Lawyers Archives - Page 77 of 78 - Lawyers With Depression

Leaving Behind a Life that Doesn’t Work

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Psychologist, James Hollis, describes depression as a “swampland”; a place that’s murky and dark where we’d rather not go. He doesn’t underestimate the power of the physical dimension of depression; the chronic fatigue, difficulty concentrating and disrupted sleep. Nor does he dismiss the notion that depression, for some people, has a genetic basis. But what he suggests, which is different than your standard psychological tome on the topic, is that depression can be the result of our psyche, or “true self” if you will, trying to assert itself. We are depressed, he opines, because we are essentially living a life we don’t want and didn’t consciously choose. We are living out a script created for us by our parents and societal expectations to be successful, accomplished and respected in a way that’s not in accord with our real needs and desires.

At some, the psyche protests; it tells the guys upstairs running the ego’s show, “We’ve had enough! We’re staging a work stoppage!” And so the psyche withdraws large amounts of energy from the false life we’ve been trying to construct and live out of. We try harder during a depression to compensate by swimming even harder in the habits we know best: exerting more effort, distractions or maybe even addictions. But, the psyche won’t budge. It wants to take us in another direction; it wants us to pay attention to our own inner compass and turn in that direction. In doing so we are enlivened and a depression may lift – – maybe. It seems like the true self doesn’t give a damn about all of our “career objectives” and false gods. That’s not its objective and it demands to be heard.

In my own life, this most certainly played out in my decision to become a lawyer. As I have previously written, my dad was an unrepentant alcoholic who abused me, my siblings and my Mom. Yet, early in his life, he was a hero in many regards: captain of his football team, a sailor in the Pacific theater during WWII and a graduate of the University at Denver. But somewhere along the way, as he aged and had more children, the wheels fell off. This would have large ramifications in my own life.

I became the hero of my family in a way that my dad never managed to achieve in his adult life. I played sports, was a “good kid”, earned great grades in college, and went to law school. Like many people who do well in undergraduate school, I didn’t know what to do with my marshmallow degree in psychology. So, true hero that I was, I went to law school. I must admit that I didn’t like it very much even though I did well. Its emphasis on rules and analysis, too often to the exclusion of the human journey, sometimes bored me silly. I would often wander off to the undergraduate library and read great works of literature while my orphaned law books sat at the edge of my desk. “Pick me up,” they pleaded. I turned a deaf ear and went back to my novel.

One evening, towards the end of my first year, I went to dinner with my Mom and older brother. I began pouring my heart out to her that I wasn’t happy in law school.

My mom listened half-heartedly. Her eyes began looking around the restaurant to avoid my gaze. “Have they changed the wallpaper in here,” she managed in a sing-song voice. I persisted: “Mom, I really need your help. I need you to hear me.” My brother, who had been sitting quietly next to me, got annoyed: “Stop, bothering mom; you’re upsetting her!” So I stopped. I learned that whatever I was planning to do about law school, dropping out wasn’t an alternative. As the hero, being lost – or worse yet, a failure – was simply unacceptable. I never listened to what my psyche was trying to tell me. That choice would come back to bite me later in life as one of the causes of my depression.

I can now see the unrealistic expectations that my parents unintentionally laid on me. Somehow a “successful” son would make up for all the brokenness in their own lives. It would somehow redeem the pain that our home had harbored for so long.

Now, after years of struggle, I realize I have choices. I don’t have to unconsciously live out my parents unlived lives. I can forgive them and move on. I now choose to be a lawyer, but on my own terms. With that comes responsibility. No one is going to make healthy choices for me. My depression certainly caused a “work stoppage in my life.” It isn’t something I would have ever consciously have chosen – who would have? But I used the experience to go back to the drawing board of my life to figure out what I really wanted out of life. I didn’t want to continue to be stuck in the muck of depression so I had to change. I had to build a life that worked for me.

And that’s still a work in progress . . . .

Is There Any Room For Kindness in the Law?

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Rabbi Abraham Joshua Heschel once wrote, “When I was young, I used to admire intelligent people; as I grow older, I admire kind people.” Kindness is an element that’s often missing in the practice of law. Perhaps the absence of this most human of qualities is why lawyers are so unhappy and unfulfilled. Likewise, kindness is often lacking during a depression. During such times, others may not be kind to us. Whether it’s out of ignorance or simply not caring, it hurts. Moreover, there’s the lack of kindness towards our selves during a depression. During such times, we use most of our energy grappling with the darkness just trying to find our way home. Kindness towards our selves seems unobtainable if not inconceivable.

When we get our bearings and depression lifts, it might be helpful to turn our ship towards kindness as an important quality to nurture in our work lives. Some of my more cynical brethren think I’m smoking weed when I talk like this. They opine: “You’d get crushed if you acted kindly. Don’t be a fool.” But, I’m not some idealistic dreamer, I’m actually a realist. Having been in the litigation trenches for over 20 years, I know all too well the brutality, hand-to-hand combat, scheming and grenades that are lobbed back and forth into our bunkers. I think I’m a realist because I’m well acquainted with and see the tremendous cost of it all. These experiences were, most certainly, a cause of my depression as it is for many lawyers.

Since I don’t want to return to my former melancholic state, I have thought about the cost of not incorporating kindness into my day – yes, even during my workday. It can be done in small ways, such as becoming aware of our tone of voice when we speak to our secretary, seeing our client’s phone inquires not as annoyances to endure but as opportunities to be of service or bringing a cup of coffee to the receptionist.

Kindness is intricately connected to the heart, more than the mind. We can’t crunch the numbers or do a cost-benefit analysis about this sort of thing. We have to simply take chances. In my own experience, the following Zen adage holds true: “Just leap and the net will suddenly appear.”

I believe that the fatigue most lawyers complain of is often connected to the lack of kindness. Kindness has an enlivening and authentic dimension to it. Harold Whitman once wrote, “Don’t ask yourself what the world needs. Ask yourself what makes you come alive. And then go and do that. Because what the world needs are people who have come alive.”

Poet, David Whyte, who I’ve written about before, speaks to such corporate titans as IBM, Mobil Oil and Citibank about meaning and beauty. In one moving passage of his book, “Crossing the Unknown Sea, he talks about his friendship with a pretty hip monk named Brother David Steindl Rast who happens to be a psychiatrist. Here is an excerpt of their dialogue:

“’Brother David?’” I uttered it in such an old, petitionary, Catholic way that I almost thought he was going to say, “Yes, my son?” But, he did not; he turned his face toward me, following the spontaneous note of desperate sincerity, and simply waited.

‘Tell me about exhaustion,’ I said. He looked at me with an acute, searching, compassionate ferocity for the briefest of moments, as if trying to sum up the entirety of the situation and without missing a beat, as if he had been waiting all along, to say a life-changing thing to me. He said, in the form both of a question and an assertion:

‘You know that the antidote to exhaustion is not necessarily rest?’ ‘The antidote to exhaustion is not necessarily rest,’ I repeated woodenly, as if I might exhaust myself completely before I reached the end of the sentence. ‘What is it, then?’

‘The antidote to exhaustion is wholeheartedness.’ He looked at me for a wholehearted moment, as if I should fill in the blanks. But I was blank to be filled at the moment, and though I knew something pivotal had been said, I had not the wherewithal to say anything in reply. So he carried on:

‘You are tired through and through because a good half of what you do here in this organization has nothing to do with your true powers’.”

Perhaps it’s tough to bring kindness, or wholeheartedness if you will, into our lives until we listen to our deeper human needs, both our own and others. That deep need which tells us that we are more than our jobs that we convinced ourselves we can’t change or leave. We must discover our “true powers” and part of that journey is reconnecting with this most fundamental of human yearnings – the desire for simple kindness.

One Lawyer at Midlife

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A few weeks ago, I attended my 30^th High School Reunion at a local watering hole. As my wife and I drove to the event, I felt the wind of the seventies blowing through my now thinning hair. Bachman Turner Overdrive’s “Taking Care of Business” blared out of my speakers; a feel good anthem of my generation. The song felt like a buoy that I had long ago sailed past only to return to now.

Walking into the tavern was like stepping through a time portal to a different time and place; its strangeness exaggerated by the dim light and pop of Bud Light’s being pried open. Above is a photo of me at the reunion with our Valedictorian. The thinning hair alluded to above is self-evident.

As I walked around the room, I sensed that my interactions with everyone would be cursory:

“Hi — How are you? — Married? — Divorced – Oh, I understand — Kids?– What you doing now?”

The changes in our bodies and faces bespoke the eternal passage of time; each of us entering the Fall of our lives.

Midlife, and all the challenges this stage of life brings, has been on my mind. You know, the sort of thing that wakes you up at 3 a.m. In a few weeks I’ll turn 48 and have been out of law school for 21 years. Besides the reunion, one other thing supplied the voltage for this middle age meditation.

I’ve been reading a book by Robert A. Johnson called, “Living Your Unlived Life: Coping with Unrealized Dreams and Fulfilling Your Purpose in the Second Half of Life.” He points out that the first half of our lives is spent addressing matters in the outside world – learning a trade, marrying and raising children and finding our way in this difficult world. Then, “in the second half of life, the hunger of our missing pieces often becomes acute. It dawns on us that time is running out. So we often set about rearranging things on the outside. Such changes distract us for a time, but what is really called for is a change of consciousness.”

There is something inside of all of us which has been unlived. This is part of the maturation process and just plain growing up. We choose this; we don’t choose that. As we age, our lives take on certain defining features that we never could have foretold in young adulthood. As I mingled at my reunion with people from so long ago, I imagined what unlived lives they each had. We all smiled and made small talk as we swayed to the music. All the while, I imagined their hopes to live their unlived lives gently humming beneath the surface.

Johnson further extrapolates on the unlived life:

“We must work very hard, until exhaustion, just to get ego awareness working well in contemporary life. It takes the whole educational system and all of our socialization processes to promote this consciousness, and our entire society is highly invested in this struggle. However, in the process of becoming differentiated adults, we inevitably become split. We all have both a lived and an unlived life. Most psychotherapies are designed to patch up wounded people and then throw them back into the battle of oppositions. They guide people in how to become better adapted socially: more adept at making money, more highly disciplined, more dutiful, more economically productive. Even when such therapy is successful and gets an individual back out into the rat race again, you can watch them wither over time under the weight of it all.

In the second half of life we are called to live everything that we truly are, to achieve greater wholeness. We initially respond to the call for change by rearranging outer circumstances, though our split is actually an inner problem. The transition from morning to afternoon that occurs at midlife calls for a revaluation of earlier values. During the first half of life we are so busy building up the structure of the personality that we forget that its footings are in shifting sands.”

Many, many lawyers are exhausted by the weight of their lives at the midpoint of their journey. It seems that their careers, and all the obligations that go along with it, have built a momentum that is seemingly unstoppable. So, they settle for distractions (entertainment, money, good food, etc.) along the road to retirement to blunt the pain. This pain is the pain of the unlived life; the part of their inner lives they didn’t get to live while committing large chunks of their time to building their careers.

We must turn and face ourselves at midlife. We must stop running and finally listen to that inner voice which is trying, desperately, to get us to listen; perhaps for the first time in a long time. It dawns on us that we are not the immortals we fancied ourselves in our youths to be. We recognize and sense our mortality and we have yearnings. We want to start living a life, instead of enduring one. Or, as Bruce Springsteen once said, “At some point, you have to stop thinking about the person you want to be and be that person.”

And maybe that’s what depression is about for some of us: painful symptoms that leak out because of un-reconciled parts of us demanding to be heard and lived. If the central concern of the first half of our lives is building up our resumes of success, maybe the second half of life is a deeper search for meaning and purpose. For me, the unlived life has recently found expression as a writer. I feel meaning in writing about things flowing through the deeper currents of life; in sharing my insights, musings and struggles with you.

Suicide: The Death of a Law Student

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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.

The Ladder of Success

Many lawyers are consumed with the goal of becoming successful. Often, traditional success means money, status and power. According to veteran lawyer George W. Kaufman, author of the book, The Lawyers’ Guide to Balancing Life and Work, “For too many lawyers, the goal of success becomes the primary driver. But surveys of working lawyers tell us that a great many of them are unhappy even when their planned goals are realized . . .” This view was echoed by therapist, Alden Cass in an article on burnout in New York Magazine titled, Can’t Get No Satisfaction. Cass, who treats Wall Street lawyers in New York City, says, “I can’t tell you how many people come into my office and ask, “How come I have this money and I can’t find happiness?”

Most lawyers are never taught about the problems and pitfalls of pursuing success without also combining it with the pursuit of meaning and purpose. My parent’s only imperatives were that I go to college, get a good job and “be happy.” I worked long hours, endured constant stress and moved up my old firm’s pecking order. But somewhere along the way, I realized that something was terribly wrong with my life. I wasn’t just unhappy; I was full of sorrow. The great mythologist, professor and author, Joseph Campbell captured the irony of our common struggle for success: “You climb the ladder of success and when you get to the top you find it’s leaning against the wrong wall.”

I fell off that ladder and into a well of depression.

I was never taught how to navigate the waters of difficult emotions. When I looked around at my fellow lawyers, they all seemed so together — like a show room car that never got dented and was always polished.

Through my depression, I learned a lot about the darkness. That it isn’t exactly an illness, but part of the human journey for all of us. Educator and author, Parker Palmer, who went through and struggled with depression, wrote:

“Many young people today journey in the dark, as the young always have, and we elders do them a disservice when we withhold the shadowy parts of our lives. When I was young, there were very few elders willing to talk about the darkness; most of them pretended that success was all they had ever known. As the darkness began to descend on me in my early twenties, I thought I had developed a unique and terminal case of failure. I did not realize that I had merely embarked on a journey toward joining the human race”. Listen to a great podcast where Parker is interviewed for a show called, The Soul of Depression.

So much of the literature out there about success focuses on “work-life” balance. The formula in many of these tomes is the same: set limits, exercise and make time for family. All of these are well and good, but seem to so often fail us. There’s simply not enough gravity in them to keep us in orbit. What’s lacking is a basic truth: Life is made up of struggles and losses and how we deal with them. Such struggles can reach a crisis pitch in which we enter a sort of darkness.

In his book, Dark Night of the Soul: A Guide to Finding Your Way through Life’s Ordeals, psychologist, Thomas Moore says:

“A dark night may not feel like depression. In a long illness or a troubled marriage you may be anxious, but not depressed. On the other hand, a clinical depression might well qualify as a dark night. Whatever you call it, the experience involves you as a person, someone with a history, a temperament, memories, emotions, and ideas. Depression is a label and a syndrome, while the dark night is a meaningful event. Depression is a psychological sickness; a dark night is a spiritual trial.

Many people think that the point of life is to solve their problems and be happy. But happiness is usually a fleeting sensation, and you never get rid of the problems. Your purpose in life may be to become more who you are and more engaged with the people and the life around you, to really live your life. That may sound obvious, yet many people spend their time avoiding life. They are afraid to let it flow through them, and so their vitality gets channeled into ambitions, addictions, and preoccupations that don’t give them anything worth having. A dark night may appear, paradoxically, as a way to return to the living. It pares life down to its essentials and helps you to get a new start”.

And maybe that’s what we all need – a new start. To wake up to a new vision about what success really means to us and how we need to act in our lives as lawyers to meet that meaning.

I remember the words of Mother Teresa on the topic of success. It’s worth mentioning that a book published in 2007, Come Be My Light – The Private Writings of the Saint of Calcutta, says that Mother Teresa felt deep sorrow, despair and one could argue “depression” for the last fifty years of her life. Yet, in the most profound sense –whether you are religious or not — wasn’t she a success? She once said, “We are not called to be successful. We are called to be faithful.” In other words, we can’t control the outcomes. But, we can live a life that is directed by our spirits. And THAT is a life of success.

When Is My Depression Going to End?

I find writing about depression for lawyers a delicate balancing act. On one hand, I don’t want to pull any punches about just how awful depression is or how adversely it can affect your life and career. On the other hand, I want to offer hope and encouragement to those who are in the trenches and deal with it every day. I will try to do both today.

I have been encouraged by some to write only “positive” articles about dealing with depression. But I just can’t do that. To not deal with the more troubling aspects of depression seems to me a form of denial. The other day, I was at my local bookstore checking out the Self-Help section for any new titles on depression. Some of the titles seemed like they were being pitched by used car salesmen: “Overcome Your Depression in 30 Days!” This doesn’t help the conversation about depression because it sets up ludicrous expectations in the minds of those who suffer from it and their loved ones about the speed of recovery. For many with depression, they’re in it for the long haul.

One of the hardest parts about dealing with depression on a daily basis is its seemingly unpredictable nature: When is it going to start again and how long will it last?

Elizabeth Wurtzel, author of the best-selling book, Prozac Nation, gets it right when she wrote:

“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. The fog is like a cage without a key”.

Many, many lawyers go into a mode of survival waiting for a depression to end. To me, the degree to which such a depression can create catastrophe in our lives as lawyers seems driven by the episode’s severity: is it a tropical depression or a full blown hurricane?

If it a low to medium grade depression, tools like Cognitive Behavioral Therapy (“CBT”) are very helpful. With CBT, we work in therapy to replace destructive, depressing, negative self-talk with positive, healthy and realistic self-talk. The efficacy of this approach has been studied and documented using PET scans of the human brain. Such scans show that an area in the frontal cortex (the thinking part of our brain) is hyperactive in depressives before CBT and then calmed down after successful CBT treatment. This same area of the brain is activated when people do self-referencing [relating external events, particularly negative ones, to the self] and depressives do too much of this. They spin around in a cycle of negative thoughts and try to use the cerebral cortex to snap out of their depression. With CBT, they learn to decrease their self-reference to the things that are negative. It’s a form of rehabilitation of the cortex where depressives learn to turn the volume down.

This is a critical skill for lawyers to develop. According to psychologist, Martin Seligman, author of the best-selling book, “Authentic Happiness,” lawyers are pessimists. They develop thinking habits which see problems as permanent and intractable. They also feel an overdeveloped sense of ownership or responsibility for such problems. Optimists, on the contrary, see problems as temporary, solveable and not necessarily their “fault”. The important point here is that optimism is a skill that can be developed and practiced. Read Seligman’s chapter, “Why Are Lawyers So Unhappy?”

If it is a deeper depressive episode, more like a trough of despair, CBT won’t work very well. During such an episode, there is the sense that it’s never going to end. Yet, this is the distorted voice of depression talking because for the majority of people with depression, IT DOES END. The trick is to learn how best to weather the storm.

I find that when I am in a deeper depression, I need to go outside my mind and get into my body. Consistently, the things that helped me the most were the following:

1. It’s virtually impossible to feel depressed while exercising and even for a good period of time thereafter. The problem, as most of us know, is getting to the gym or the park. Behavioral prompts can help. Always have your gym gear in your car. Also, be realistic. Remember that it takes at least 21 days to form a habit. So, those first 21 days won’t be the easiest ones. Tell your family and friends about the importance of exercise to you and have them support and remind you about this on a daily basis.

2. Cut off any unnecessary negative input in your life during these times. Don’t listen to any sad music, watch violent T.V. shows or read somber books. This isn’t a forever type of deal. Think of it more as a “timeout”. Some people stop reading the newspaper during an episode as well. Also, the time you’re not doing these activities gives you the time that you’ll need to exercise.

3. See a massage therapist. Touch has a powerful effect on the human body and is known to cause the release of endorphins (the feel-good chemicals). It doesn’t involve any thinking on your part. For busy lawyers, it’s a time to relax and receive something positive for the day.

Remember to be kind to yourself today.

In Praise of Kindness

This week, I was privileged to receive the Special Service Award from the Erie County Bar Association for my work in assisting lawyers with depression. It was a particularly emotional night for me. You see, my 81 year old mother was in the audience. She’s in very poor health and it was difficult for her to walk to our table at the event. My father died 30 years ago. So mom has been my only parent since I was 18 years old.

Each of the award recipients were asked to keep there remarks short. Accordingly, I will try to keep this blog short. I thanked the bar and many others for their love and support. First and foremost, my wife, Kelsey. No man could ask for a more beautiful and loving partner. Then I said:

“Last but not least, I want to thank my mother who is here tonight. She taught me one of life’s most important lessions: kindness counts.”

Rabbi Harold Kushner, author of the best selling book, When Bad Things Happen to Good People, said that when he was a young man, he admired people who were cunning. But as he grew older and wiser, he admired people who were kind. See this great clip of him.

I told the audience the whopping statistics; about how major depression afflicts 350 billion people in our world. Forty million people in our own country suffer from it. It is the leading cause of disability worldwide and costs the U.S. economy 70 billion dollars a year in lost productivity.

But, as Helen Keller once said, “Life is full of suffering, but it’s also full of the overcoming of it.”

To me, being of service to others has helped me cope with my own depression. It has given me more than I have ever given. Giving to other appeals to what is best in people. To what Abraham Lincoln called, “the better angels of our nature.”

My role model for service is Mother Teresa. She used to carry around “business” cards that she handed out to people. On the front, was her contact information. On the back, read a beautiful prayer she had written.

The fruit of silence is PRAYER

The fruit of prayer is FAITH

The fruit of faith is LOVE

The fruit of service is love is SERVICE

The fruit of service is PEACE.

I wish all of you the peace that comes from loving service.

A Lawyer’s Heart

I’ve felt plenty of anger over my twenty years as a litigator. Sometimes, and thank God they were few and far between, I would blow up at opposing counsel or a client. More often, my anger would sometimes simmer just below the surface. This is an all too common reality for today’s lawyer. “By definition, the adversarial system is conflict-ridden, and conflict creates certain types of emotions like anger, guilt and fear, which causes stress, says Amiram Elwork, Ph.D. author of the book, Stress Management for Lawyers.

According to Chicago litigator, Shawn Wood, the “nature of civil litigation involves two lawyers (often Type A personalities) squaring off against one another under circumstances where there will be a winner and a loser, and part of each lawyers job will be to capitalize on any possible error in judgment that the other side makes.” I really don’t buy into this completely. Many lawyers that I know aren’t “Type A” personalities. They are usually hard working and successful. But, it can take a tremendous toll on their mental and physical health. They struggle with the simmering variety of anger.

Anger turned outward is hostility. Such hostility can express itself in a number of ways for lawyers. Andy Benjamin, Ph.D., both a lawyer and psychologist who treats lawyers with stress, anxiety and depression, describes hostility as an “array” of the following thoughts and behaviors:

Holding persistent negative, hostile, or cynical thoughts during relationship interactions;
Chronic impatience;
Frequent irritability
Disconnecting from others due to an empathetic deficit (for example, being rigid in relationship interactions);
Suffering continual fatigue.

You could say most people have these problems in our hectic, stressful world. “But lawyers are particularly susceptible to stress-related illnesses because of the unique interplay of the legal profession and lawyer personality” says the ABA Journal. A study that followed University of North Carolina law students as lawyers for 30 years suggested that those with significantly elevated levels of hostility were more likely to have died prematurely from cardiovascular disease.

According to Jesse Stewart, assistant professor of psychology at Purdue University, depression and hostility commonly occur together. When a person is both depressed and hostile, the traits interact in a complex way to elevate inflammatory proteins in the body. The combination of hostility plus depression appears to be as dangerous a risk factor for heart disease as high blood pressure or even smoking.

Edward C. Suarez, Ph.D., of Duke University, says a recent study, “. . . suggests the possibility that men who are . . . hostile and exhibit depressive symptoms, even in the mild to moderate range, are at heightened risk for cardiac events.” This is so because of the release of adrenaline during times of stress. According to Dr. Cleaves M. Bennet, clinical professor of medicine at UCLA Medical Center, “Adrenaline is the growth hormone for the heart muscle. On the one hand, its good to have a big, strong heart, but at the same time that the heart is getting bigger and stronger, the arteries are narrowing to protect the tissue.”

Given the clear connection between lawyer hostility, depression and the heightened risk for a cardiac event, what can lawyers do about it?

First and foremost, they need to educate themselves about the connection between depression, hostility and heart disease. Most people don’t see the correlation. But, there’s no denying the science which makes the links.

Second, because hostility creates stress in the body (i.e. the release of adrenaline and cortisol when the body goes into the fight or flight mode), it’s critical to discharge the stress through some form of exercise. When I go through a good workout after a confrontational day, it’s as if I am wiping the slate clean. I am discharging the stress that is causing so much trouble in my body and bringing it back into some kind of balance. Exercise is really just a formalized form of the flight response to stress. Our bodies want to step on the gas. Listen to your body and let it run.

Third, you need to find out where your hostility is coming from. Is it from problems in your personal life that you bring into your daily life as a lawyer? If so, these need to be met and addressed. Or, is it the other way around? Is it the daily grind and confrontation at the office that you bring home? It’s important to figure this out. If opposing counsel is a jerk and elicits a hostile reaction from you, it might be time to learn (and, yes, it is a skill you can learn) different ways of being assertive without harming your heart and increasing your risk for depression. If it is problems at home, identify them and if need be, go for counseling.

Fourth, learn to tell the difference between being assertive and being aggressive. For further reading on this topic, check out this article “Are you Assertive – or Aggressive?” and the article “Assertive, Not Aggressive.” To help evaluate your own levels of perceived stress and associated health risks, visit the University at Pittsburgh Center’s Healthy Lifestyle Program Web site.

Creating a Self-Care Toolkit

I talked with a wonderful woman from halfway across the country this morning about her ongoing battle with depression. At one point, she asked me so tenderly, “Am I ever going to get better?” My unwavering response was “Yes”. Maybe I had no right to say this. After all, I’m not an expert. But I have talked with hundreds of lawyers across the country who have shared their depression stories with me. Many of them have recovered or are on their way. The woman also shared with me that she was in therapy and taking antidepressants, but was still having a lot of problems with depression. I offered her a little hard won advice which I will share here.

When we think about recovery, we need to envision a Self-Care Toolkit. What’s that? It’s behaviors that you are going to do that are healthy and offer you relief and hope. Certainly, seeing a psychologist and a psychiatrist are self-caring acts. But, there is a lot more that we can do to help ourselves. I call them the pillars of recovery. Here are a few that I shared with my friend on the phone today:

1. Join a support group for depressed people. Ask your psychologist or psychiatrist if they know of one. If not, maybe they will start one that you can participate in. Alternatively, contact the Depression & Bipolar Support Alliance. It’s a national organization dedicated to helping people just like you. Here is the link to finding a support group in your area. Another idea is to contact a Lawyers Assistance Program (LAP) in your State or community. These programs are confidential and are there to help lawyers with problems including depression. They may be able to help you find a lawyers support group in your community. Here is the link to find a LAP in your state. Please note that a support group is not the same thing as group therapy. Here is a great article from the Mayo Clinic about the difference between the two and the benefits of joining a group. One of the biggest problems is the loneliness that we as people with depression experience. We often think to themselves, “No one understands my pain”. We compound this loneliness by isolating themselves from others. The act of joining a support group is a much healthier choice than walling ourselves off.

2. Start a journal. Depression often causes us to bottle up our emotions or feel like we just can’t sort them out. In one study , conducted by The University of New England, police officers spent 15 minutes at the end of their shift writing in a journal about stressful events and feelings that had occurred during the shift. In just four days the officers experienced a 28% reduction in stress, anxiety and depression. “Keeping a journal is a good way to start coping with depression”, says Jessie Gruman, Ph.D., Executive Director of the Center for the Advancement of Health in Washington. “It’s not aggressive, it’s something you can do by yourself, and it gives you the chance to see your feelings in black and white and then make plans to do something about them.”

3. Help your spouse/partner to help you. Many spouses/partners who love people struggling with depression don’t know what to say or do. Sometimes, although well intentioned, they say something that only makes you feel worse and more alone. What a spouse/partner needs to do is get educated. I have recommend reading the book, When Someone You Love Is Depressed: How to Help Your Loved One Without Losing Yourself, by Laura Epstein Rosen, Ph.D. It’s important for your partner to be on the same page because depression affects the whole family. I recommend that you buy the book for your spouse as a gift. It lets them know that you care and realize that they struggle with how to help. Read this article from Psychology Today about how families often do better at recognizing depression than patients. Need online help? Wonderful resources can be found at the Families for Depression Awareness website at www.familyaware.org.

More later. For now, be well.

Managing Your Depressive Symptoms Is Not Enough

If you have been living with depression long enough, you will inevitably face the question of whether managing your depression is enough. Many lawyers dealing with depression (and there are 200,000 in America) are struggling to get rid of their symptoms of depression. I understand the value and necessity of this all too well. But once the symptoms seem manageable, what next?

In his book, What Happy People Know, psychologist, Dan Baker, offers his criticisms of much of modern day psychology: “Clinical psychology – the treatment in a clinical setting of people with mental disorders – was begun with great fanfare as an adjunct to modern medicine in the late 1800s. It was patterned after the conventional medical model of fighting pathology. Clinical psychology was based on the assumption that most people are mentally healthy – and happy- but some people contract mental pathologies that conform to neat diagnostic compartments, and require standardized treatments. The only problem is that it doesn’t work very well. It fails approximately two-thirds of the time.” As I write, let it be known that I attend therapy twice per month!

There is a great debate worldwide about the causes of depression. Most agree that it is a complex condition related to a combination of factors both genetic and environmental. While there is value in thinking about depression as a disease of sorts – say on par with diabetes or heart disease – there is a real danger to as well. That’s because it isn’t just a “disease;” it’s also a psychological and spiritual malady. If those aspects aren’t addressed, those who suffer from it may never taste the wonder and joy of life. They are left with the discontent of a life where they are only managing their depressive symptoms. Don’t we have the right to expect more?

Dr. Baker central point is that the approach of clinical psychology was not designed to help people find happiness. “It assumed that if mental illness were cured, happiness would naturally follow, as the normal human condition. But that doesn’t happen for the vast majority of people.” He continues, “I believe that even when people do not have diagnosable psychological illness, they still cannot be considered psychologically healthy unless they are happy. The absence of disease is not the same as health, just as the absence of poverty is not the same as wealth.” For a further exploration of the issue of happiness, see the interesting article in The Atlantic Magazine, “What Makes Us Happy” by Joshua Wolf Shenk. Interesting, Mr. Shenk is the author of Lincoln’s Melancholy: How Depression Challenged a President and Fueled His Greatness.

I believe Dr. Baker’s point is well taken. Yes, it is critically important to treat the symptoms of clinical depression. But we must stop and pause: is that enough? If it is, I can’t help but feel as though we have allowed ourselves to be victims on some level. Depression then has the danger of defining our identities as people. We are more than that. We must aspire to live a fuller life with times of joy, happiness and a sense of being alive. As Mark Twain once wrote, “Let us endeavor to live that when we come to die even the undertaker will be sorry.”