In a blog from Margaret Wehrenberg, Ph.D., she writes that good memories aren’t something that we have to wait to come upon us. We can deliberately bring them up, relish them and in so doing, help heal ourselves from depression. Read the Blog.
Exiting Neural Networks: How to Strengthen Positive Memories on Purpose
Dan’s Top 10 Stress and Anxiety Book Picks
There’s a wonderful piece in todays New York Times Magazine, The Manic in Me: If I Couldn’t Conquer my Anxiety, the Least I Could do was Understand It by Daniel Smith. He writes:
“There are two types of anxiety sufferers: stiflers and chaotics. Stiflers are those who work on the principle that if they hold as still, silent and clenched as possible, they will be able to cut the anxiety off from its energy sources, the way you cinch off the valve from a radiator. Chaotics, by contrast, work on no principle whatsoever. Although chaotics are sometimes stiflers when alone, when they are around other people, and especially intense interpersonal situations, they are brought into a state of such high psychological pressure that all the valves pipes open of their own accord, everything is released in a geyser of physicality and verbiage, and what you get is a kind of shimmery, barely stable equilibrium between internal and external states, like in those rudimentary cartoons where the outlines of the characters continuously squiggle and undulate”.
Smith captures some of the panicked nature of anxiety sufferers. But he’s not describing the anxiety that’s a normal part of life. Anxiety can even be useful when it alerts us to danger. But for some people, anxiety is a persistent problem that interferes with daily activities – – just as depression does – – such as work, school or sleep. This type of anxiety can disrupt relationships and enjoyment of life, and over time it can lead to serious health concerns and other problems.
Scientists know there is a high degree of comorbidity (i.e. the presence of a disease in addition to the primary disease) with anxiety and depression: up to 60% of patients whose primary diagnosis is anxiety also suffer from depression and vice versa. Check out my earlier blog, How Stress and Anxiety Become Depression.
All this being said, and without further adieu, here are my top 10 picks. Feel free to suggest your own.
Why Zebras Don’t Get Ulcers: An Updated Guide to Stress, Stress-Related Diseases and Coping – Robert Sapolsky, Ph.D.
Why don’t zebras get ulcers–or heart disease, clinical anxiety, diabetes and other chronic diseases–when people do? In a fascinating that looks at the science of stress, Stanford biologist Robert Sapolsky presents an intriguing case, that people develop such diseases partly because our bodies aren’t designed for the constant stresses of a modern-day life – – like sitting in daily traffic jams or racing through e-mails, texting and running to pick up our kids after a tough day at work. Rather, humans seem more built for the kind of short-term stress faced by a zebra–like outrunning a lion.
This book is a primer about stress, stress-related disease, and the mechanisms of coping with stress. How is it that our bodies can adapt to some stressful emergencies, while other ones make us sick? Why are some of us especially vulnerable to stress-related diseases and what does that have to do with our personalities?”
Sapolsky, a neuroscientist, concludes with a hopeful chapter, titled “Managing Stress.” Although he doesn’t subscribe to the school of thought that hope cures all disease, Sapolsky highlights the studies that suggest we do have some control over stress-related ailments, based on how we perceive the stress and the kinds of social support we have. Watch this fantastic National Geographic Documentary featuring Dr.Sapolsky explaining Stress and Anxiety.
Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness – John Kabat-Zinn, M.D.
As a busy lawyer, I was immediately attracted to the title Full Catastrophe Living. It literally leapt of the bookshelf and cracked me on the head. Who doesn’t live a life so jammed with stuff to do that it feels like a catastrophe?
Chronic stress saps our energy, undermining our health, and making us more vulnerable to anxiety, depression, and disease. The heart of the book is based on Kabat-Zinn’s renowned mindfulness-based stress reduction program at the University at Massachusetts Medical Center. Check out this video clip of Dr. Kabat-Zinn. The author takes the phrase “full catastrophe living” from book and movie Zorba the Greek. If you’ve never seen it, an Englishman Basil – – who is half-Greek – – inherits a run down mine in a small Greek town. To help him restore it, he hires a local character named Zorba to be the foreman of the local laborers. Zorba, full of the zest of a life truly lived, is asked by Basil, “Do you have a family?” Zorba responds “Wife, children, house – – the full catastrophe!!!”
The Mindful Way through Anxiety: Break Free From Chronic Worry and Reclaim Your Life – Susan M. Orsillo, Ph.D.
Anxiety isn’t the same thing as stress. You can’t just “get over” anxiety. In fact, the very things most people do to try to feel better–avoiding feared situations, pushing worry out of mind–only make the problem worse. This book presents a powerful new alternative that can help you break free of anxiety by fundamentally changing how you relate to it. Mindfulness, a simple yet powerful way of paying attention to your most difficult emotions and life experiences, seems like it is everywhere these days and being offered as a solution to much of the mental distress that ails modern society. Yet, in my own limited experience, it is worthy of such attention because it works.
Undoing Perpetual Stress: The Missing Connection Between Depression, Anxiety and 21st Century Illness – Richard O’Connor, Ph.D.
Author of my favorite book on depression, “Undoing Depression”, Richard O’Connor, Ph.D., has written another simply brilliant book on the consequences of “perpetual” stress in our lives – the alarming and escalating rates of clinical anxiety and depression. This was the first book I read that made clear to me the connection between stress, anxiety and depression. It formed the basis for my blog on the topic How Stress and Anxiety Become Depression. The human nervous system was never meant to handle this many stressors. It’s as if the circuit breakers in our brains are blown by too much stress running through our brain’s circuitry. This book is a perfect fit if you want to learn a lot about the brain and physiology of stress – I found it fascinating. If you’re looking for a quick read and pick-me-up, this isn’t it. Read the Book Review.
The 10 Best-Ever Anxiety Management Techniques – Margaret Wehrenberg, Ph.D.
Medication, once considered the treatment of choice, is losing favor as more and more sufferers complain of unpleasant side effects and its temporary, quick-fix nature. Now, thanks to a flood of fresh neurobiology research and insights into the anatomy of the anxious brain, effective, practical strategies have emerged allowing us to manage day-to-day anxiety on our own without medication. Addressing physical, emotional, and behavioral symptoms, Margaret Wehrenberg, Ph.D., a leading mental health clinician, draws on basic brain science to highlight the top ten anxiety-defeating tips. Everything from breathing techniques to cognitive control and self-talk are included. I really like that the 10 chapters are highly readable and short. Dr. Wehrenberg is also a frequent blogger at the Psychology Today website. Here’s one of her blogs, The One-Two Punch of Negativity and Fear.
Things Might Go Terribly, Horribly Wrong: A Guide to Life Liberated from Anxiety – Troy DuFrene
This book approaches the problem of anxiety a little differently than most. Instead of trying to help you overcome or reduce feelings of anxiety, it will help you climb inside these feelings, sit in that place, and see what it would be like to have anxiety and still make room in your life to breathe and rest and live, really and truly live, in a way that matters to you. This approach is based upon a research-supported form of psychotherapy called Acceptance and Commitment Therapy, also known as ACT which starts with the assumption that the normal condition of human existence is suffering and struggle, ACT works by first encouraging individuals to accept their lives as they are in the here and now. This acceptance is an antidote to the problem of avoidance, which ACT views as among the greatest risk factors for unnecessary suffering and poor mental health
Get Out of Your Mind and Into Your Life – Steven C. Hayes
This is another book that uses the ACT approach. It’s different than the book above because it offers a five-step plan for coping with painful emotions such as anxiety and depression. How I love plans! I also liked the wisdom contained here: the recognition that painful feelings cannot be controlled will open you to the possibility of fully emotional living. When anxiety arises in our bodies and minds, we erroneously believe that we have the power to rein these in, stop them and thus effectively eliminate it. However, this approach only leads us further down into the well of panic. Anxiety is not the problem. It is our attempts to squash and control it that strengthen anxiety and prevent us from coping with it effectively. Learn what steps you can take to approach anxiety differently.
The Worry Cure – Robert L. Leahy
For “highly worried people,” or those who suffer from the “what-if disease,” this book presents a systematic, accessible self-help guide to gaining control over debilitating anxiety. Leahy is an expert in changing thought processes, and he walks worriers step-by-step through problems in the way they think, with pointers on how to change these biases. The author then outlines a seven-step worry-reduction plan (remember, I love plans!) beginning with identifying productive and unproductive worry, progressing to improving skills for accepting reality, challenging worried thinking and learning to harness unpleasant emotions such as fear or anger.
The Anxiety and Worry Workbook – David A. Clark, Ph.D.
Like many of the other books I’ve recommended, this one is also grounded in cognitive behavior therapy.
I like this book because included in it are carefully crafted worksheets, exercises, and examples that reflect the authors’ decades of experience helping people who really, really struggle with anxiety. Learn practical strategies for identifying your anxiety triggers, challenging the thoughts and beliefs that lead to distress, safely facing the situations you fear, and truly loosening anxiety’s grip–one manageable step at a time. Like depression, coping effectively with anxiety involves learning helpful new and constructive ways of thinking about the problems we all face. So often, it isn’t the reality of a situation that makes us anxious, but the stories we tell ourselves about the events that happen moment-to-moment.
Self-Coaching: The Powerful Guide to Beat Anxiety – Joseph J. Luciani, Ph.D.
This is a good book for those who don’t want to see a therapist or, if they do, need extra doses of encouragement and practice to overcome their anxiety. The author advises readers to identify themselves as specific personality types (e.g., “Worrywarts,” “Hedgehogs,” “Perfectionists”) and then gives specific instructions on how to change the particular thought patterns associated with this type of personality. So many people who struggle with anxiety never got what they needed while growing up – – enough love, encouragement and affirmation. Lacking these core experiences, we develop can develop particular maladaptive strategies to cope with people and situations that push our buttons. This is the only book that I’ve read that pairs specific coping recommendations with particular personality types.
Healing Anxiety and Depression — Daniel Amen, M.D.
Dr. Amen is a true pioneer in uncovering the connections between the brain and behavior. In this excellent book, he provides an overview of how the brain works and how medication, diet, supplements, exercise and social and therapeutic support can help anxiety. Check out this video clip of Dr. Amen talking about his comprehensive approach. As science’s understanding of how anxiety and depression work has grown, there is an emerging picture that both of these conditions are “whole body” problems that demand whole body solutions. Like depression, we can’t just take a pill. Rather, we need to look at every aspect of our lives so that we can address anxiety on multiple levels.
Margaret Wehrenberg, Ph.D., writes that folks with depression must move from expectations of perfect to “good enough!” Read the Blog
Dan’s Top Ten Depression Books
Undoing Depression – Richard O’Connor, Ph.D.
This is the best book I’ve read on depression. Perhaps it’s more compelling than most books on this subject because Richard O’Connor, a therapist in New York City, has gone through major bouts of depression himself. Depression has often been compared to heart disease; an illness fueled by complex and interrelated factors: genetic, biochemical, environmental. In this book, O’Connor focuses on an additional factor often overlooked: our own habits. Unwittingly, we get good at depression. This 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. With a truly holistic approach that synthesizes the best of the many schools of thought about this painful condition, this book offers new hope, and new life, for sufferers of depression. Go to Dr. O’Connor’s website
The Noonday Demon – Andrew Solomon
Winner of The National Book Award following its release a decade ago, this is a beautifully written book by depression sufferer, Andrew Solomon. Drawing on his own struggles with the illness and interviews with fellow sufferers, doctors and scientists, policy makers and politicians, drug designers and philosophers, Solomon reveals the subtle complexities and sheer agony of the disease. With uncommon humanity, candor, wit, and erudition, he not only helps us understand depression, but also the human condition. Go to Andrew Solomon’s website to read a chapter
The Mindful Way through Depression – J. Mark Williams, Ph.D.
Mindfulness, a simple yet powerful way of paying attention to your most difficult emotions and life experiences, can help you break the cycle of chronic unhappiness once and for all. It seems like every few days, there is a new book or article out on the power of mindfulness. Here, four uniquely qualified experts explain why our usual attempts to “think” our way out of a bad mood or just “snap out of it” lead us deeper into the downward spiral. Through insightful lessons drawn from both Eastern meditative traditions and cognitive therapy, they demonstrate how to sidestep the mental habits that lead to despair, including rumination and self-blame, so you can face life’s challenges with greater resilience. Jon Kabat-Zinn gently and encouragingly narrates the accompanying CD of guided meditations, making this a complete package for anyone seeking to regain a sense of hope and well-being. Go to a review and summary of this book
Listening to Depression – Lara Honos-Webb, Ph.D.
I first read this book five years ago and was struck by its originality: depression isn’t just a disease to be fixed with medication and therapy, but a warning signal that our lives are off track and needs to be healed. In this sense, depression and its painful symptoms is a sort of unwelcome wisdom. Dr. Honos-Webb argues that we too often try to cut off or numb our feelings of depression instead of listening carefully to what they are telling us about our lives. Listening to Depression offers insightful ways to reframe depression as a gift that can help you transform your life for the better. Go to an interview with Dr. Honos-Webb
Lincoln’s Melancholy – Joshua Wolf Shenk
I am a little biased here. I am a lawyer and Lincoln is my hero. He not only was a great trial lawyer, but also struggled with depression his entire life. Giving shape to the deep depression that pervaded Lincoln’s adult life, Joshua Wolf Shenk’s Lincoln’s Melancholy reveals how this illness influenced both the president’s character and his leadership. Lincoln forged a hard path toward mental health from the time he was a young man. Shenk draws from historical record, interviews with Lincoln scholars, and contemporary research on depression to understand the nature of his unhappiness. In the process, he discovers that the President’s coping strategies—among them, a rich sense of humor and a tendency toward quiet reflection—ultimately helped him to lead the nation through its greatest turmoil. Go to the author’s excellent website about the book
Unstuck: Your Guide to the Seven-Stage Journey Out of Depression – James S. Gordon, M.D.
One of our country’s most distinguished psychiatrists and a pioneer in integrative medicine, Dr. Gordon believes that depression is not an end point, a disease over which we have no control. It is a sign that our lives are out of balance, that we’re stuck. It’s a wake-up call and the start of a journey that can help us become whole and happy, one that can change and transform our lives. Unstuck is a practical, easy to use guide explaining the seven stages of Dr. Gordon’s approach and the steps we can take to exert control over our own lives and find hope and happiness. Unstuck is designed for anyone who is suffering from depression, from mild subclinical depression (“the blues”) to its severest forms. Go to this PBS television intereview with Dr. Gordon
Unholy Ghosts: Writers on Depression – Nell Casey
The only book of its kind, Unholy Ghost is a unique collection of essays about depression that, in the spirit of noveliest William Styron’s Darkness Visible. Unlike any other memoir of depression, however, Unholy Ghost includes many voices and depicts the most complete portrait of the illness. With an introduction by Dr. Kay Redfield Jamison, Unholy Ghost allows the bewildering experience of depression to be adequately and beautifully rendered. The twenty-two stories that make up this book will offer solace and enlightenment to all readers. Go to an excerpt of the book
Depression is Contagious – Michael Yapko, Ph.D.
Dr. Yapko has identified the types of relationship patterns that lead to negative ways of thinking, feeling, and relating to others and culls from the latest findings in neuroscience, social psychology, epidemiology, and genetics to provide a practical, proven plan for developing the skills and insights you need to forge stronger, healthier social connections and enjoy an enriching, interconnected life. While commonly prescribed drugs address some of depression’s symptoms, they cannot change the social factors that cause and perpetuate the disorder. By treating a social condition as though it’s a disease, the problems compound rather than diminish. The foundation for recovery is to build a healthy social life based on understanding what to expect from our relationships, what we should give, and how to relate to and accept others — skills that have been neglected by modern society. Dr. Yapko’s groundbreaking plan of action — filled with skill-building emotional and mental exercises, anecdotes, and illuminating explanations. Go to an article written by Dr. Yapko about his approach to treating depression
I Don’t Want to Talk About It – Terrence Real
Depression is a silent epidemic in men who hide their condition from family, friends, and themselves to avoid the stigma of depression’s “un-manliness.” Problems that we think of as typically male — difficulty with intimacy, workaholism, alcoholism, abusive behavior, and rage-are really attempts to escape depression. And these escape attempts only hurt the people men love and pass their condition on to their children. Real reveals how men can unearth their pain, heal themselves, restore relationships, and break the legacy of abuse. He mixes penetrating analysis with compelling tales of his patients and even his own experiences with depression as the son of a violent, depressed father and the father of two young sons. Go to a video of Terry talking about men and depression
What to Do When Someone You Love is Depressed – Mitch Golant and Susan Golant
There are few circumstances in life as hard and at the same time as important as being a friend to a person who is suffering from depression. What to Do When Someone You Love Is Depressed offers guidance to the friends and family of a depressed person on how to keep one’s own spirits up and at the same time do what is best to help a loved one get through a difficult time. Read an excerpt here
The Zen Path through Depression – Philip Martin
Extremely accessible to people with little or no Zen experience as well as to longtime students of Buddhism, The Zen Path through Depression shows how the insights and exercises of Zen offer relief for those suffering from depression. Read an excerpt here
Beyond Blue – Therese Borchard
In this part memoir/part self-help, Therese Borchard, who blogs about depression at her site, Beyond Blue, endears herself to the reader and then reduces even the most depressed to laughter as she provides a companion on the journey to recovery and the knowledge that the reader is not alone. Go to her popular depression blog now
Get it Done When You’re Depressed –Julie A. Fast and John Preston, M.D.
When a depressed person can’t meet the expectations of society, the depression becomes worse and a vicious cycle begins. The goal of Getting Things Done When You’re Depressed is to break this cycle. Readers will learn how to prepare themselves mentally for working while depressed, how to structure their environment so they can work more easily, how to work with others and how to prevent depression. Go to an interview with the author
The 10 Best-Ever Depression Management Techniques – Margaret Wehrenberg, Ph.D.
What I like about this book is that it provides an overview of the some of the best techniques out there that scientists and therapist are using to help and heal people from depression. As Margaret Wehrenberg explains, you must first understand your brain. Drawing on cutting-edge neuroscience research presented in a reader-friendly way, Wehrenberg skillfully describes what happens in the brain of a depression sufferer and what specific techniques can be used to alter brain activity and control its range of disabling symptoms. Containing practical, take-charge tips from a seasoned clinician, this book presents the ten most effective strategies for moving from lethargy into action, taking charge of your brain, and breaking free from depression to find hope and happiness. Read an excerpt here
The Company We Keep
Life is partly what we make it, and partly what it is made by the friends we choose – Tennessee Williams, playwright
People in and out of the law often ask, “What causes such high rates of depression in the legal profession?”
I’ve written about some of the causes in law students (too much competition and too little feedback), lawyers (chronic stress which changes brain chemistry) and judges (loneliness that can contribute to and/or help cause a depressive episode).
There’s another dimension to it, though. It’s the company we keep. It’s not just the rough and tumble of fighting with opposing counsel that grinds on lawyers’ mental health. It can also be more subtle forces . . . like our colleagues.
When we’re depressed, it’s like we’ve jumped out of a plane and are in free fall. We lose our sense of perspective and hope as we speed towards the ground trying to untangle our chute.
Hanging out with cynical lawyers is like jumping out of that plane after they’ve just handed you an anvil. This only adds more weight onto the backs of lawyers who may be already struggling to get out from under depression’s shoe. The grousing of other attorneys is unhealthy for a depressive because it only serves to reinforce their pessimistic view of the universe.
Behind Closed Doors
Over the years, my door has been a revolving one. You know there’s trouble when a colleagues enter, give you a conspiratorial glance and silently shut the door behind themselves. Often – too often – it’s to replay negative experiences they’ve had at work and how unhappy they are. They’re usually not looking for solutions as much as collusions; confirmation that others don’t like their law jobs either and that everyones common fate in the law is misery.
A lawyer friend of mine, who used to meet me for coffee, would tell me how unhappy he was in his job. “Most people are assholes in this field,” he would snort. I’d then tell him about all of the positive experiences I have had — and still enjoyed — with other lawyers. He looked like he was listening, but he had already tuned out. It simply didn’t confirm his dreary conclusions about his professional life. As if he hadn’t heard me, he’d just return to his diatribe about how much being a lawyer sucks.
I sometimes have difficulty saying “no” to people and setting appropriate limits. Especially, when I sense they’re in trouble like my friend in the above story. But, I finally concluded that I wasn’t helping matters for my friend or myself. He didn’t want to change his mind or explore options. And the exchanges only served to bring me down. I let the friendship go because I needed to set boundaries. I just couldn’t spend more time with my friend. I needed to spend time around others who, while they may be in distress, want to change and heal. Or just hang out with others who enjoyed life and had never been despressed.
Bitching about the law is common fare when lawyers break bread; a midday break which leaves one with a sort of indigestion of the mind.
These brothers and sisters in arms – those who we toil beside in the legal trenches – are usually good people. But, that doesn’t change the fact that their inner discontent isn’t good for us.
We tend to hang out with the same people every day for lunch. We do so because of flat-out inertia or we just don’t know what else to do with ourselves and, well, just drift into it. I recall the times in my career when I did this too much. My cadre of complaining colleagues ramped up my stress level to the point where I felt compelled to unload. This becomes a chorus of woe because complaining just breeds more . . . complaining.
In her book The (Un)happy Lawyer: A Roadmap to Finding Meaningful Work Outside of the Law, Monica Parker, a Harvard Law graduate, recommends ditching your lawyer friends:
“I’m betting a lot of the people you know are lawyers. How many of them are happy practicing law? I can count the happy lawyers I know on one hand. How many of them are successful at finding other opportunities? Expecting these people to help you make a career change is the proverbial blind leading the blind. The miserable leading the miserable blind, actually.”
Afterward my lunches, I’d walk back to my office feeling hollow and dispirited. I kept making resolutions to not join in the negative banter. When that failed, I just decided I had to begin to break away. This involved setting up a different routine – lunch with non-lawyers, the library, church or catching up of work at Starbucks. They didn’t know why I had stopped going to lunch. But, like everything else in life, they got used to it. If I had to have lunch with them for some work-related problem, I tried to have it with only one person from this group. It was less overwhelming when dealing with only one person’s negative views on reality and gave me a fighting chance to interject some positive elements in a way I couldn’t with the lunchtime crowd. If all else failed, I e-mailed or sent memos.
Some Food for Thought
Pick a person who you admire or who has a career that they like or love. What do they like about it? Are there some habits they have which make them happy at work, even small ones, which you can apply to your law career?
Negativity feeds on itself. Notice that when you don’t join in the gripe, how it brings down the fervor of your day a notch. Moreover, when we don’t participate in it, we feel a little lighter than if we had. Try it and see for yourself.
When we are depressed, we go into a default mode. We don’t deliberate about going into a dark mood, so much as fall into it. There are so many triggers that cause depression that we can feel we’re being shot at from all sides. We commonly succumb. The time to work our way through this swamp is not when we’re under depression’s spell. We must prepare beforehand. Write it out a self-care plan which includes positive people.
One thing that I’ve found particularly helpful is a reminder from my psychologist that we’re always observing ourselves as we behave. For example, when we work out, we observe ourselves doing something good for our body. Not participating or setting limits on colleagues dumping their negativity on us makes us feel more in control of our life and positive. This simple approach can dispel the hopelessness that so often accompanies depression. Another why of skinning the cat of depression – which requires more practice than getting to the gym for most of us – is to describe the good parts only when you are talking about situations. In her book The 10 Best-Ever Depression Management Techniques, Margaret Wehrenberg writes:
“Get into the habit of reviewing what went right in any situation – observe what worked out fine despite stumbling blocks along the way. For people with depression this may take some practice! You are probably accustomed to instead focusing on what went wrong. But ignoring what satisfies you can be a trigger to depressed mood. So learn to rate your experiences of what went right rather than on what went wrong.”
Finally, think about joining a depression support group. While people can and do talk about difficult and sometimes painful things, the emphasis is a constructive one – learning to deal with your law job in a more constructive way so as not to facilitate a depressive episode or getting support in coming out of one. It’s important to join one because depression can be so isolating. Being part of a group teaches you that other people understand and truly care about you. You can find a lawyer support group near you by contacting your state’s Lawyer Assistance Program. If your community doesn’t have one, or you’d rather not go to a group with other lawyers, check out the Depression and Bipolar Support Alliance website which has support groups all over the country.
Search out warm hearts and contented others whether in the law or not. They’re out there. Your happiness depends on it.