Kay Redfield Jamison Archives - Lawyers With Depression

The Suicide of a Law Student Hits Home

When people are suicidal, their thinking is paralyzed, their options appear spare or nonexistent, their mood is despairing, and hopelessness permeates their entire mental domain. The future cannot be separated from the present, and the present is painful beyond solace. ‘This is my last experiment,’ wrote a young chemist in his suicide note. ‘If there is any eternal torment worse than mine I’ll have to be shown.’ – Kay Redfield Jamison, M.D., “Night Falls Fast: Understanding Suicide”

A second-year law student at the University at Buffalo School of Law, Matthew Benedict, died by suicide earlier this week by leaping from the Liberty Building he had been clerking at according to the Buffalo News. Another account of Matt’s life and suicide was reported in The New York Law Journal.

Matt’s funeral is tomorrow. By all account’s he was a tremendous, loving, talented, bright young man.Matt was kind-hearted, passionate and driven.

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Dan’s Top 10 Video Picks on Depression

Films can teach us a lot about depression. Not only can they provide information. They can also move us emotionally by drawing us into the subject with interviews, animations, and other techniques that aren’t amenable to books. Here are my favorite videos that address the topic of depression.

Living with Depression

I came across this short video recently. And was very moved. It captures, with sublime music and moving images of a young woman, her struggles with clinical depression and the loneliness she endures. Powerful. Over four million people have viewed it. Running time is 3 minutes and 22 seconds

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The Deadzone of Depression

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

Kay Redfield Jamison, M.D., in her book, Night Falls Fast, writes:

I wish I could explain it so someone could understand it. I’m afraid it’s something I can’t put into words. There’s just this heavy, overwhelming despair – dreading everything. Dreading life. Empty inside, to the point of numbness. It’s like there’s something already dead inside.

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

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

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

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

— This depression isn’t forever. It will pass.

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

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

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

— I appreciate all of the goodness in my life.

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

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

According to psychologist, Deb Serani, Psy.D, there are both emotional and psychological reasons why this is so:

So, why do these gratitude experiences boost happiness and alleviate depression? Scientists say that these techniques shift our thinking from negative outcomes to positive ones, elicit a surge of feel good hormones like dopamine, serotonin and oxytocin, and build enduring personal connections.

The insight and reflection of counting these moments is what makes the practice of gratitude so powerful. But the key to combating depression is making these positive experiences part of the fabric of your life.

Try this for a while and see if it helps you. Don’t wait until you are in the zone of depression to construct the cards because your thinking during such times will be distorted.

Doing this is a healthy and self-empowering step that you can take today.

By Daniel T. Lukasik, Esq.

To Know Suicide: Depression Can Be Treated, But It Takes Competence

From The New York Times, best-selling author and psychiatrist, Kay Redfield Jamison writes, “Certainly, stress is important and often interacts dangerously with depression. But the most important risk factor for suicide is mental illness, especially depression or bipolar disorder.” Read the News

The Death of Robin Williams, Depression and Suicide

Our hearts are broken. This funny, kind and gentle man is gone. He, like the 30,000 other souls that commit suicide each year in this country, was struck down by depression.

Many people find it incomprehensible that someone so talented, beloved, good and wealthy could take his own life. One commenter from Fox, Sheppard Smith, (not surprising, I guess) called him a “coward.” What a cowardly thing to say from a man who has, most likely, never suffered from the grind of depression as Robin did. However, this commenter isn’t alone in his ignorance. One poll found that over forty percent of all Americans viewed depression as “a lack of willpower.”

Rather than cowardly, I believe Robin’s well-documented life-long battle with major depression and addiction was heroic. As someone who had lived in the trenches of major depression over the years and known hundreds of fellow soldiers like Robin, I feel that people who struggle with depression are my heroes.

Ironically, Christopher Reeve, Robin’s long-time friend who studied acting and roomed with him at Julliard, defined what a hero is:

“I think a hero is an ordinary individual who finds strength to persevere and endure in spite of overwhelming obstacles.”

Given his brilliance, fame and wealth, one could say that Robin was anything but “ordinary.” Yet, he was a flesh-and-blood human being, just like you and I, who suffered tremendously. And he, tragically, decided he just couldn’t take it anymore.

Until he committed suicide, he had somehow found the strength to persevere over the course of his life despite his poor mental health. I’m sure that there was many times that such perseverance involved pushing through the pain of depression on a daily if not moment-to-moment basis. The pain, known all too well by sufferers, must have been so dreadful that he was holding on by his fingertips.

A loss of hope was at the bottom of Robin’s decision to end his life, a loss that no amount of love, support and guidance could assuage.

As Elizabeth Wurtzel wrote in Prozac Nation:

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.

Psychiatrist Kay Redfield Jamison, a professor at Georgetown University, herself a sufferer from depression, had this to say about suicide in her seminal book on the subject, Night Falls Fast:

Rest in Peace, Robin. Thank you for all the gifts you freely gave to the world. Your suffering is over.

Best Depression Quotes

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

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

The so-called ‘psychotically depressed’ person who tries to kill herself doesn’t do so out of quote ‘hopelessness’ or any abstract conviction that life’s assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire’s flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It’s not desiring the fall; it’s terror of the flames. And yet nobody down on the sidewalk, looking up and yelling ‘Don’t!’ and ‘Hang on!’ can understand the jump. Not really. You’d have to have personally been trapped and felt flames to really understand a terror way beyond falling. David Foster Wallace

The term clinical depression finds its way into too many conversations these days. One has the sense that a catastrophe has occurred in the psychic landscape. Leonard Cohen

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

Depression presents itself as a realism regarding the rottenness of the world in general and the rottenness of your life in particular. But the realism is merely a mask for depression’s actual essence, which is an overwhelming estrangement from humanity. The more persuaded you are of your unique access to the rottenness, the more afraid you become of engaging with the world; and the less you engage with the world, the more perfidiously happy-faced the rest of humanity seems for continuing to engage with it. Jonathan Franzen, How to Be Alone

I’m here. I love you. I don’t care if you need to stay up crying all night long, I will stay with you. There’s nothing you can ever do to lose my love. I will protect you until you die, and after your death I will still protect you. I am stronger than Depression and I am braver than Loneliness and nothing will ever exhaust me. Elizabeth Gilbert, Eat, Pray, Love

Choking with dry tears and raging, raging, raging at the absolute indifference of nature and the world to the death of love, the death of hope and the death of beauty, I remember sitting on the end of my bed, collecting these pills and capsules together and wondering why, why when I felt I had so much to offer, so much love, such outpourings of love and energy to spend on the world, I was incapable of being offered love, giving it or summoning the energy with which I knew I could transform myself and everything around me. Stephen Fry, Moab Is My Washpot

I didn’t want to wake up. I was having a much better time asleep. And that’s really sad. It was almost like a reverse nightmare, like when you wake up from a nightmare you’re so relieved. I woke up into a nightmare. Ned Vizzini, It’s Kind of a Funny Story

I thought the most beautiful thing in the world must be shadow, the million moving shapes and cul-de-sacs of shadow. There was shadow in bureau drawers and closets and suitcases, and shadow under houses and trees and stones, and shadow at the back of people’s eyes and smiles, and shadow, miles and miles and miles of it, on the night side of the earth. Sylvia Plath, The Bell Jar

No amount of love can cure madness or unblacken one’s dark moods. Love can help, it can make the pain more tolerable, but, always, one is beholden to medication that may or may not always work and may or may not be bearable. Kay Redfield Jamison, Night Falls Fast

Depression is melancholy minus its charm. Susan Sontag

You are constantly told in depression that your judgment is compromised, but a part of depression is that it touches cognition. That you are having a breakdown does not mean that your life isn’t a mess. If there are issues you have successfully skirted or avoided for years, they come cropping back up and stare you full in the face, and one aspect of depression is a deep knowledge that the comforting doctors who assure you that your judgment is bad are wrong. You are in touch with the real terribleness of your life. You can accept rationally that later, after the medication sets in, you will be better able to deal with the terribleness, but you will not be free of it. When you are depressed, the past and future are absorbed entirely by the present moment, as in the world of a three-year-old. You cannot remember a time when you felt better, at least not clearly; and you certainly cannot imagine a future time when you will feel better. Andrew Solomon, The Noonday Demon

Depression is the most unpleasant thing I have ever experienced. . . . It is that absence of being able to envisage that you will ever be cheerful again. The absence of hope. That very deadened feeling, which is so very different from feeling sad. Sad hurts but it’s a healthy feeling. It is a necessary thing to feel. Depression is very different. J.K. Rowling

Do not abandon yourselves to despair. We are the Easter people and hallelujah is our song. Pope John Paul II

The absolute worst part of being depressed is the food. A person’s relationship with food is one of their most important relationships. I don’t think your relationship with your parents is that important. Some people never know their parents. I don’t think your relationship with your friends are important. But your relationship with air-that’s key. You can’t break up with air. You’re kind of stuck together. Only slightly less crucial is water. And then food. You can’t be dropping food to hang with someone else. You need to strike up an agreement with it. Ned Vizzini, It’s Kind of a Funny Story

Depression is the flaw in love. To be creatures who love, we must be creatures who can despair at what we lose, and depression is the mechanism of that despair. Andrew Solomon, The Noonday Demon: An Atlas of Depression

And an inky-colored despair of rejection enveloped me like the black tortilla of depression around a pain burrito. Christopher Moore, Bite Me

So why am I depressed? That’s the million-dollar question, baby, the Tootsie Roll question; not even the owl knows the answer to that one. I don’t know either. All I know is the chronology. Ned Vizzini, It’s Kind of a Funny Story

Music can lift us out of depression or move us to tears – it is a remedy, a tonic, orange juice for the ear. But for many of my neurological patients, music is even more – it can provide access, even when no medication can, to movement, to speech, to life. For them, music is not a luxury, but a necessity. Oliver Sacks

Grief is depression in proportion to circumstance; depression is grief out of proportion to circumstance. Andrew Solomon, The Noonday Demon

We don’t have a great war in our generation, or a great depression, but we do, we have a great war of the spirit. We have a great revolution against the culture. The great depression is our lives. We have a spiritual depression. Chuck Palahniuk, Fight Club

Killing oneself is, anyway, a misnomer. We don’t kill ourselves. We are simply defeated by the long, hard struggle to stay alive. When somebody dies after a long illness, people are apt to say, with a note of approval, “He fought so hard.” And they are inclined to think, about a suicide, that no fight was involved, that somebody simply gave up. This is quite wrong. Sally Brampton, Shoot the Damn Dog: A Memoir Of Depression

It’s so hard to talk when you want to kill yourself. That’s above and beyond everything else, and it’s not a mental complaint-it’s a physical thing, like it’s physically hard to open your mouth and make the words come out. They don’t come out smooth and in conjunction with your brain the way normal people’s words do; they come out in chunks as if from a crushed-ice dispenser; you stumble on them as they gather behind your lower lip. So you just keep quiet.” Ned Vizzini, It’s Kind of a Funny Story

A loss of focus can be the most debilitating of depressive symptoms, rendering a person unable to work effectively or plan for the future, which seems desolate, devoid of the possibility of redemption. John Nelson, M.D.

The depressed person is constantly chewing on himself. He needs to find something else to chew on. The form of diversion is not important, but the act of diversion is. Penelope Russianoff, When Am I Going to Be Happy?

Depression is not only an experience in the mind; it is also an affliction of the body. There is a lack of energy, a painful heaviness; sadness and a grief that permeate to our marrow. Philip Martin, The Zen Way through Depression

In an age of hope men looked up at the night sky and saw “the heavens.” In an age of hopelessness they call it simply “space”. Peter Kreeft

The opposite of depression is not happiness, but vitality – the ability to experience a full range of emotions, including happiness, excitement, sadness, and grief. Depression is not an emotion itself; it’s the loss of feelings, a big heavy blanket that insulates you from the world yet hurts at the same time. It’s not sadness or grief, it’s an illness. Richard O’Connor, Ph.D., Undoing Depression

Depression can be set off by a variety of stressors: sexual abuse, housing problems, illness in one’s child, and the other common problems you might imagine. To suggest that depression arises from loss is to skew the argument in the direction of the metaphor . . . , the one that likens apparent depression to ordinary bereavement. Likewise, “sadness” does not capture the essence of depression, which is a marked disruption of brain and mind characterized by painful apathy. Not only in degree but also in quality, sadness and depression are different. Peter Kramer, M.D., Against Depression

One of the features of depression is pessimistic thinking. The negative thinking is actually the depression speaking. It’s what depression sounds like. Depression in fact manifests in negative thinking before it creates negative affect. Most depressed people are not aware that the despair and hopelessness they feel are flowing from their negative thoughts. Thoughts are mistakenly seen as privileged, occupying a rarefied territory, immune to being affected by mood and feelings, and therefore representing some immutable truth. Hara Estroff Marano

I am now the most miserable man living. If what I feel were felt by the whole human race, there would not be one cheerful face left on earth. Abraham Lincoln

My hunch is that the disease/defect model of depression, is unwittingly contributing to the ongoing stigma of depression. Through the lens of the disease model, the legions of the formerly depressed are a “broken” people who need lifelong assistance. I would like to see a more revolutionary public education approach, with campaigns that emphasize the unique strengths that are required to endure depression. Even if a person is helped by drugs or therapy, grappling with a severe depression requires enormous courage. In many ways, a person who has emerged from the grip of depression has just passed the most severe of trials in the human experience. If we acknowledge that surviving depression requires a special toughness, we will not see formerly depressed people as a broken legion, but as a resource who can teach us all something about overcoming adversity. Jonathan Rottenberg, Ph.D.

Where’s the big national foundation leading the battle against depression? Where is the Jerry Lewis Telethon and the Annual Run for Depression? Little black ribbons for everyone to wear? The obvious answer is the stigma associated with the disease. Too much of the public still views depression as a weakness or character flaw, and thinks we should pull ourselves up by our bootstraps. And all the hype about new antidepressant medications has only made things worse by suggesting that recovery is simply a matter of taking a pill. Too many people with depression take the same attitude; we are ashamed of and embarrassed by having depression. This is the cruelest part of the disease: we blame ourselves for being weak or lacking character instead of accepting that we have an illness, instead of realizing that our self-blame is a symptom of the disease. And feeling that way, we don’t step forward and challenge unthinking people who reinforce those negative stereotypes. So we stay hidden away, feeling miserable and yourselves for ourselves for our own misery. Richard O’Connor, Ph.D., Undoing Depression

Depression is not a disease, the end point of a pathological process. It is a sign that our lives are out of balance, that we’re stuck. It’s a wake-up call and the start of a journey that can help us become whole and happy, a journey that can change and transform our lives. Healing depression and overcoming unhappiness mean dealing more effectively with stress; recovering physical and psychological balance; reclaiming parts of ourselves that we’ve ignored or suppressed: and appreciating the wholeness that has somehow slipped away from us, or that we have never really known. James Gordon, M.D., Unstuck

Scientists know that traumatic experiences such as child abuse and neglect change the chemistry and even the structure of the brain. They sensitize the stress response system so that those who are abused become overly responsive to environmental pressures. They shape wiring patterns in the brain and reset the sensitivity level of the machinery. Eventually, even small degrees of stress provoke an outpouring of stress hormones, and these hormones in turn act directly on multiple sites to produce the behavioral symptoms of depression. They push the brain’s fear center into overdrive, churning out negative emotions that steer the depression’s severity and add a twist of anxiety. Ellen McGrath, Ph.D.

Depression can be seen as a break-down in the service of offering the person an opportunity for a break-through. In this way, depression can be a corrective feedback to a life with little reflection. We only reflect on those things that break down in life. For example, if life is going along smoothly you won’t spend time thinking about the meaning of life. We tend to think deeply about life when something is not working. When we identify a problem, we begin to reflect on what caused the problem and how to fix the problem. If you are disconnected from your deepest feelings and impulses you may still manage to get through life without realizing it. Lara Honos-Webb, Listening to Depression

The opposite of depression is not happiness, but vitality – the ability to experience a full range of emotions, including happiness, excitement, sadness, and grief. Depression is not an emotion itself; it’s the loss of feelings, a big heaving blanket that insulates you from the world yet hurts at the same time. It’s not sadness or grief, it’s an illness. Richard O’Connor, Ph.D., Undoing Depression

When we ruminate, we become fruitlessly preoccupied with the fact that we are unhappy and with the causes, meanings, and consequences of our unhappiness. Research has repeatedly shown that if we have tended to react to our sadness or depressed moods in these ways in the past, then we are likely to find the same strategy volunteering to ‘help’ again and again when our moods start to slide. And it will have the same effect: we’ll get stuck in the very mood from which we are trying to escape. As a consequence, we are at even higher risk of experiencing repeated bouts of unhappiness. Mark Williams, The Mindful Way through Depression

Perhaps all the dragons of our lives we fear are princes and princesses who are only waiting to see us once beautiful and brave. Perhaps everything terrible is in its deepest being something helpless that wants us to help. Rainer Maria Rilke

We only reflect on those things that break down in our life. For example, if life is going along smoothly you won’t spend time thinking about the meaning of your life. We tend to think deeply about life when something is not working. When we identify a problem, we begin to reflect on what caused the problem and how to fix the problem. If you are disconnected from your deepest feelings and impulses you may still manage to get through life without realizing it.But if you begin to open to the possibility that there was something fundamentally wrong with your level of functioning before your depression, only then does the idea of depression as a gift begin to make sense. A breakdown can become a gift when it is in the service of increasing reflection on your life which will lead you to ask the fundamentally important questions: What is wrong with my life? What can I do to correct the problem? When you listen to your depression, you can heal your life. Lara Honos-Webb, Ph.D., Listening to Depression

Depression has a mind of its own. When you are depressed, you think in generalizations (nothing works out), you don’t give yourself credit (I can’t do anything right), and you label yourself in the most negative terms (loser, ashamed, humiliated). You set demanding standards that you will never live up to. You may think you need to get everyone’s approval, or excel at everything you do, or know for sure something will work out before you try it. Your thinking keeps you trapped in self-criticism, indecisiveness, and inertia. Robert Leahy, Ph.D., How to Beat the Blues

Depression is the inability to construct a future. Rollo May, Ph.D.

Every time a person gets depressed, the connections in the brain between mood, thoughts, the body, and behavior get stronger, making it easier for depression to be triggered again. At the earliest stages in which mood starts spiraling downward, it is not the mood that does the damage, but how we react to it. Mark Williams, The Mindful Way through Depression

The Failure of Will theory is popular with people who are not depressed. Get out and take your mind off yourself, they say. You’re too self-absorbed. This is just the stupidest thing you can say to a depressed person, and it is said every day to depressed people all over this country. And if it isn’t that, it’s, ‘Shut up and take your Prozac.’ These attitudes are contradictory. Conquer Your Depression and Everything Can Be Fixed by the Miracle of Science presuppose opposite explanations of the problem. One blames character, the other neurotransmitters. They are often thrown at the sufferer in sequence: ‘Get out and do something, and if that doesn’t work, take pills.’ Sometimes they’re used simultaneously: ‘You won’t take those pills because you don’t WANT to do anything about your depression, i.e. Failure of Will. Susanna Kaysen, Unholy Ghosts: Writers on Depression

Perhaps, the answer is that my ravaged mind rails against the idea of God, but something deeper in me calls out as if God might answer. ‘There are not foxholes,’ I guess, and depression is the deepest and deadliest foxhole I’ve been in. It may be the ‘dark night of the soul’ that the mystics talk about but in depression it is not so much that one becomes lost in the dark as one becomes the dark. Parker Palmer

Depression can seem worse than terminal cancer, because most cancer patients feel loved and they have hope and self-esteem. David D. Burns, Ph.D.

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

One description of depression is that it is like the shapeless sagging of a rubber band that has been kept too taunt for too long. When feelings have been strong, stressed, unprocessed, or held captive over a period of time, we just stop feeling altogether. Persons and events no longer have the power to enliven us; we operate on a low level cruise control. Usually we keep functioning, but there is no positive or creative affect toward persons and things, and even less toward ourselves. We basically stop living our only life. Ron Rohr

All of us feel shamed by life. All of us consider ourselves failures of some kind, screw ups in something really important to us. Notice how shame, consciously or unconsciously pulls us away from risk, ratifies our negative sense of worth through self-sabotage or compels us into frenetic efforts of overcompensation or yearning for the validation from others that never comes; how much each of us needs to remember one definition of grace as accepting the fact that we are accepted despite the fact that we are unacceptable James Hollis, Ph.D., What Matters Most

Everyone knows 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 clinical depression, but the difference is like the difference between the sniffles and pneumonia. Richard O’Connor, Ph.D., Undoing Depression

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 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 merely a troubled person to someone who has mental illness. Daniel Karp, Speaking of Sadness

Mysteriously and in ways that are totally remote from natural experience, the grey drizzle of horror induced by depression takes on the quality of physical pain. William Styron, Darkness Visible

Is It Lawyer Unhappiness or Depression?

Since you get more joy out of giving to others, you should put a good deal of thought into the happiness that you are able to give – Eleanor Roosevelt

There’s a Difference

Is there a difference between discontent and depression, a lack of fulfillment and true melancholia?

The lines between murky malaise and downright clinical depression are blurred in everyday conversation, the popular media and discourse amongst professionals and academics about what troubles the legal profession. Two journal articles – which, by the way, I enjoyed immensely, “Stemming the Tide of Law School Depression: What Law Schools Need to Learn from the Science of Positive Psychology” and “On Being a Happy, Healthy, and Ethical Member of an Unhappy, Unhealthy, and Unethical Profession” took this approach by canvasing studies that have been done on law student and lawyer unhappiness, discontent, stress, anxiety, depression and wellness.

But unhappiness is not depression, not even close. I am not saying that this was the authors’ intentions, or for that matter, even their suggestion. Nor I am saying that these issues aren’t related to one another. Yet, I don’t think this lumping-of-the-maladies approach is particularly productive because it plays into the popular myths that depression is just an amplification of everyday sadness or, worse, a banal self-absorption with all that’s wrong in one’s life. Remarkably, a recent poll showed that 45% of Americans think of depression as a failure of will.

Another problem with the lumping together approach is that sadness and depression call for radically different solutions. In the two journal articles cited above, the first concentrates on positive psychology and how it can help alleviate distress and the later on living an ethical life and picking the right job — no doubt important considerations for everyone. Yet I’m not sure that any of these approaches is a panacea to the epidemic of depression in the law.

To me, unhappiness and discontent are part of the human predicament. It’s unavoidable that all of us will go through epochs in our lives when things unequivocally stink; we mope and wonder why meteorites always seem to pelt us when our car battery’s dead, our kids are in an uproar and the day at the office was survivable at best. In the book Zorba the Greek, the larger than life Zorba was asked if he was married and replied with great gusto, “Me? Wife, kids, job — the full catastrophe!!”

But depression isn’t part of the human condition. It’s a multifaceted illness, for some disabling and for many cruel. For many of its victims, the pain isn’t so much a feeling of sadness, but of nothingness. There’s no air to breath, little room to escape this type of pain – until one, hopefully, gets treatment or it passes, mercifully, of its own inscrutable violation.

How can nothingness be painful? Perhaps, it’s because it’s emotions that give life its vibrancy. These visceral forces energize us, heighten the intensity of our lives and make the human experience so rich. The absence of this life force leaves us impoverished, longing and mourning for that richness in our being we once knew.

Psychiatrist Kay Redfield Jamison, herself a depressive, captured this experience when she wrote:

“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.”

At least when the problem is one of discontent, we have our faculties (e.g. the ability to concentrate), are capable of making choices and bring focused energy to bear on changing matters in small or large ways. For someone in the throes of depression, the power to choose is diminished if not extinguished. Richard O’Connor, Ph.D., in his seminal book Undoing Depression, writes in his blog:

“Everyone knows 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 clinical depression, but the difference is like the difference between the sniffles and pneumonia.”

No, depression isn’t unhappiness. But discontent in one’s vocation is a real problem and often very painful. We feel like a jammed door that won’t let us open into a life that works on some fundamental level. We know something is wrong, sense that we’re stuck like in the traffic of our lives. Our happiness is trying to tell us something and we know it. Our emotional core senses we’ve been living a life out of sync with who we really are. And if we’re in the legal profession, we’re not alone in this experience – far, far from it.

Drifting Towards Unhappiness in the Law

There has been much debate about whether lawyers are really unhappy, to what degree, why that is so and what can be done about it. The Wall Street Journal interviewed Gretchen Rubin, a Yale Law School alumnus who clerked for Sandra Day O’Connor, about her book “The Happiness Project.” Here’s her take on why so many lawyers find themselves in funks:

“There’s [this] whole notion of ‘drift’ that I think a lot of people fall into with law school. They’d don’t decide, necessarily, to go to law school, but they drift into it, really for a lack of a better idea. And that’s one of the reasons so many lawyers are unhappy. They hear these lines that, on their face, seem to make sense: ‘It can’t hurt to take the LSAT.’ ‘I can always go to law school.’ ‘I can always change my mind later.’ That’s what happened to me. I drifted into it.”

Gretchen realized that she had never made any real choice about whether to go to law school, let alone join the legal profession. Yet, how many lawyers really chose their jobs? Most of us stumble around. There is a steep learning curve to life and there are few instruction manuals. It’s often through trial and error that most people find their way. The discovery that you’ve invested lots of time and money into a career that you later find was a bad fit is troubling indeed. Many aren’t willing or able to make the leap to change matters; hence, unhappiness and distress.

Perhaps the notion of happiness depends on how long you’ve been in the profession. Recently minted lawyers seem to expect something more from their jobs than their predecessors. The New York Times article The Falling Down Professions notes:

“Especially among young people, professional status is now inextricably linked to ideas of flexibility and creativity, concepts alien to seemingly everyone but art students even a generation ago. ‘There used to be this idea of having a separate work self and home self,’ notes Richard Florida, the author “The Rise of the Creative Class: And How it is Transforming Work, Leisure, Community and Everyday Life.” ‘Now they just want to be themselves. It’s almost as if they are interviewing places to see if they fit them.”

In a sense, it’s amazing that young lawyers are even taking into consideration flexibility and creativity; all the more so given the sour economy and the glut of law school graduates — currently about 150,000 per year. But an increasing number of young lawyers seem willing to seek a job fit that jives with their desire for not only a decent paycheck, but a decent life. Many middle-aged or older lawyers eventually get there, but often after a lot of struggle and pain. Some switch jobs to find a better fit (the litigator who starts a real estate practice) or others chuck the whole profession and start life anew in other fields.

In the new book “The Happy Lawyer: Making a Good Life in the Law,” the authors point out that six experiences that are critical to making a person satisfied with her life, including security, autonomy, authenticity, relatedness, competence, and self-esteem. Certainly, money can and should be part of the equation, but not to the exclusion of other intrinsic values.

There’s nothing new here, but don’t we all need to be reminded of this message over and over again? At the very least, it’s a counterweight to the popular and legal culture which puts way too much emphasis on money and deludes us into thinking that more of it will mean greater happiness.

According to psychology expert and lawyer Dan Bowling, “Common sense, though, would suggest that the happiest lawyers are those who feel they are really good at law practice, who deal with clients and can see results of their work, or who have a sense that they are involved in a greater cause. Another question about the research, he say, ‘and I think it’s a fair question is this one. ‘It’s the so-what question. It is: Whoever said law is supposed to be easy? Law is a career sacrifice for clients. . . . Who said we’re supposed to be happy?’ Bowling has an answer: ‘I think the law can be a jealous mistress, but I also think she can be kind, too,” he says.

A contrary view is offered in “Scholars Debate: Is Law a Picnic?” by Harvard Law Professor David B. Wilkins who reports that in a study of 4000 lawyers in the first decade of their careers: “. . . contrary to what many believe, there is ‘no evidence’ of ‘any pervasive unhappiness in the profession,’ he says – at least not among those who began practicing in 2000. In that group, nearly three-quarters reported being ‘satisfied’ or ‘very satisfied’ with their jobs.

Perhaps happiness is somewhat determined by the type of law we go into. In The Happy Lawyer, the authors note that those who work for government, in a small firm, or in a solo practice, as well as those attorneys who work aligns with their values, are more likely to be satisfied with their careers.

In “On Being a Happy, Healthy, and Ethical Member of an Unhappy, Unhealthy, and Unethical Profession,” Patrick Schlitz writes:

“This is the best advice I can give you: Right now, while you are still in law school, make the commitment—not just in your head, but in your heart—that, although you are willing to work hard and you would like to make a comfortable living, you are not going to let money dominate your life to the exclusion of all else. And don’t just structure your life around this negative; embrace a positive. Believe in something—care about something—so that when the culture of greed presses in on you from all sides, there will be something inside of you pushing back. Make the decision now that you will be the one who defines success for you—not your classmates, not big law firms, not clients of big law firms, not the National Law Journal. You will be a happier, healthier, and more ethical attorney as a result.”

We each have to take our own journey in life to find out what makes us happy. Just don’t get stuck in negative rumination about what’s wrong in your life. Think about what could be “right” in your life. Believe, at the very least, in the possibilities and follow your passion. Make no mistake about it, there will be a cost. If one follows one’s passion there may be risk, the displeasure of our peers and family members and financial concerns. But if one doesn’t take this journey, if money carries too much weight in what we’re willing to do to make a living, we will be unhappy; if this situation goes on to long, maybe depressed.

Rear-ended by Depression

The abject pain of clinical depression is magnified expontentially when one considers that sufferers usually blame themselves for their plight. “What’s wrong with me?” is a common refrain. Most people with depression feel “bad” to their core. They can’t always articulate why this is so, but they know that they can’t shake their own self-condemnation. There is no place to hide from it, no true rest for the weariness it brings. We lay awake at night and hope that tomorrow it will be better.

I had a conversation last week with a mental health professional who asked me, “What in the world do lawyers have to be depressed about? They’re rich and powerful. Lawyers should stop complaining and realize how good they have it.” Yet a lack of gratefulness has little to do with depression. I used to recite a list of things I had to be grateful about – and there were many – but it all fell on depression’s deaf ears.

When others tell us to “snap out of it,” we may buy it hook, line and sinker and even believe that they know what they’re talking about. Well-meaning friends may try to reign in our sorrow by suggesting that they can identify with our suffering.

In her book about her own depression, An Unquiet Mind: A Memoir of Mood and Madness, psychiatrist, Kay Redfield Jamison writes:

“Others imply that they know what is 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.”

Such attempts by others, even when well intentioned, always brought about a deep sense of loneliness in me. I had, like most people, gone through my fair share of difficult experiences in life like losing a job. But this experience – this blast furnace of melancholy – was not that. We get over losses in our lives, we adapt. We can’t just “get over” depression.

There is a sense that we have been rear-ended by depression; out of seemingly nowhere, our lives are crashed into and changed forever. In a very real sense, we will never be the same. Some will recover from their depression, many will not. That’s not a very popular thing to say, but it’s been my experience from talking with hundreds of lawyers from around the country who I’ve been privileged to share with. For many, recovery will be an on-again off-again sort of affair. They will have to work hard to recover and make lots of effort to stay healthy.

Part of the reason why too many lawyers don’t get better is simple: most don’t get any form of treatment for their depression. A study by the National Institute of Mental Health revealed that as many as 80% of people in this country get no form of help whatsoever. Looking out a window, I wonder how high the rate is for lawyers. It’s most likely a mixed bag. While it’s true that people from a higher socio-economic class tend to get treatment – mostly because of their access to good medical care – most attorneys still don’t because of the stigma associated with mental illness.

Such shame – dumped on people from others and the self-inflicted variety – is particularly deep for lawyers. This is so because of the myths surrounding their internal world. Lawyers feel like they’re supposed to be veritable Supermen able to bend steal and solve all manner of a clients’ problems without wrinkling their power blue suit. If they’re in pain, they’re told to “suck it up.” We live in a nation of winners where, deep down, many feel like losers.

This sort of mentality, in part, explains the epidemic rates of depression in the law. Studies have concluded that lawyers suffer from depression at a rate of twice the national average or about 20%. This means that 200,000 out of the one million lawyers in this country suffer from depression.

What’s a depressed lawyer to do? First, one must stop blaming oneself. This is tough because most people with depression have been living with this cognitive distortion for a long time – maybe their whole lives – and this corrosive self-talk promotes the viscous cycle that is clinical depression. If one can’t stop blaming oneself for having depression, it’s tough to get better. Little by little, we need to learn to let that bullshit go and start walking a healthier path.

The poem, The Journey, by Mary Oliver, captures some sense of this path for me. I hope it will for you.

One day you finally knew

what you had to do, and began,

though the voices around you

kept shouting

their bad advice – –

though the whole house

began to tremble

and you felt the old tug

at your ankles.

“Mend my life!”

each voice cried.

But you didn’t stop.

You knew what you had to do,

though the wind pried

with its stiff fingers

at the very foundations,

though their melancholy

was terrible.

It was already late

enough, and a wild night,

and the road full of fallen

branches and stones.

But little by little,

as you left their voices behind,

the stars began to burn

through the sheets of clouds,

and there was a new voice

which you slowly

recognized as your own,

that kept you company

as you strode deeper and deeper

into the world,

determined to do

the only thing you could do – –

determined to save

the only life you could save.

Suicide: The Death of a Law Student

David.Nee.Photo.Friends

I am Chair of the Committee to Assist Lawyers With Depression in Erie County. Our committee is producing a documentary about depression in the legal profession. It will be made available to Bar Associations, legal organizations and law schools around the country later this fall. As part of this project, I headed off to New York City last week to interview some remarkable people. One of them was Andrew Sparkler.

Andrew is a lawyer in Manhattan who graduated from Fordham Law School four years ago. During his first year, he met a remarkable young man named David Nee. David is shown in the photograph above sitting between two of his law school friends.

David went to one of the finest preparatory schools in the country, Princeton University and then to Fordham. In my interview, Andrew told me that David was happy-go-lucky, the life of the party and always sought to make others feel comfortable. He was brilliant, often not having to study for exams and still getting good, if not great, grades. Something, however, changed during his Third Year of law school – at least in his friends eyes. David would disappear for weeks on end. When friends called him, he didn’t phone back. When he finally showed up, he always had some sort of plausible excuse.

Shortly after law school graduation, while studying for the Bar exam, David Nee died by suicide. In a note which he left, he said that he had been struggling with depression since he was fourteen years old. This poor soul, I thought. On the outside, he seemed so happy and carefree; on the inside, stuck in the dark world of depression.

Andrew Sparkler, his friends and family were devastated by David’s death. Why didn’t they know he was depressed? They decided to remember David by forming the David Dawes Nee II Foundation, a not for profit created to educate law students about depression and suicide. What a noble effort that deserves our praise and support.

Dave (not his real name) is in his late fifties and had battled depression most of his life. One day, he was driving his usual route to work. As the car sped by him, all he could feel was the pain of his existence. He suddenly got off the Niagara Falls exit. Once there, he parked his car. He got out, took off his shoes, socks and watch. He was methodical. He was a good lawyer after all. He thought of his wife and what his death would do to her. He called his best friend who got him into a psychiatrist that afternoon where he was immediately put on antidepressants and went into counseling.

In her best-selling book, Night Falls Fast: Understanding Suicide, psychologist, Kay Redfield Jamison states:

“Suicide is a particularly awful way to die: the mental suffering leading up to it is usually prolonged, intense, and unpalliated. There is no morphine equivalent to ease the acute pain, and death not uncommonly is violent and grisly.”

Jamison, who also suffers from depression, notes that there is a suicide every 17 minutes in this country. Identifying suicide as an often preventable medial and social problem, Jamison focus attention on those under 40 (suicides by those who are older often have different motivations or causes according to her book). Citing research that suicide is most common in individuals with mental illness (diagnosed or not), particularly depression, she clearly describes the role of hormones and neurotransmitters as well as potential therapies. Click here to hear an interview with Dr. Jamison on the Charlie Rose show.

Given that lawyers suffer from depression at a rate twice that of the national average and that the number one cause of death of middle aged lawyers is suicide, I believe that the legal profession must face this issue. It isn’t as if lawyer suicide is a sometime sort of thing. It happens a lot. Even one is too many.

The point here is not to be depressing by addressing suicide. The point is to speak up about just how dangerous depression is. It just isn’t just a mental illness; it’s also a killer.

A recent news article reported that 27 million American are on antidepressants – a staggering figure. Given the strong connection between depression and suicide, how can we avoid a frank discussion on this topic?

For more information, support and resources, check out the American Association of Suicidology.

I welcome everyone’s comments on this important topic.