Undoing Depression in Lawyers

There’s some interesting research to suggest that happy people view the world through certain comforting illusions, while depressed people see things more realistically. [i] For instance, the illusion of control. You can take a random sample of people and sit them in front of a video monitor with a joy stick, and tell them their joy stick is controlling the action of the game on the screen. (But the point of experiment is that it actually doesn’t). Depressed people will soon turn to the lab assistant and complain that their joy stick isn’t hooked up correctly. Normal people, on the other hand, will go on happily playing the game for quite some time.

I think this explains a lot about why lawyers are so prone to depression. Because of their experience with the law, most attorneys have lost their rose-colored glasses some time ago. (Or else they never had them and chose the law as a career because it suited their personality). Attorneys know that life is hard, and doesn’t play fair. They’re trained to look for every conceivable thing that could go wrong in any scenario, and they rarely are able to leave that attitude at the office.  They see the worst in people (sometimes they see the best, but that’s rare). They tend to be strivers and individualists, not wanting to rely on others for support. They have high expectations of success, but they often find that when they’ve attained success, they have no one to play with, and have forgotten how to enjoy themselves anyway.

All this makes it hard for attorneys to get help with their depression. They tend not to recognize it as such; they just think it’s stress, or burn out, or life. They don’t expect that anyone is going to be able to help. Most of my attorney-patients have contacted me because their relationships are falling apart, but they don’t see that it’s depression that makes them such a lousy partner – tense, irritable, critical, joyless, tired all of the time, relying on alcohol or other drugs. If they’d gotten help for the depression a couple of years previously, their spouse wouldn’t be moving out now. The truth about depression is that it not only makes you feel horrible, it wrecks your life. And that’s why I wrote the book, Undoing Depression, in the first place. I was running an outpatient clinic, and grew exasperated with seeing the people whose lives wouldn’t have been so ruined if they had got some help when they first needed it –  before they alienated their children and spouse, got fired, went into debt, developed a substance abuse problem, etc. I thought there was a need for an intelligent self-help book, one that points out all the bad habits that depression engenders and which, in a vicious circle, keeps reenforcing the disease. But the truth is that self-help isn’t nearly enough for most depression sufferers. It’s as if you stepped over an invisible cliff, and you can’t find your way back doing what you normally do, because that’s what led you over the cliff in the first place. Depression is the original mind/body disease; your physical brain is damaged because of the stress in your mind, and you’re unlikely to undo that damage without help.

Depression is highly treatable, but if you want a lasting recovery you have to change your life. The ugly fact is that depression is very likely to reoccur. If you had one episode of major depression, chances are 50:50 that you’ll have another; if you have three episodes, it’s 10:1 you’ll have more. But you can improve those odds if you get good professional help, with medication and with talk therapy. We won’t put your rose-colored glasses back on, but we can help you see how negative thinking and the negative acting is contributing to your disease.

[i]  See for example, Shelly Taylor: Positive Illusions; and Julie Noren: The Positive Power of Negative Thinking.

Richard O’Connor, Ph.D., is the author of two noteworthy books, Undoing Perpetual Stress: The Missing Connection Between Depression, Anxiety, and 21st Century Illness andUndoing Depression: What Therapy Doesn’t Teach You and Medication Can’t Give You. He is a practicing psychotherapist with offices in New York City and Canaan, Connecticut.  He has suffered from clinical depression and is a member of a depression support group.

 

Lawyers, Don’t Let Perfectionism Ruin Your Health

Duke University Law grad, Jennifer Alvey explores why lawyers have such poor mental and physical health: “Part of the answer lies in lawyers’ predisposition toward perfectionism. I often encounter lawyers who can only envision doing something if they can be all in. Doing something less-than-perfectly is seen as failure. When it comes to exercise and diet, this kind of thinking can set anyone up for failure because they will try to make big, grand changes at once, be unable to sustain them, and quickly quit in disgust.”  Read the rest of her Blog

Preventing Depression Among Lawyers

Kevin O’Keefe, CEO and founder of LexBlog, writes, “Having personally experienced the lows of depression and the positive energy that comes from blogging and social media, I have to believe the effective use of social media could prevent depression for many lawyers.”  Read his Blog

One Woman Lawyer’s Journey Through Depression

Acknowledging my depression for the first time during my third year of law school was as terrifying a realization as it was liberating.  Between finishing up final classes, getting ready for the bar exam, and preparing for the first semester of my LL.M degree program, I fought every day to simply get out of my own way, and I fought even harder to hide it.  I would wake up in the morning in tears, yet by the afternoon I was at school, going through the motions, and relieved to just make it to the end of the day.

This contradiction of being in law school and living with depression was an unbearable secret.  At my core, I was beyond ashamed and embarrassed. I would beat myself up over and over again with the same though: how did I mange get myself to law school only to end up feeling this way?  I was so lost, and I was experiencing a pain that was as indescribable and unfamiliar as it was pervasive and present.   I convinced myself this that feeling this way was the price I had to pay to become a lawyer, to live up to this expectation I had created about myself.  So just get through it, I told myself.   This is the way it’s to be done.  Suck it up.  Survive.

In the months to come, however, my depression worsened.  Despite having passed the bar exam, started course work toward my LL.M degree, and a relationship with a man who said he cared for me, I crashed.  I spent entire days in bed, with no one to the wiser.  I stopped answering my phone and emails, and I wasn’t going to classes.  Getting out of bed felt like stepping off the edge of a cliff.  Life having any sense of forward momentum and progress was something that seemed to happening for other people, and I was left struggling, trying to figure out how to keep up.

Something inside me managed to articulate clearly and loudly that something was wrong with me that went beyond telling myself to suck it up.  One morning, moved by forces that to this day are still a mystery to me, I found my way to the university’s student counseling services.  A social worker took me in a back room for an intake interview.  Directly and clearly, I was honest for the first time about what was happening to me.  The next thing I knew I had a calendar filled with multiple weekly appointments with a psychiatrist who immediately put me on an anti-depressant and talk therapy.

Believe me when I say that those talk therapy sessions in the student counseling center changed my life.  My therapist saw through me with kindness and compassion in a way I didn’t think was possible for another person to do, and she understood the how and why of what was happening to me.  She helped me put words to emotions and thoughts that existed only in my head.  I learned that I could say I was dealing with depression, and that with work it was something I could learn to manage.

But my therapist also told me this was only the beginning for me with understanding and successfully managing my depression.  She said we had only scratched the surface. Her words were profound and prescient.  As my experience with law evolved from getting through the competitive and pressure filled environment of  law school to the demands of practice, so did my experience with depression and its affect on my ability to know and to listen to love myself.  For a while, I felt good, and depression felt like memory.  I found I was more comfortable with and better at being a working lawyer than I was a law student.  Practice requires you to touch more upon your true nature more, I think, than law school.  There was less posturing and more action, and I am more suited for that reality.  I still, however, had a lot to learn about asserting myself and holding my own in intense environments.   As the red flags of my depressive behaviors and thoughts would pop up, I realized that no matter what anti-depressant I was on, or what words of wisdom I tried desperately to recall from a therapy session, I was still out of sync with myself emotionally and my surroundings.  This was a powerful insight, but I still could not in the moment handle the stresses I experienced on a daily basis successfully or in a way that felt true to myself.  Sexism, cutthroat competitive colleagues, long hours, bitter partners who saw heaping insult upon you as affective training and as lawyerly karmic right.  The romantic ideal of the practice of law as noble and worthwhile was elusive and false.  The reality was all too much.

Even as I become more successful in advancing my career, obtaining a Federal clerkship and a Big Law job, my depression didn’t dissipate and disappear, as I had naively hoped it would (because as all lawyers know, the right job and status fix things, right?).  Instead, its presence became more insidious, because when I felt it, I immediately knew it meant that something was dreadfully wrong, and the fear of where it could take me became all-consuming.  The energy it took for me to hold my own with colleagues and clients and still at the end of the day deliver good work took over, and any healthy sense of self-care I had learned when I first acknowledged depression in my life was pushed aside.  I now felt like a failure at the most fundamental level because I couldn’t control my depression.  Even as my experiences with depressive tendencies became more insightful and clearer to me in their meaning, I was still at a loss as to what to do, and I brutally beat myself up for not being able to fix it.

After completion of a project I was on in 2009, I left my job, and I left life as a working lawyer.  And again, I crashed.  For a time, I swung too far in the other direction, internalizing depression to the point where it became my identity.  I didn’t know where depression ended and my sense of self began, and concluded that the entirety of my life would be determined by its presence.  Therapy and medication again were options, but this time, I knew in my gut what I needed was beyond the relief they would provide.

Only with time and by stepping back from thinking of myself as both a lawyer and as someone with depression have I have learned that ultimately I am neither one of those things.  I have learned that when I fight and ignore my intuition is when I get into trouble.  That is what depression at its worst takes from me.  It takes away my voice.  When outside noise and pressure and people are too loud, and are in turn amplified in my mind by my depressive thinking, I, in the most glorious sense of the word, am gone.  The “I” whose evidence of worth is proved by mere existence; the “I” that only has to live and breathe to be worthy, is nothing to me.  All I can see is worry and striving and other people’s judgments, and my own judgments, and angst and pain.

I don’t know that I will work in law again, but I entertain the thought now and then.  This thought isn’t without a realistic notion of what it will take to get back into the profession, so, equally, I honor the thought that I may never find a fit for myself in law.  I’ve also accepted depression in my life as a siren meant to warn me I’m headed for trouble. This clarity isn’t without fear.  I’ve had hard times since I left my last job as a lawyer, but I can honestly say that what I’ve learned about myself and life since has so far been worth it all.

By Anonymous

 

Law Students, Depression & Suicide

In January 2014, CNN reported that lawyers are among the top five occupations associated with suicide. In the summer of 2014, just before the start of the law school academic year, a law professor from the University of Vermont died by suicide. Since then, in a period of eight months, the United States law school community has seen seven law student deaths from suicide. Approximately one suicide per month, and the actual number may be greater than what has been reported by the media and the law schools.

law classroom

In the painful days, weeks, and months after a suicide, family members and loved ones often are left with unanswered questions. Many times one of those questions or comments is some version of “I don’t understand why (s)/he did not just ask for help.”

A study published in the American Journal of Psychiatry, it was found that of people aged 35 and younger who died by suicide, only 15% had received mental health treatment within one month of their death by suicide and just 24% had received mental health treatment within one year of their suicide. The study also found that 23% of those who died by suicide who were under 35 visited a primary care doctor within one month of their death and 62% visited a primary care doctor within one year of their death.

While interpretation of statistics should be done with caution, the data suggests that young people at risk for suicide present more often to primary care physicians than mental health professionals. And while this perhaps speaks to the need to better train primary care physicians to recognize warning signs of suicide, it also begs the question just posed: why don’t people who are feeling suicidal reach out for help?

stressedstudents1

Based on feedback from law students who attended one of the Dave Nee Foundation’s Uncommon Counsel programs at 35 different schools in the 2013-2014 academic year, 64% agree or strongly agree with the statement that law students do not seek help when needed for fear of the professional consequences. One of our 2L attendees suggested: “…lobby the ABA and character and fitness people to recognize treatment for depression is a good thing, and that legal professionals are people too.” Another 1L attendee noted, “I think it is worthwhile to discuss the stigma associated with seeking mental health services, i.e. perception that s/he ‘can’t hack it’ is weak, thin-skinned, that you’re ‘unstable’ or ‘crazy’. Professional consequences of people knowing this about you, etc.”

While it is easy to point to the ABA and to other systems that may contribute to stigma, it is harder to see systemic change. It is easier to begin with individual change.  Here are some things that you can do beginning right now to help reduce the stigma associated with mental health treatment.

Talk non-judgmentally with anyone you are concerned about:

  • It is OK to ask someone if they need help.
  • It is OK to ask someone if they are thinking about suicide, it will NOT give them the idea.
  • It is NOT OK to say “You are not thinking about suicide are you?” or “What do you have to be depressed about?”
  • It is OK to say, “I have noticed some changes in your behavior, is everything OK?”
  • It is OK to say “It sounds like you are experiencing depression, often times people with depression have suicidal thoughts, are you thinking about suicide?”

Be mindful of language:

  • The term “died by suicide” is preferable to “committed suicide” as the term “commit” has negative connotations.
  • Avoid talking about suicide attempts as “successful or unsuccessful”; there are more suicide attempts in a year than completed suicides.
  • When describing individuals with a mental health diagnosis, try not to define them by that diagnosis. Put the person first, “s/he is a person with bipolar disorder” not “s/he’s bipolar.”

Promote mental health care services:

  • We are encouraged regularly to get a physical exam annually; we are regularly tested for blood pressure, glucose, and BMI.  Why not promote a mental health check up?
  • Visit Screening for Mental Health to find out how to bring an online screening service to your place of employment.

For more tips on how to help someone or for ways you can be involved in reducing stigma please visit the Dave Nee Foundation’s website.

Memories_Dave

June of 2015 will be the 10th anniversary of Dave Nee’s suicide. Dave was a beloved and brilliant brother, friend, son, and student. The suicide of Dave Nee prompted his loved ones, friends, and family to honor Dave’s life and prevent deaths like his from happening again by establishing the Dave Nee Foundation. Ten years later, there is much that the Foundation has done to promote wellness, raises awareness about depression & anxiety, and to prevent suicide in the legal field via law school and state bar association presentations. We know that 97% of our Uncommon Counsel attendees agree or strongly agree that the information learned will help them to recognize the symptoms of depression. We know that 95% of our Uncommon Counsel attendees agree or strongly agree that as a result of the presentation they can identify three warning signs of suicide. Perhaps most importantly, we know that 97% of Uncommon Counsel attendees agree or strongly agree that they know what steps to take if they felt a law student was at risk for suicide. (All data based on 2013-2014 Uncommon Counsel program feedback.)

As much progress and impact we hope we have had, until there are NO news stories of lawyer and law student suicides, we will not be satisfied. We hope that our passion and commitment might inspire other stakeholders, perhaps more powerful ones, like the ABA, the NCBE, law school administrators, and Big Law firms, to take steps towards creating cultural change and help us to destigmatize getting help and treatment for mental health concerns in the legal profession.

By Katherine Bender

Upon graduating from Georgetown University as an English and Theology major, Katherine Bender began teaching at an independent Catholic secondary school for girls in Philadelphia. During this time, she became increasingly interested in the social concerns of young women and decided to pursue a degree in community counseling with a focus on women’s issues at the University of Scranton. After completing an internship providing individual counseling to undergraduate students at a residential college, as part of her Master’s degree in counseling, she began working as a full time mental health counselor for college students in Daytona Beach, Florida.

Recognizing that advocating for students with mental health issues in higher education would likely require a Ph.D., Kate began her doctoral work at Old Dominion University in January of 2011, focused her dissertation on research regarding college student suicide prevention, and in the summer of 2013, successfully completed her doctoral program. She now has a PhD in Counseling, Counselor Education & Supervision.

She joined the team at the Dave Nee Foundation as Programming Consultant in September of 2012 and became Programming Director in September 2013. In this role, she leads the Uncommon Counsel program and LawLifeline. She sees her role with the Dave Nee Foundation as an excellent way to continue to provide outreach services and to raise awareness about depression, anxiety, and suicide prevention for higher education students.

You can reach Kate by email at Kbender@daveneefoundation.org

 

 

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