Can Creativity Cure Depression? An Interview With Dr. Carrie Barron

creativity cure book

Dr. Carrie Barron, a board-certified psychiatrist/psychoanalyst on the clinical faculty of the Columbia College of Physicians and Surgeons who also has a private practice in New York City.  She has published in peer-reviewed journals, won several academic awards, and presented original works related to creativity and self-expression at national meetings of the American Psychoanalytic Association. Along with her husband, Alton Barron, M.D., a hand and shoulder surgeon, she co-authored the book, The Creativity Cure: How to Build Happiness with Your Own Two Hands.

Dan:

Why is depression such a problem in our culture?

Carrie:

I think the level of stress has gone up enormously because we have so much to do and we’re on twenty-four hours a day. So I think because of technology, which offers us so many great things, but gives us much to do. I think that’s part of it. I also think, especially for children, we’re in a striving, ambitious, be productive all the time mentality – for children and adults. We need to play, we need to hangout, we need to have spontaneous time. I think spontaneous thought does a lot for alleviating depression and anxiety.

Your Brain on Depression: A Fascinating Interview with Neuroscientist, Dr. Alex Korb

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The following is an edited transcript of the podcast recorded interview with Dr. Alex Korb.  

Hi, I’m Dan Lukasik from lawyerswithdepression.com. Today’s guest is Dr. Alex Korb. Dr. Korb is a neuroscientist, writer, and coach.  He’s studied the brain for over fifteen years, attending Brown University as an undergraduate and earning his Ph.D. in neuroscience from UCLA. He has over a dozen peer-reviewed journal articles on depression and is also the author of the book, The Upward Spiral: Using Neuroscience to Reverse the Course of Depression One Small Change at a Time. Interesting, he’s also coached the UCLA Women’s Ultimate Frisbee team for twelve seasons and is a three-time winner for Ultimate Coach of the Year.  His expertise extends into leadership and motivation, stress and anxietymindfulness, physical fitness, and even standup comedy. Welcome to the show.

Do You Need To Take Medication For Your Depression?

Today’s guest post is by Dr. Eve Wood, a psychiatrist who treats patients struggling with depression, anxiety, burnout or extreme stress.

Do you find yourself wondering if you need to be on medications for depression, or hoping you can stop them? If so, you are not alone!

In 1980, Americans filled 30 million prescriptions for antidepressants, and in 2010, 30 years later, the number of prescriptions for antidepressants filled had risen to 264 million in a year!

What are we to make of this? Twenty eight percent of attorneys nationwide are struggling with depression! Why? And, what is to be done about it? In this short blog, I intend to highlight the relationship between stress, burnout, and “depression”, and the role of diagnosis, medical treatments, and other strategies. I encourage you to think broadly about what you can do to make your life better.

What is Depression?               

To be totally clear: We do not really know what depression is! We have a lot of theories, and can identify biological correlates, with some depressive symptoms. And, we do know that a small percentage of people suffer with an incapacitating illness that won’t quit. However, much of what is being called Depression today, is probably Burnout, or a normal response to abnormal stress!

While I am simplifying the diagnostic process a bit, I think you will appreciate the point. We diagnose Depression by establishing that you have a requisite number and type of symptoms, to meet the diagnostic criteria, as laid out in the DSM (Diagnostic and Statistical Manual). Over the course of the last 35 years, there have been 6 iterations of the DSM. As the book has gotten longer, and the number of diagnoses has progressively increased, the “illness” criteria has gotten too loose to be useful.

Before the printing of DSM III, the incidence of depression was quite low, prevalence rate of 1.2% in 1996. After the DSM III was released in 1980, a NIMH study found the prevalence of Depression had risen to 5%. After DSM III-R the prevalence rate had risen to 10 % of the adult population in the United States. And, the rate continues to rise.

In my 35 years in medicine, I have not seen the numbers of people with serious depression, true debilitating symptoms that no one could deny were life-threatening, change much. I have, however, seen a significant escalation in the numbers of people told they “have depression” and consequently get treated with medications.

Today, when you might be dealing burnout, exhaustion, disillusionment, or extreme worry, you are given a clinical diagnosis or two, and prescriptions. This strategy stops you from looking at the precipitants to your distress, and proactively identifying solutions. It also exposes you to “side-effects” or unnecessary risks.

But, Isn’t my Depression due to a Chemical Imbalance in my Brain?

Chances are pretty good you’ve been told that your depression is due to a chemical imbalance in your brain, and medications correct that abnormality. The problem is, all attempts to prove that theory have totally failed.

The fallacy is reinforced by the names given to psychiatric medications. For instance, the term SSRI (selective serotonin reuptake inhibitor) was chosen to imply that the medication inhibits the uptake of a neurotransmitter and thus creates benefit. It originated when the pharmaceutical company SmithKline Beecham, was trying to distinguish its medication Paxil, from its competitor Prozac.

“SSRI” came out of their marketing department and was used to market a new “class” of drug, even though all antidepressants (new and old) have some impact on serotonin. And, we have no idea how significant that impact is! The term SSRI gives rise to cool pictures of neurons and chemicals which can be used to sell drugs.

Do Antidepressants Work?

Clinical trials of antidepressants show that only 1/3 of patients get better in 8 weeks. The other 2/3 respond in part or not at all! And, within 3 years, 75% of the responders have quit treatment, likely due to side effects, cost or diminishing efficacy.

In many studies of antidepressant effectiveness, drugs perform no better than placebo. And, several studies have found that the biggest predictor of response is you believe meds will help, and vice versa!

So, do pills work? At times, yes, and they even save lives. But, they don’t help most people consistently. And, other interventions might be just as good, or better tolerated. Examples with clear anti-depressant efficacy include improved work-life balance, therapy, specific breathing practices, yoga, mindfulness, light exposure, meditation, nutritional interventions, cognitive restructuring techniques, spiritual practice, time in nature and exercise.

What Should You About Medication?

You are probably wondering whether you should be on medicine. The answer is unique to you and your history. That said, here is what I have seen in 35 years of work with attorneys. Many of you are experiencing normal responses to extreme stress. While you have tremendous power to self-heal, rebound, and thrive when episodically stressed, you become depleted, and burned out when the pressures on you are continuous.

The symptoms of burnout; emotional exhaustion, interpersonal disengagement, and a low sense of meaningfulness and accomplishment are very similar to those of depression. And, interventions for burnout, often transform depression symptoms. Most of my clients stop, or massively reduce their medication need, as they tackle burnout, build resilience, decrease stress, and improve their lives.

In choosing your next steps, consider when you last felt well, and your attendant life circumstances. What was working, or gave you joy? Have medicines saved your life, or are you taking pills because you can’t seem to make your life work? Do you need training on techniques and tools to promote well-being, and minimize your need for medications?

If your life is not as you wish, you can change it! You are a gifted, capable person, as evidenced by how far you have come. You can learn evidence-based solutions, to transform what doesn’t work!

Dr. Eve A. Wood helps lawyers and judges dealing with depression, anxiety, burnout and extreme stress learn to transform their lives for well-being, joy and professional fulfillment. She offers practical, science-based programs and coaching that promote whole person healing, decrease stress and depletion, transform anxiety/depression and reduce reliance on medication.

 

 

 

 

 

Big Law Tackles Mental Health Crisis Issues With On-Site Programs; Is Its Business Model at Fault?

The ABA Journal report that Big firms have long been reticent to openly address addiction and other mental-health problems, despite research showing lawyers face higher rates of substance abuse, depression, and suicide than the wider population,” the article says. “Law firm leaders say the need to keep up appearances in a competitive industry has contributed to the resistance. That attitude, however, is slowly changing. Read the article.

A Trial Attorney’s Dirty Little Secret: Depression

Once upon a time, I was a trial attorney at a personal injury defense firm. I was good at it.  I always pushed hard; always did the best job possible.  I won a good share of cases, and, of course, lost a few as well.  I was valued highly enough to be made a partner shortly after joining the firm.

But I had a dirty little secret.  I had bipolar disorder, which was well-controlled through a close partnership with a good psychiatrist.  Still, in my mind, if word ever got out, my employers would see me as weak, a liability.  To a degree, I understood.  If the insurance companies that paid the bills learned that one of the firm’s trial attorneys had such a condition, their mandate would be clear: if you want our business, get rid of him. That is what I assumed.

Throughout my career, colleagues would make offhanded remarks about someone “not taking his medication.” I would grit my teeth and ignore it.

Instead, I was able to construct an alter-ego, the “happy warrior.”  I had a smile on my face and a sardonic remark ready on cue. But I went about my daily business feeling like a secret agent in a Cold War spy movie.  If my cover was ever blown, I was certain that my career would be at an end.

Over time, maintaining this secret identity while dealing with the usual strains of trial practice gave rise to a growing depression.  Yet I still performed at a high level and still got results.

Although I had a close friend at the firm, another partner, he would deflect when I tried to talk to him about my depression, so I stopped.  I began to worry that others at the firm might know about me.

Fear and the sense of isolation only fed upon themselves in a continuous cycle.  I finally experienced a severe episode of depression that led to a period of disability.  When I told my boss what was going on, he expressed genuine surprise that I was suffering from depression at all.

When I returned to work, I felt better, but I remained wary.  Instead of engaging in a conversation about what had happened, we all acted as though nothing had occurred.  The computer was rebooted, and business continued on as usual.  I went back undercover, and no one seemed to mind.

Simply due to scheduling conflicts and adjournments, it was some time before I tried another case.  I admit that I was a little nervous, but I was having no trouble handling my case load.  I was puzzled when my boss came into my office one afternoon as I was preparing for the trial.  He asked me if I felt good to go.  He had never done that before.  I said, “yes,” because I felt perfectly up to the task.  I never asked myself, “If he is worried about my performance, why is he even letting me try the case?”

At trial, the insurance company sent an adjuster to audit the proceedings, a routine procedure.  I knew him well, and he had an excellent grasp of the case, even though he had not been involved before trial.  We had constant discussions about what was going on, and we seemed to be in sync.  Suddenly, the insurance company pulled my old friend off the case and replaced him with a mid-level manager who consistently praised my performance.

The case went to verdict, and the jury awarded somewhat less than what the insurance company had offered settle for.  To preclude the possibility of an appeal, the insurance company threw in a few more dollars.  Case closed, on to the next one.  To me, that was a pretty good result.

Was I in for a big surprise.

Shortly after the trial, year-end reviews were scheduled.  I was getting ready for another trial, and I was very excited about it, so I wasn’t really paying attention to what was going on in the office.  Other attorneys were getting their reviews – important because raises would be discussed – but I was never called in.

Ultimately, my case settled after much hard work on all sides, and the usual time for reviews was long past.  I did start to worry then.  I even made a remark to my secretary about it.

The call finally came.  When I stepped into the conference room and saw every equity partner in the firm waiting for me, I knew.  The spy had been caught, but what would happen?

My boss said that they waited to speak with me because they did not want to put pressure on me while I was preparing for another trial.  He asked me if I felt capable of trying cases.  I paused, and then broke under the years of strain.  I wept, and answered, “No.”  Whether that “No” was true then or true now or was ever true, it was the most humiliating moment of a 20-year career.

My boss started to dissect my prior trial, telling me that the insurance company’s representative was reporting that I was doing a bad job.  He even told me that the supervisor at the insurance company knew that I had depression.  After the expected awkward silence, another partner suggested that “we find a creative solution” to keep me at the firm.  I made some suggestions over the next few months.  No replies were forthcoming.  I was quietly being swept out the door.  It wasn’t hard to get the message. I found another job, and moved on.

The whole experience seemed to confirm everything I feared about being a lawyer with depression.  Currently, I am not practicing, and am seeking other opportunities.

But if the story ends there, what is the point?  Can I offer my account as a teaching opportunity?  At the very heart of the tale lies the sad truth that we, as lawyers, trained to be superlative communicators, can utterly fail to make each other understood when it comes to depression.  Should I have been more candid about my condition?  My employers never told me what concerns they had or what they knew.  Could all of us have been proactive for our mutual benefit, especially after I returned to work?  I believe that there had been an opportunity to open a constructive dialogue, but my fear told me to keep my mouth shut.  I cannot speak for my former employers, although I highly doubt that they held any malice.  I doubt that they thought much about it at all, until some critical pressure was brought to bear, whether from within or outside of the firm.  Unfortunately, by the time everyone was talking, my job at a firm I loved was gone.

I miss working there.  I still have close friends there.  I see them when I can, which is not often enough.  Just recently, I ran into my secretary, and we briefly chatted about my plans for the future.  And then she said something that cut me to the quick: “You were a good lawyer.”

— Anonymous Guest Blog

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