as we spend more and more time toiling at the office.
Andrew Benjamin, Ph.D., J.D., a lead researcher in studies about the mental health of law students and lawyers, concludes that much of the dissatisfaction in the profession comes from a widening gap between the values we truly care about and the things we end up pursuing in in our jobs as lawyers. This takes place over time and its effects are cumulative. Many end up leaving the profession. Or, if they stay, are mired in unhappiness, discontent and can’t see a way out.
Dr. Benjamin found that approximately 20% of lawyers – about twice the national average – aren’t just unhappy; they’re suffering from clinical anxiety or depression. We aren’t talking about everyday stress, sadness, blues or categorical grumpiness. We’re talking rubber to the road clinical anxiety and depression; devastating diseases that cause breakdowns in every area of one’s life. Put in perspective, Benjamin’s studies suggest that a whopping 200,000 of this nation’s 1 million lawyers are struggling – some very badly.
Certainly a gap between our values and the way we live as lawyers doesn’t cause depression. But it’s one of many factors that include a history of depression in one’s family and emotional abuse and/or neglect during one’s formative years that make a person prone to depression.
Lawyers also seem to have a particularly fearsome type of stress overload; a jacked central nervous system fueled by the adversarial nature of the trade. Modern science now knows that there is a powerful connection between chronic and remitting stress and the development of clinical depression. As I wrote in “How Stress and Anxiety Become Depression,” chronic stress and anxiety causes the release of too many fight-or-flight hormones such as cortisol which damages areas of the brain that have been implicated in depression: the hippocampus (involved in learning and memory) and the amygdala (involved in how we perceive fear).
The point of all this sobering news isn’t to rain on anyone’s parade. Law can and should be a noble calling and a satisfying way to make a living. Rather, these warnings are meant to impart some thorny wisdom: living out your values and dreams are just as important as – to quote my brother Wally’s favorite expression, “carving out a living”. Or, as Studs Terkel earlier surmised: “. . . to have a sort of life, rather than a Monday-to-Friday sort of dying.”
It’s scary when you sense that you’ve wasted a lot of time doing a type of law – or law at all – that fails to connect with your deeper values. Part of the fear is driven by the growing sense as we age that we don’t have forever – we are finite beings. When we don’t know the way, can’t find path to move our outer life closer to our inner life, we can experience a sort of existential terror. We may be sitting in a classroom, at court or just wandering downtown during our lunch break and a visceral sense that we yearn for something else will hit us. How many of us quickly dismiss such thoughts as minor meanderings that aren’t worth our time. But, these thoughts may keep coming. Listen to them. If we don’t, we may risk greater peril.
Gregg Levoy, author of Callings: Finding and Following an Authentic Life, talks about the dangers of not following the murmurs coming from within us all:
“Of course, most people won’t follow a calling until the fear of doing so is finally exceeded by the pain of not doing so – pain that we appear to have an appalling high threshold for. Eventually the prospect of emotional and financial turmoil, the disapproval of others and the various conniptions of change, can begin to seem preferable to the psychological death you are experiencing by staying put. Those who refuse their passions and purposes in life, though, who are afraid of becoming what they perhaps already are – unhappy – won’t of course experience the unrest (or the joy) that usually accompanies the embrace of a calling. Having attempted nothing, they haven’t failed, and they console themselves that if none of their dreams come true then at least neither will their nightmares.”
So remember your values and where they are trying to lead you. That’s realistic. Our values are not set in granite; they can and will change over time. Yet the only tuning fork you will ultimately have is trying to build a solid bridge between who you really are and what you are in the real world. We can and will hit choppy waters as we sail our ships in our careers. There will be many temptations – money, power. This story has been played out for millennia. As you go through your career, watch the currents and stir your ship bravely, with integrity and passion.
As Apple founder Steve Jobs wrote:
“Your time is limited, so don’t waste it living someone else’s life. Don’t be trapped by dogma – which is living with the results of other people’s thinking. Don’t let the noise of other’s grievances drown out your own inner voice; and most important, have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary.”