Holiday Survival Guide for Lawyers with Depression

From The Anxious Lawyer website, “Unfortunately, for all too many people, and particularly for all too many lawyers, the holiday season is a time filled with sadness, self-reflection, loneliness and anxiety. It is a season that comes with a “holiday depression” of its own which can affect anyone, whether it be due to time pressures, family issues, financial worries, memories of past holidays or just loneliness.” Read the Blog

Why I’m Speaking Up About Lawyers and Depression

From The Mighty, “Lawyers aren’t supposed to have problems; we’re supposed to fix them. Most male lawyers I know would rather drop dead than admit they have problem with depression. I guess the exception to this observation is when the wheels have fallen off. Then, and only then, do they recognize (hopefully) they are experiencing depression.” Read the Blog

“Plop, Plop, Fizz, Fizz” – Oh, What a Relief it is? Our Relationship with Antidepressants

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Most folks with depression have a complicated relationship with their antidepressant medications.

I certainly do.

While these pills saved my life years ago when major depression struck, years later, I often wonder if I still need to take them, or, if they’re still effective.

If I feel tired and flat on a particular afternoon, is it depression, the side effects of my meds or a jumble of both? Or maybe, it’s just my persistently pensive nature?

I think about this a lot these days – and maybe you do as well.

While the one-two punch of Cymbalta and Lamictal have kept me out of the dungeon of major depression for years, its comes with a cost. I have interludes of passivity, numbness, and fatigue. Maybe a low-grade depression at times, as well. If I ditch the drugs, maybe I will feel more “alive,” I think. I fantasize that cutting my ties with meds could lessen the days lost to the deadening grayness of a medically induced sense of normalcy I sometimes go through.

But I also feel anxiety. If I went cold turkey and lived medication-free, would it end, well, in disaster? A return to the swampland of depression? A deadman’s land if ever there was one. Can I take that chance? Should I?

There’s scary research that suggests once you stop antidepressants that work (or sort-of-work) for you and try to go back on the same ones because being off of them caused your depression to return (or you just couldn’t tolerate the horrible side effects that can come with discontinuation), there’s a good chance they won’t be as effective.

So, what’s a depressed person supposed to do? What should I do?

There are two camps that offer some guidance on this issue. Both have persuasive arguments about why those afflicted should or shouldn’t stay on meds.

The Stay on the Meds Camp

If depression is an “illness,” like diabetes or heart disease, I need these meds to balance out my of whacky neurochemistry. Given my risk factors: a family history of depression (genetics), a crazy childhood with a nutty, abusive and alcoholic father, and a high-pressure job with too much stress, I should stay on the pills.

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In his insightful essay in the New York Times, In Defense of Antidepressants, psychiatrist, Peter Kramer, author of the best-selling books, Listening to Prozac and Against Depression, suggest that studies show this: for mild or moderate depression, talk-therapy is as or more effective that medication. But for the Moby Dick sized sucker called Major Depression? Medications are warranted, and, indeed, lifesavers. They help many to function and live productive lives, albeit with a range of mild to more severe side effects.

The Get off the Meds Camp

Some people (including psychiatrists) see meds as the devil’s handiwork: supposed chemical solutions to emotional problems that flat-out don’t work. Many psychiatrists’ (and family doctors who write the overwhelming majority of scripts for these drugs in the U.S.), they maintain, are “pill pushers” who do the bidding of “BigPharma”, a multi-billion dollar industry in this country. Antidepressants aren’t so much a cure as a curse.

Irving Kirsh, Ph.D., author of The Emperor’s New Drugs: Exploding the Antidepressant Myth, writes:

“Putting all [the research] together leads to the conclusion that the relatively small difference between drugs and placebos might not be a real drug effect at all. Instead, it might be an enhanced placebo effect, produced by the fact that some patients have broken [the] blind and have come to realize whether they were given drug or placebo. If this is the case, then there is no real antidepressant drug effect at all. Rather than comparing placebo to drug, we have been comparing ‘regular’ placebos to ‘extra-strength’ placebos.”

The remedy from this group? Psychotherapy. They see depression as the result of off-kiltered, negative thinking patterns. The way out of these ruminative, pessimistic thoughts involves working with a therapist who uses, most often, Cognitive Behavioral Therapy, to challenge and encourage patients to replace such thoughts with more realistic and positive ones.

In his book Undoing Depression: What Therapy Doesn’t Teach You and Medication Can’t Give You, Richard O’Connor, Ph.D. argues that both therapy and medication are effective, but limited in certain respects.  He advocates an additional factor often overlooked in depression recovery: our own habits. Unwittingly we get good at depression. We learn how to hide it, how to work around it. We may even achieve great things, but with constant struggle rather than satisfaction. Relying on these methods to make it through each day, we deprive ourselves of true recovery, of deep joy and healthy emotion.

The book teaches us how to replace depressive patterns with a new and more effective set of skills. We already know how to “do” depression-and we can learn how to undo it.

Some Recent News on the Meds and Therapy Conundum

The New York Times reports that a large, multicenter study by Dr. Charles Nemeroff, then a professor of psychiatry at Emory and now at the University of Miami, found that for depressed adults without a history of abuse, there was a clear ranking order of treatment efficacy: Combined psychotherapy (using a form of cognitive behavior therapy) and an antidepressant (in this case, Serzone) was superior to either treatment alone. But for those who had a history of childhood trauma, the results were strikingly different: 48 percent of these patients achieved remission with psychotherapy alone, but only 33 percent of these patients responded to an antidepressant alone. The combination of psychotherapy and a drug was not significantly better than psychotherapy alone.

So what’s a depressed person supposed to do?

I don’t know, really.

We’re in a pickle, aren’t we?

Maybe there’ll be a soon-to-be discovered test that can guide us on precisely what to do. But for now, many of us will stay-the-course and, for better or worse, stick to the “plop, plop, fizz, fix”.

I see myself somewhere in the middle of all this. I’ve never been hospitalized or tried to commit suicide. But I have known depression’s scorching winds, gales that have torn the flesh from my body. I will never forget this pain. It’s scarred me. And I never want to return to it.

If you’re thinking of discontinuing your meds, here’s a great article on how to do it safely.

I welcome your comments about your depression journey with or without medicaton.

Copyright, 2017

by Daniel T. Lukasik

Depressed? Look for Help From a Human, Not a Computer

National Public Radio reports, “Online programs to fight depression are already commercially available, and while they sound efficient and cost-saving, a study out of the U.K. reports that they’re not effective, primarily because depressed patients aren’t likely to engage with them or stick with them.” Read the rest of the News

 

The Reason Why Big Law Lawyers Are Unhappy

The website LawFuel reports: “A recent report shows that just 44 percent of BigLaw lawyers report satisfaction with their careers, compared to 68 percent of public sector lawyers.”  Read the News

Depression is a Thief: It Steals the Stuff You Love

Depression is a thief. It sneaks into your heart and steals from you your passion: not only your power to conjure enthusiasm but also those exact things that once, that maybe all your life, excited you.

In other words, those things you loved not in the sparkly-pink-hearts sense of kissing or strolling along the beach with them or wearing white lace gowns to marry them — although in some cases, those too: Depression whooshes in through open windows, easily as any breeze, then yoink! 

Burglary victims, stickup victims: Unlike us, they realize they’ve been robbed.

All my life, until last year, I was very interested in very many things. The vastness of these interests made my childhood bedroom a museum, piled with barometers, feathers, halfpennies and fossils. So numerous were my passions that picking one as a college major or career felt like infidelity: Becoming a Wild West historian meant not becoming a marine biologist. Mastering Japanese meant not mastering Danish (weird, I know) or breeding dragonflies. Designing hats meant not being a forest ranger or parapsychologist or ethnomusicologist or bonsai gardener or gemologist. Instead of choosing one, I chose to write about them all, and more, and so went 30 years.

Then whoosh. After a lifetime spent looking things up, looking at things, spinning rapturous anecdotes about gold prospectors and sunken ships, last year these topics that had so thrilled me that I mistook them for myself lost all their light. They existed: France did not roll up like a rug and vanish. Sea chanteys were not erased from history. But suddenly I saw these things I’d loved the same way I’d always seen math and sports: as flat, alien realms irrelevant to me.

On shelves, polished agates and haiku volumes mocked me. In the world, all sumptuosity vanished from surfboards and cinnamon rolls. My keyboard rapidly became an enemy. Writing — shimmering reefs of detail, one deft word — was also yanked away, leaving me blinking blankly at my hands which long wrought fun and wonder and a living but now produced less and less, plus every word they typed felt like a lie. Which is to say: a sin.

Discussing boredom bores, as every poet knows. So — those who’ve never been there, I will spare you. Those who have, and are: Accept my fellowship. Get help. Last year I noticed certain friends avoiding me because, sans hilarious narwhal factoids and bone-marrow narratives, I was puzzlingly dull.

But I feel somewhat better now, so I can warn: Depression is a thief. It steals intangible yet priceless things. We have every right to shout I want my stuff back.

Stolen jewels you might replace. Stolen cash you can report to the cops. Stolen cars sometimes track their stealers via GPS. Passions, though. “Excuse me, officer, I’ve lost my enthusiasm, yearning, creativity and curiosity. I’ve lost interest in archery and baking. Oh, and also in bringing my kids to beaches. A marauder took it. Catch that thief! Issue an all-points bulletin!”

To whom do you report stolen interest in Tanzanian politics, preference for oolong over keemun, preoccupation with stars if you’re an astronomer?

Report them to your therapist, if you have one. But if you don’t? Because you haven’t yet assessed your losses? Because you think they’re your fault?

To whom, then? Partners? Friends? See, that’s the thing. These passions we’ve lost were what bonded us to them. Worse, if our friends and partners are themselves those passions — well.

Depression is a cruel thief that raids your heart, your home, your future, your present, your past. It steals your most precious possessions not to keep or use or give away or sell but just because they’re there. Those loves for which you lived become loot burning by the wayside. This is stealthy, silent theft that masquerades as aging, failure, sulkiness, stupidity, ingratitude, unmindfulness, unwillingness to try. This is a monumental crime that masquerades as just another day.

Depression is a master thief that slips through gaps you never knew you had. As deft in daytime as in darkness, it wakes no watchdogs and it trips no alarms. It happens to the best of us.

Which is not to say I’m the best. It is a mere figure of speech. But we are legion, those of us who have been robbed in this manner stand here stolen-from, raising no chorus of outrage because most of us don’t know we’ve been robbed. We sensed neither warning nor denouement, no “OMFG” moment but a slow and subtle awareness: Huh. Where’s my awe? 

Another tricky aspect of depresssion’s thefts is that it leaves the shells of what it takes. And/or replaces stolen goods with holograms.

So we say: See? Nothing has changed. So celebrate! Seize every moment and rejoice! You’ve got nothing to cry about. No leprosy, no blindness. 

So for a while we sip coffee calmly in our homes which still seem full. See, there’s my laptop. There’s my child.

We tell ourselves we cannot have been robbed because our lives look as they did before — which, to the naked eye, was perfect.

All the while, depression runs in circles, laughing, long arms loaded with our stuff. Once — if — we realize we’ve been robbed, we scoff because our losses are all in our minds.

Which makes us say, in hopeful moments: This was not grand theft but a transition. Transformation. What was lost will be replaced with other, better things — as in tales whose frogs become princes and straw becomes gold. So maybe, hey: Instead of Danish, Cornish. Or no languages at all but … what? Chemistry? Shoes? My reluctance to write: Is this too not catastrophe but a cosmic shift, a breathless pause before I start to sing or sail instead?

Or will I write again, but about wildly different subjects, such as sports, or in some wildly different manner, such as rhyme?

By turns pompous and panicky, I pronounce my own anomie a holy threshold, a garlanded crossroads beyond which — behold.

Or not.

Yet.

I feel somewhat better now than last year, whose sleepless nights sent me crawling across carpets, tearing into bits not one but two paperback copies of The Secret Sharer, sobbing How can this be my life now? when that life looked like paradise and I thought: I will be punished for sorrow I cannot explain or justify. I’ll be given “something to cry about” for failure to snap out of this, failure to meditate, failure to write, failure to sleep. For not demanding and getting my stuff back, abracadabra, I will be penalized with injury or irony. On some bright day I shall be sickened. Stabbed. Because in 2014 I lost interest in 10,000 things.

But really, I feel somewhat better now. This geode glitters in the sun. I saw pelicans yesterday. My reluctance to write, my sense of having nothing to say anymore to anyone, scares me — and makes me, among other things, a stranger to myself.

Pssst: Depression doesn’t just steal. It also lies. In voices very like our own, which we mistake for ours, it asks: Why did you ever have such pointless passions anyway? They weren’t passions but pastimes, tools for killing time.

Depression says: You idiot. You brat. Depression says: I did not sneak into your heart and home and steal your loves: You lost them, scatterbrain. You let me in.

Copyright, 2015 by Anneli Rufus

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