Tackling Depression in the Workplace

I recently interviewed a friend and former co-worker who lost a career and a 13-year job due, in large part, to a bout of severe depression and anxiety that was not being managed well by her behavioral health specialist. This friend has depression in her family and had been through several depressive episodes in her life, but had come out of each of them with a combination of medication, support from friends, therapy, and self-exploration. In her 30+ years of working, she had never before lost a job because of her mental health issues.

Prior to this episode, she had been widely praised at her company for over a decade, and most of the time had received praise, bonuses, and regular raises. Her social security reports showed a steady upward trend in her compensation over the years that she had been in the workforce, the way it was supposed to. She felt she had done well professionally.

But then, things got hard. She had just left an abusive relationship, and the combination of trauma and her genetic predisposition to depression had sent her into a spiral of sometimes-suicidal depression, for which she sought professional help.

Attorney Mental Health and Wellness

Great podcast interview with Florida State Law Professor Larry Krieger expounds upon why Attorneys often struggle with depression and the wellbeing factors that may lead to satisfaction in a legal career.  Listen here.

What Resilient Lawyers Do Differently

Paula Davis-Laack, a contributor who writes about stress-resilience, burnout and well being at work discusses how the ability for lawyers to adapt to a changing workplace environment is essential for resilience.  Part of the challenge of doing so involves greater flexibility in how lawyers approach problems, receiving criticism constructively and developing positive working relationships with your colleagues.  Read the article here.

How to Prevent Stress From Shrinking Your Brain

 

Have you ever felt so stressed out and overwhelmed that you can’t think straight? We now know that prolonged stress or trauma is associated with decreased volume in areas of the human brain responsible for regulating thoughts and feelings, enhancing self-control, and creating new memories. A new research study, published in today’s issue of Nature Medicine, is a first step in uncovering the genetic mechanism underlying these brain changes.

Depressed People’s Brains are More FragmentedIn this study, conducted by Professor Richard Dumin and colleagues from Yale University, scientists compared the genetic makeup of donated brain tissue from deceased humans with and without major depression. Only the depressed patients’ brain tissues showed activation of a particular genetic transcription factor, or “switch.” While each human cell contains more than 20,000 genes, only a tiny fraction of them are expressed at a given time. Transcription factors, when activated, act like light switches, causing genes to be turned on or off. This transcription factor, known as GATA1, switches off the activity of five genes necessary for forming synaptic connections between brain neurons. Brain neurons or nerve cells contain branches or dendrites that send and receive signals from other cells, leading to interconnected networks of emotion and cognition. The scientists hypothesized that in the depressed patients’ brains, prolonged stress exposure led to a disruption of brain systems involved in thinking and feeling. Depressed brains appeared to have more limited and fragmented information processing abilities. This finding may explain the pattern of repetitive negative thinking that depressed people exhibit. It is as if their brains get stuck in a negative groove of self-criticism and pessimism. They are unable to envision more positive outcomes or more compassionate interpretations of their actions.

Glucocorticoids Damage Brain Neurons 

The stress response involves activation of a brain region known as the amygdala, which sends a signal alerting the organism to the threat. This results in activation of the HPA (hypothalamic-pituitary-adrenal) axis and release of a cascade of hormones, including cortisol, widely regarded as the quintessential “stress hormone.” While short-term cortisol release prepares the organism to sustain “fight or flight” and fend off an attacker, long-term exposure appears to cause brain neurons to shrink and interferes with their ability to send and receive information via branches called dendrites. In animal studies, under chronically stressful conditions, glucocorticoids such as cortisol can remain elevated for long periods.

Traumatic Experiences Can Shrink the Hippocampus in Those Who Don’t Recover

This finding is another piece of the puzzle regarding how stress and prolonged distress may impair our ability to think in creative and flexible ways. Research in both mice and humans has demonstrated an association between stress exposure (foot shock in mice, life events in humans) and shrinking of the hippocampus – the brain center responsible for forming new, time-sequenced memories. Studies in women with PTSD resulting from childhood sexual abuse and Vietnam veterans with PTSD have shown 12-26 percent decreases in hippocampal volume, relative to those without PTSD. In another study, patients recovered from long-term major depression showed a 15 percent decrease in volume of the hippocampus, compared to non-depressed patients.

Major Life Stress Damages the Prefrontal Cortex

In addition to hippocampal shrinkage, major life stress may shrink brain neurons in the Prefrontal Cortex (PFC), the brain area responsible for problem-solving, adaptation to challenge, emotional processing and regulation, impulse control, and regulation of glucose and insulin metabolism. In a study of 100 healthy participants conducted by Dr. Rajita Sinha and colleagues at Yale University, and published in the journal Biological Psychiatry, those with more adverse life events had greater shrinkage of gray matter in the PFC, compared to their less-stressed peers. Recent major life events, such as a job loss, make people less emotionally aware while life traumas, such as sexual abuse, seem to go further, in damaging mood centers that regulate pleasure and reward, increasing vulnerability to addiction and decreasing the brain’s ability to bounce back.

Summary 

While the evidence is not yet conclusive, these studies suggest that prolonged exposure to stress can shrink the brain, both via the damaging effects of cortisol on brain neurons and by disrupting expression of genes that facilitate neuronal connections. This raises the question of whether there is anything we can do to prevent such damage. Since we can’t always control how much we are exposed to financial, relationship, or illness stress, are there preventive activities we can do to maintain cognitive resilience so we can continue to deal effectively with the stressors? It is not known if we can reverse the damage by these methods, but we may lessen it and make our brains more resilient to stress.

Brain-Enhancing Activities to Combat Stress

While the below list is not exhaustive, the three activities below have enhanced brain functioning in controlled studies.

Take a Daily DHA Supplement – DHA or Docosahexaenoic acid is an Omega-3 fatty acid that is a central building block of brain tissue. DHA is thought to combat the inflammatory effects of cortisol and the plaque buildup associated with vulnerability to Alzheimer’s disease. According to Dr. Mehmet Oz, in one study, a dose of 600mg of DHA taken daily for 6 months led the brain to perform as if it were three years younger.

Exercise Most Days – In studies with mice exercise led to a more improved performance on cognitive tasks than exposure to enriched environments with lots of activities and stimulation. Exercise leads to increases in BDNF or brain-derived neurotropic factor, a substance that strengthens brain cells and neuronal connections. BDNF is also thought to promote neurogenesis or the creation of new brain cells from existing stem cells in the hippocampus. Although these effects can’t be studied in living human brains, researchers have found increases in BDNF in the bloodstream of humans following workouts.

Do Yoga, Meditate, or Pray – These activities can activate what scientist Herb Benson at Massachusetts General Hospital calls “the relaxation response,” which lowers blood pressure and heart rate and lowers subjective anxiety. Benson and scientists from a genetics institute showed, in a recent study, that inducing the relaxation response can beneficially alter the expression of genes involved in inflammation, programmed cell death and how the body handles free radicals. The effects shown were in the same genes implicated in PTSD and depression. According to Jeffery Dusek, Ph.D., co-lead author of the study, “Changes in the activation of these same genes have previously been seen in conditions such as post-traumatic stress disorder; but the relaxation-response-associated changes were the opposite of stress-associated changes and were much more pronounced in the long-term practitioners.”

About the Author

Melanie Greenberg, Ph.D. is a licensed Clinical Psychologist and expert on Mindfulness and Positive Psychology.  Dr. Greenberg provides workshops and speaking engagements for organizations,  life, weight loss, or career coaching, and psychotherapy for individuals and couples. Visit her website: http://www.drmelaniegreenberg.biz

This article originally appeared in Psychology Today.

 

Out of the Blue of Depression

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August.

It seems like the sweet sun’s been high in a blue sky for months.

It’s steamy outside. But that’s just fine with me.  My feet aren’t cold, dark clouds don’t threaten snow, and everyone’s outside watering yards and going for walks at night.

Author Natalie Babbitt captures some of  summer’s magic when she writes:

“The first week of August hangs at the very top of summer, the top of the live-long year, like the highest seat of a Ferris wheel when it pauses in its turning. The weeks that come before are only a climb from balmy spring, and those that follow a drop to the chill of autumn, but the first week of August is motionless, and hot. It is curiously silent, too, with blank white dawns and glaring noon’s, and sunsets smeared with too much color.”

I’ve been upbeat and productive these past few months.  I wake with the light thrown through cracks in my bedroom curtains. I charge up on coffee, create a killer to-do-list, and fly out the door with a sort of crazy, off-kilter optimism.  Looking out at the sun-baked, south of France Monet-like landscape, all is good.

I am out of the blue of depression. And haven’t been in that god forsaken place since a murky week-long stretch last spring.  I am sure the stinky weather had something to do with it.  Months of accumulated winter darkness had tipped me into a dark well. Happily, it didn’t last too long.

And for this, I am grateful.

One of the things I do to stay healthy is to take time to reaffirm the goodness in my life when things are on-kilter and going well. It’s like building up a reservoir of fresh water that I can tap into when my streams run dry. I do this by taking the time to be grateful for the good people and things in my life. It warms my soul. And may even put a smile on my face.

Yes, it can be very hard to feel grateful when depressed. When in a bog of waist deep misery, it’s not only unlikely that we’ll give thanks, it might be impossible. We just can’t conjure up the goodness at such times. Everything feels like a mess.  We’re fragmented, lonely, and depressed.  There isn’t much to hope for. We sort of trudge through our days existing, but not really living.

The devil of depression seems to squeeze out all the goodness out of life. We’re left high and dry. When this happens, we need loved ones and a therapist to help us reap the goodness both past and present.  We can’t do it alone.  But when we’re feeling well, man is it a great practice.

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Here’s a neat and timely tome on this theme from humorist and NPR’s Prairie Home Companion creator Garrison Keillor:

“To know and to serve God, of course, is why we’re here, a clear truth, that, like the nose on your face, is near at hand and easily discernible but can make you dizzy if you try to focus on it hard. But a little faith will see you through. What else will do except faith in such a cynical, corrupt time? When the country goes temporarily to the dogs, cats must learn to be circumspect, walk on fences, sleep in trees, and have faith that all this woofing is not the last word. What is the last word, then? Gentleness is everywhere in daily life, a sign that faith rules through ordinary things: through cooking and small talk, through storytelling, making love, fishing, tending animals and sweet corn and flowers, through sports, music and books, raising kids — all the places where the gravy soaks in and grace shines through. Even in a time of elephantine vanity and greed, one never has to look far to see the campfires of gentle people.”

The goodness of others is grace. It’s the universe’s way of reminding us not to fret too much, that things will work out, that our important jobs are, well, just a part of life, and that uplifting fortune cookie messages sometimes do come true.  If I could, I would stick this quote by author Anne Lamott on one of those skinny wrappers:

“I do not at all understand the mystery of grace – only that it greets us where we are but does not leave us where it found us.”

Think of the kind people you’ve had in your life from your past and today; the everyday saints who were dropped into your life for no other reason than to remind you that life can be good, that you are special and that life is worth living.

These people always leave us feeling better than when they found us.

Take the time today to reflect and take in the goodness in your life.  Depression may be part of your life.  But it isn’t the whole enchilada.

There is always the other side of the coin.

And it’s sweet when we think about it.

By Daniel T. Lukasik

Further Reading:

The Neuroscience of Why Gratitude Make us Healthier by Ocean Robbins in the Huffington Post.

How Gratitude Combats Depression by Dr. Deb Serani in Psychology Today.

9 Ways to Promote Gratitude in Your Life by Therese Borchard at Everyday Health.

 

Four Things Resilient Lawyers Do Differently

From the website Law Practice Today: “Resilience has a strong protective function. You need resilience to effectively tackle everyday hassles like managing your workload, dealing with opposing counsel, or working through a challenging situation with your significant other. You also need resilience to bounce back and grow from the big stuff like losing a big client, a death in the family, or divorce. Lawyers who develop resilience skills gain many benefits.” Find out 4 things you can do to build resilience. Read the Blog

How People Become Resilient

Maria Konnilova writes in The New Yorker magazine, “Resilience presents a challenge for psychologists. Whether you can be said to have it or not largely depends not on any particular psychological test but on the way your life unfolds. If you are lucky enough to never experience any sort of adversity, we won’t know how resilient you are. It’s only when you’re faced with obstacles, stress, and other environmental threats that resilience, or the lack of it, emerges: Do you succumb or do you surmount?” Read her Article

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