Emotion Rules When There is Depression

Stuck in a negative network, changing thoughts or actions is just plain hard.

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“I cannot do what you suggest – I know it won’t work.”

That was Jon’s mantra as he sat in my office and said that he can never be happy. The one thing he wants – a wife and family – will never happen because fate has determined he is not going to achieve that goal. Yet most opportunities he gets to meet someone new, he believes will not work.

Why is he resisting meeting new people when someday one might be interested in him? His inability to move from one idea to another to create a change in thinking or in attitude is typical for depression. And, as in Jon’s case, it seems like it’s intentional. Or at least that’s what family and friends see when they tell their depressed loved ones to “Just do it!” It is easy to judge from the outside, but it is hard to see on the inside of a person with depression.

That stuckness is a feature of underlying neurobiology. All of us think in networks: when we start to think about a topic, we enter a network of related concepts that allows thinking to be efficient and helpful. Ideas are linked and things we need to know are easier to access when we enter a network of similar ideas, experiences, or emotions. That is why when people are trying to develop a creative solution to a problem, they brainstorm. That is, they utter or write every idea that pops into their minds about solving a problem – no matter how ridiculous it sounds on the surface – and do not assess the idea until they have a long list of options. Brainstorming is valuable because it helps us remove ourselves from the already framed network and helps create a new one.

That same efficient brain that networks and categorizes also causes a problem when depression hits. Entering a negative network that connects similar thoughts, experiences and emotions result in a depressed person linking negative networks. It promotes the discouraged outlook that is typical of depression. And, unfortunately, in depression, the ability to move to another more positive network is impaired. The weakened activity of the neurotransmitters causes “stuckness” in the pathway in the brain that allows shifting of thought and emotion.

That pathway includes a part of the brain called the anterior cingulate cortex (ACC) that should allow for rapid shifting between emotion and thinking and should aid in developing creative problem-solving. But when people suffer depression, this pathway of the brain is impaired. It may be overactive – spinning in place without creating movement. Or it may be sluggish and unable pass along cognitive decisions like, “I will try something new,” to the emotional part of the brain that generates the discouraged, “I never have good results.”

Emotion rules when there is depression. The negative “It won’t work for me,” style of thinking seems to have more power than the optimistic, “Just give it a try,” method of thinking.

Sitting with Jon, I want to say, “Just do what I am suggesting!” I want him to borrow my ability to generate a new idea, but some things have to change before he can try something new. He cannot respond to “just do it” while his negative networking is making him believe that his case is different. His notions about how to act are the ones in the network of what he has typically done, which is a very negative network.

How can he get out of this?

He needs a MAP.

When you use a map – even your navigator – you have to know where you are starting and where you are going. Jon needs to know he is currently stuck and that another way just might be possible. But where is he going? He needs to believe in a reasonable solution. In our conversations, Jon is beginning to believe that his depressed thinking is a problem.

Medication might help him be less negative – it can correct the neurotransmitter problems that cause the sluggish or overactive pathway to prevent new ideas. (Supplements and nutrition and sunlight can also help!) Next, he needs to redefine his goal. If marriage to exactly the right person is the only thing that will make him happy, then I cannot help him. He needs a matchmaker and a lot of money for that. If he wants to redefine what a happy life looks like to him, therapy can guide him. But once he can see the need for help to navigate his goal of a happy life, he needs to find a map. This map will need to take him toward feeling better and developing a more flexible, creative way of thinking. If he can get out of the negative network he will be more able to generate new actions and take charge of his discouraged mood.
MAP – Move, Ask, Play

M – (You may want to consider medication as the first M and then go to this one)

Jon needs to move. Literally, move his body. The stuck brain finds it easier to shift gears when the physical body is moving. Walking, swimming, bike riding can all be good. Try movement without earbuds pumping music. The creative brain will take over and just might jump the tracks of negativity while you move. And vigorous exercise has a way of pumping up energy that lightens depression.

A – Ask for input. When we brainstorm it works better if we have more than one person adding ideas. We spur each other into different networks. Jon might benefit if he shares his challenge of being stuck with a friend or three. And it will be good for him to ask people what gives them happiness or satisfaction. He might hear that there are many ways to be content.

P – Play around with different options. Jon does not have to commit to an idea of what is fun or pleasurable or satisfying. He would benefit from playing with the children in his life whose joy is infectious. Play sports or games. Playing stimulates different networks and may result in some changes in his mood or thoughts that may help him be less depressed.

There is a saying that life is a journey, not a destination. I do not know Jon’s ultimate destination, nor does he. The outcome of this MAP will help him find a better, more creative, and less depressed way of living his life.

By Margaret Wehrenberg, Psy.D. Margaret is the author of 5 books published by W.W. Norton, includingThe 10 Best Ever Anxiety ManagementTechniques, The 10 Best Ever Depression Management Techniques and her most recent 10 Best Anxiety Busters, an ideal book for the general public. She earned her M.A. studying psychodrama and bioenergetics, and had years of experience as a certified drug and alcoholism counselor, before earning her Psy.D. She now specializes in treating anxiety and depression and has a private practice in Naperville, IL. She is a frequent contributor of articles to The Psychotherapy Networker magazine, has contributed a chapter to Clinical Pearls of Wisdom (Ed. M. Kerman), and has produced CD for breathing, muscle relaxation and imagery for anxiety management.

This article originally appeared in Psychology Today magazine.

 

Some Law Schools Take The Lead in Students’ Well-Being, Report Finds

The National Task Force on Lawyer Well-Being said in a report released earlier this week that law schools must change their cultures so that everyone—professors, administrators, and students—takes responsibility for student well-being. The report, issued by a coalition of groups including the American Bar Association and the Association of Professional Responsibility Lawyers, stems from a groundbreaking study published last year showing that more than 40 percent of students felt they needed mental-health help and a quarter were at risk for problem drinking. Read the rest of the story here.

‘Better Call Saul’ Highlights Stress and Mental Illness in the Legal Profession

The ABA Journal reports: “Chuck McGill’s suicide in Better Call Saul reflects what is happening within the legal profession throughout the United States. But anxiety and depression are not confined to practicing lawyers. A study of law school students at Yale University found that 70 percent admitted to suffering from some form of mental health issues. Eighty percent of those respondents considered help, but only half of them actually sought it out. Read the article.

 

The Strategies That Science Actually Shows Are Effective for Depression

From Forbes, Alice C. Walton writes, “And as most people who have dealt with depression know, good treatments are hard to come by—but they do exist. Part of the issue is that a given treatment may work for one person and not the other, and it may take several tries before the right therapy, or a combination of therapies, is arrived upon. Here are some of the methods that have been shown to work, and are worth considering. As always, finding a therapist you trust and connect with is often the first step to figuring out which route to take.” Read the rest of her article here.

My New Book On Depression and Anxiety in the Law and How a Lawyer Life Coach Can Help

I’ve written a new book about depression and anxiety in the legal profession.

And it’s free.

You can get an immediate, free download of “Overcoming Stress, Burnout, Anxiety, and Depression in the Legal Profession: How a Lawyer Life Coach Can Help” here.

The first part of my short book outlines the causes of too much stress, burnout, anxiety, and depression in the law.

The second part provides an overview of how my lawyer life coach practice, created specifically for lawyers and law students with mental health problems, can help someone recover and stay well.

The third part is a list of my favorite books for (1) depression, (2) stress and anxiety, and (3) lawyer wellness.

SHUTDOWN: WHY PEOPLE WITH DEPRESSION FEEL SO NEGATIVE

Depression is a state of shutdown in which an individual’s psychological system shifts toward negative feeling states and diminishes the positive feeling states. The hallmark features of a depressive episode is a high negative mood state (characterized primarily in terms of depressed/demoralized/defeated/despairing feelings and secondarily in terms of anxiety, irritability/defensive hostility, and guilt/shame) and a diminished positive mood state (loss of interest, pleasure, energy, desire, and excitement).

Why do people get depressed? The primary reason people enter depressive shutdowns because they cannot obtain the necessary psychological nourishment needed to energize their behavioral investment system. Think of it as being akin to a state of starvation, only instead of physiological nutrition, the individual is lacking psychological nutrition. What is psychological nutrition? The fundamental principle that underlies psychological organization is that of behavioral investment. The psychological system is organized to direct mental energy and action toward investments that offer a return on those expenditures. When one is a getting a good return on one’s investments, then one feels fulfilled, energized and engaged. However, when one is not getting a good return, one begins to feel frustrated, anxious, irritable, or disappointed. If one cannot find an effective pathway for getting one’s needs met, one begins to enter into a state of psychological shutdown called depression.

So what are the core psychological needs that people have that need to be nourished? There are many different possible classification systems of needs (and motives and goals that people seek fulfillment around, see, e.g., here). I offer five categories here that overlap loosely with Maslow’s classic hierarchy of needs.

Safety and Security Needs. First and foremost, the psychological investment system is concerned with basic safety and survival. If one’s physical safety is chronically threatened, if one is in constant pain, if one is chronically hungry, and so forth, the attention of the system will largely be focused here.

The Base Pleasures. Good sex, tasty food, relaxing on a warm summer day on the beach after working hard. The “hedonic” pleasures serve as a fundamental reward and signal positive investments (at least in the short term). Good investment systems are generally characterized by meaningful effort and hard work toward a productive goal, followed by short periods of relaxing and enjoying the base pleasures.

Relational Needs. Our core psychosocial need is to be known and valued by important others. Most notably, this includes being known and valued by members of our family of origin, friends/peers, romantic partners, and community. Needs for relational value are reflective of one’s degree of social influence. And folks go about achieving social influence and relational value in different ways. For example, see here for power and achievement needs relative to belonging and intimacy needs.

Developmental Growth Needs. We can think about an individual’s psychological system as being akin to an investor’s portfolio. An investor has resources that have the potential for growth and loss. An investor with a diverse portfolio whose investments are growing in a way that is exceeding expectation is flourishing. The same is true for an individual. Each individual will have “personal projects” that are engagements they are involved in that afford opportunities for growth (hobbies, interests, creative and playful endeavors, meaningful work projects, etc.). If an individual is chronically stuck and not growing or is largely cutoff from their growth pathways, or is frequently failing to meet expectations, or is deeply investing in pathways based on extrinsic reasons that are not consistent with their underlying emotional/motivational needs (or intuitive sense of potential), then the investment system is vulnerable.

Existential/Transcendental/Virtuous Needs. Adult humans are meaning-making creatures that need to have a narrative for how their lives and personal projects make sense. As Victor Frankl notes in his timeless classic Man’s Search for Meaning, if they cannot place their suffering, personal projects, virtues and relationships in the context of a larger narrative that provides meaning, then they will be vulnerable to developing a nihilistic attitude, which is the belief that their lives or actions really don’t matter, because really nothing matters. A nihilistic narrative can undercut the emotional value that folks get from engaging in such projects, leading to existential crises or depressions.

Why do people have trouble getting their psychological needs met? Sometimes the answer is obvious. For example, consider the city of Aleppo in Syria. The people of that city have been completely brutalized and many folks there undoubtedly feel depressed. (As an interesting aside, it is worth noting that the field of psychiatry/clinical psychology is divided as to whether such individuals should be considered “clinically depressed”). In other obvious cases, folks get depressed because of chronic pain or illness, or death of a loved one or because they get addicted so substances that ruin their lives or because they are abused or isolated.

Other times the issue is much more complicated. Consider that there are many people that live in nice houses and seem to be surrounded by caring people and are achieving in their lives, yet they also get depressed. Indeed, despite the fact that we have more and more technology and more and more resources and control over our environment, we seem to be struggling more than ever with feelings of depression and anxiety. What is going on in these cases?

The short answer is that I think the modern, fast-paced society is placing many new, unusual stressors on our emotional system. And I don’t think people have been well-educated about how to appropriately process negative feelings. People have been given much more freedom to acknowledge negative feelings than in past generations (read this story to see what I mean), but there has not been good education on how to learn and grow from such feelings (see here or here). What I see in my clinic is that individuals try to avoid negative feelings, and wish everything would just be fine. They often try to act publicly like everything is fine, but they have no idea how to maturely process and learn from their negative feelings. Instead, they enter into an intra-psychic battle with their negative feelings, often working to banish them, or criticize themselves out of their feelings or try to “stay positive”. This creates a powerful “split” in their psychological systems. Namely, their feeling system is sending one signal, their internal narrator is in conflict with that signal, and they are trying to publicly present a totally different image than their inner conflict. All of this sets the stage for a “neurotic breakdown”.

In addition, I see many parents who value their kids, but who do not know how to guide their children in processing negative feelings. Instead, too many have been caught up in “self-esteem nation” and act in an overprotective way, essentially communicating both that their kids are fragile and that others are responsible for keeping you happy. Another group teaches their kids to repress and minimize their feelings. I am not blaming parents here. The modern world is complicated and psychologists and psychiatrists have generally not done a great job being clear about the nature of emotions and relational needs.

At the societal level, we need to recognize both the dramatic changes the information technological revolution has brought to our world and how many of the institutions that provided guidance for the good life are breaking down. Religious systems have lost much of their authority. The political system has broken down into a polarized way. I think our educational system is broken in the way it assesses performance and fails to teach character values. Science often seems to characterize the world as an amoral, meaningless physical system. In other words, in terms of our existential/transcendental understanding, there seems little that supports the deep-seated need that many people have for true meaning making. So, we live in a fast-paced, high-stress world in which we are overloaded with choice, we regularly observe massive amounts of inequity in power and resources, we give lip service to negative feelings but often characterize them as disease states and provide very little real education about human emotions and needs, and institutions that provided deep meaning making systems have lost their authority.

The bottom line is that depression arises, in most cases, when people do not receive the necessary psychological nourishment from their investments. This arises because of brutal environments and injury from traumas, diminished capacities to meet growth expectations, intrapsychic and interpersonal conflict with important others. Unable to find a path forward folks shutdown and, unfortunately, getting depressed in modern society likely creates more problems than it solves. So folks get trapped in neurotic depressive cycles.

There is clearly no easy fix, as depression is a massive health problem. But I do believe there is much that can be done. We need (and can achieve) a much better shared understanding of human psychological needs and nourishment. We also need a clear recognition from institutions like the World Health Organization that depression emerges as a function of psychological malnourishment, rather than being brain disease stemming from neurological malfunctions.

My ultimate vision is for the development of a holistic meaning-making system that harmonizes the natural sciences, the social sciences, and the humanities in a way that affords an understanding of our human natures such that we can have a more effective guide toward fulfillment during these rapidly changing times.

Gregg Henriques, Ph.D., author of A New Unified Theory of Psychology, directs the Combined Clinical and School Psychology Doctoral Program at James Madison University. He is a licensed clinical psychologist with expertise in depressionsuicide, and the personality disorders. He has developed a new meta-theoretical system for psychology articulated in many professional journals and is now applying that system to researching well-being, personality, and social motivation, and he and his students are working on the development of a general system of psychotherapy. Henriques received his M.A. in Clinical/Community Psychology from UNC-Charlotte and his Ph.D. in clinical psychology from the University of Vermont. He also completed several years of post-doctoral training at the University of Pennsylvania under Aaron T. Beck exploring the effectiveness of various cognitive psychotherapy interventions for suicide and psychosis. Henriques teaches courses in personality theory, personality assessment, social psychology and integrative adult psychotherapy.

 

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.

Finding Motivation Even Through the Apathy of Depression

From Esperanza magazine, blogger Margaret Lanning writes, “Lack of motivation is probably the most difficult part of depression I continue to wrestle with. Trying to figure out how to get up and get moving is extremely challenging. It can make or break a day. When I feel apathetic, my senseless thought cycle starts with the notion that I need to choose to do something (clean the kitchen). Then comes immediate resistance (I don’t want to clean the kitchen), then the guilt trip (good mothers clean kitchens so the family can be healthy), then the compromise (I can have a bite of chocolate if I clean the kitchen), then the shut-down (but I still don’t want to clean, and I’ll probably eat the whole chocolate bar), then the self-punishment (I am a bad person because I’m still sitting here).” Read the blog.

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