The 10 Best-Ever Depression Management Techniques Archives

Depression and Loss of Energy: A Waiting Game

Reversing the downward spiral of depression takes less energy than you think.

Depression and loss of energy — it is the beginning of a waiting game that does not end well.

Sometimes depression is born from loss of achievement, loss of goals, and loss of positive feelings about oneself. When low energy plays a role, a person who is not blessed with high drive and physical energy can see a spiral into depression start quickly. But even people with more energy lose it while bearing the weight of the losses. And, without a lot of energy, people begin to wait for things to get better around them rather than take action to make a change.

The Downward Spiral

Spiraling — the word makes it seem like a gentle way to go down, but when it comes to depression, going down is hard to stop, and once at the bottom, reversing the spiral takes intention and support. I hear about this often from my younger depressed clients — those adults who started out of high school or college ready to be successful but who found the world did not fulfill the vision they had.

Jeremy (not his real name) was one such young man. He never had to work too hard to get a passable grade point and was popular enough to have a solid romantic relationship. He was ready happy with his life. But, as commonly happens, the college romance did not last, which made him feel down in the dumps. Then the company he worked for, facing hard times, cut his hours. He now did not earn enough to live on but he expected the company, not himself, to change and he took no action. He waited for work to increase his hours, but in the meantime, he felt like a failure, and the waiting sapped him. His self-esteem, already suffering from being single again, took another hit as he saw his money dwindle to nothing. He started to isolate himself from friends without funds for fun and without a date to go along. Waiting was his enemy. Without meaningful activity beyond limited work hours, that isolation increased his depressed mood.

Waiting also intensified the mental and physical fatigue, so he slept later in the morning since he did not have to get to work early. He began to think he had a lot of time every day to work on his situation, so he did not start on possible job hunting and, as the day melted away, it was too easy to let himself decide that tomorrow was a good day to start fresh. But that waiting also increased his fear that nothing could change and his mood became very depressed. That depression and his situation robbed him of the very things he needed to reverse the spiral: meaningful work (purpose, as well as money), positive interactions with others, pride in his achievements, sense of competency, and a feeling of being loved.

This spiral is one I have seen repeatedly in young adults who have not met with easy success out of high school or college. They often did not have to work at jobs during those years to obtain phones or cars or clothes or do costly activities, such as attend concerts or sporting events. One young man I worked with as he finished high school, Casen (again, a pseudonym), felt literally terrified of applying for a part time job so that he could begin developing job skills and a resume and have some spare cash. Without classroom demands, he moved into waiting mode: waiting to apply to community college, waiting for a job that might fall into his lap. (The job that a friend would provide not that Casen would go search for since the friend said he could get his boss to hire Casen). Waiting did not bring him the job or the college acceptance letter, and he felt even more scared and more depressed. And he judged himself rather mercilessly: believing he would never succeed. That negative mindset robbed him of even more energy, and the more time he spent watching shows on his laptop, the less energy he had to reverse the downward spiral to depression.

What can be done about this? It is typical that an outside force will help. If you are reading this you might be saying to yourself phrases like, “Yeah — the outside force of getting evicted or starving! That would work!” If so, you would be correctly identifying motivators! At times, though, a person in a downward spiral ends up living with family or friends who are being helpful to them in averting disaster, but the pattern of waiting on something outside themselves does not change until motivation can pick up.

Reversing the Downward Spiral

How is it possible to reverse the spiral? Raising energy is a primary initial goal — with or without motivation. To start the spiral on an upward trend, simply:

Stop telling yourself negative things: you only reinforce the belief they are true. Interfere with negativity, saying, “Stop! I choose to believe I will solve this!”

Stop isolating. Get in contact with people, any interaction with others will help you also get outside of your own negative thoughts or mood.

Stop talking about your own life for a short while. When you only ruminate on your troubles, they seem larger. Ask someone else about his or her life. Hearing about another’s life, you can look at your reactions. I love the saying that troubles shared are cut in half and joys shared are doubled.

Then start the upward spiral with attention to developing a sense of purpose. Don’t assume this is a deep spiritual quest. In fact, it can be initially as simple as scheduling your day and meeting some regular commitments. An important brain change toward a less depressed mood occurs results from intentional activity. You get a blip of glutamate, an activating neurochemical, and one of dopamine, the feel-good neurochemical, and the combination is energizing. The bigger the step you take, the more you get. And any action will supply enough energy to do a little more.

My Tips

If you are underemployed — set a daily schedule that begins with a reasonable wake-up time.

Have a pattern to the day what news show you listen to or watch when you have your coffee when you feed a pet or meet a friend for tea.

Leave the house — you might have to start with leaving your room and interacting with others in your home- but forcing yourself toward less isolation is important.

At work, be sure to talk to your colleagues and ask them how they are; It improves the chance of a positive social exchange that can increase your self-esteem a bit and moves the spiral upward a fraction.

Set small goals — like walking the dog an extra 5 minutes — and notice you achieved them. There’s a bit more glutamate and dopamine!

Do something physical. When you move your depressed body you gain energy rather than lose it, so even a few minutes of tidying up can raise enough energy to do a bit more.

The above ideas tend to work best when you are working with another person who supports you, such as a therapist, a 12-Step sponsor, or a good friend who knows your goals and will help you keep track of them.

As you stop the waiting game — that passive waiting for life to change without you doing something to change it — the spiral reverses. You will be surprised that you will slowly feel your energy rise so you will be more able to take the next steps toward success.

By Dr. Margaret Wehrenberg, Psy.D.

This article first appeared in Psychology Today website.

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

Worry and Anxiety in Depression: Anxiety May Try to Help, But Then it Hurts: What Should You Do?

Anxiety is a normal human feeling.

Anxiety is what you feel when you are faced with uncertainty. When you do not know what is going on or what you should do about it, you react with a feeling of anxiety.

What makes anxiety pass? Resolving the ambiguity. Figuring it out. What’s happening or what to do about it. Then the feeling is gone, and you are relieved. You may still have work to do or a problem that needs to be fixed, but the anxiety about it is finished.

When people suffer from depression they often also feel anxiety and spend too much time worrying, which increases their depression. The parts of their brain that are involved in that normal reaction to ambiguity are working overtime. And the thinking brain, low on energy due to depression, cannot stop that worry train. When they worry too much and can’t exert enough control, then the feeling of anxiety persists beyond any situation that includes some uncertainty. In fact, the anxious feeling can be present before any uncertainty. Then it creates the nagging sense in your gut that something is wrong, so your helpful brain, the one that wants an explanation for every feeling you have, goes on a search to figure out what might be the source of that anxiety.

Because the natural response to anxiety is to try and figure out what to do, you may start to think over all the possible reasons you could feel worried, and you will inevitably find one. When you are depressed your brain generates too many negative thoughts and cannot effectively shove them aside. You can get stuck in a loop of worrying one worry after another. However, because real problems are not the reason you have the sensation of anxiety, you either think and rethink in an effort to get relief or you move on to yet another worry. Thus: rumination and “serial worrying”, hallmarks of anxiety fuel depression.

There is a lot you can do about this. You can use your brain to change your brain. Here are 2 ideas to start out:

1. If it is a real problem, you will not fail to notice it: In your “thinking brain” you can assess if the problem you are worrying about is a real problem. If it is not a real problem (perhaps just a potential problem) you can decide “not to believe everything you think”. This is a conscious, determined choice to disbelieve the sensation of anxiety that feels so real. In its place you put an intentional more positive thought: You are competent to know when you have problems that need attention. Then you move your thoughts along to something more positive.

2. Stop and Interrupt: You will also have to use your thinking brain to stop and interrupt the worrying. As they say in the 12 Step programs, this process is simple, but it isn’t easy. You must plan what you prefer to think about on a daily basis and then when the unnecessary worry pipes up, you stop, interrupt yourself, and replace it with the preferred thought. The hard part is doing this every time an anxious feeling creeps in or a worry pops into your head.

There are many ways to use your brain to change the brain. Learning various methods and putting them into place starts a process that is the first step to lifelong change. You might need some outside help to achieve this persistence in the face of such distress, but controlling anxiety is doable over time. As you get more control of anxiety, your depression will diminish too.

Margaret Wehrenberg, Ph.D.
Author of The 10 Best-Ever Anxiety Management Techniques and The 10 Best-Ever Depression Management Techniques

Dan’s Latest Top 10 Book Recommendations on Stress, Stress-Management and Anxiety

Over the years, I’ve read too many books to count about stress, anxiety, and depression. Like most people, I’m always looking for tips and clues about how to handle things better.

Some of these books have turned out to be real stinkers. Others, retreads of books and articles that have said the same things over and over again.

I have found some gems, though. Books that have something original to say, or are well-written.

I’ve found that the most useful ones make me want to read them further after the first 25-pages, or so. Good rule of thumb.

I hope you find help, hope, and insight between their pages.

Manage Your Time to Reduce Your Stress: A Handbook for the Overworked, Overscheduled, and Overwhelmed — Rita Emmett

The title of this book grabbed my attention because it seemed to capture so much more than just stress management. Stress management is truly about managing being overworked, overscheduled, and overwhelmed.

According to the author, the key is not time management but “stuff management — taking control of all those tasks to do, people to see, commitments and obligations to fulfill. Mismanagement of all that “to-do” stuff is what leads to stress. Emmett combines quick, easy-to-digest tips and infectious good humor to give readers positive ways to handle stress and their overly busy lives.

You can also check out her website for other helpful tips and ideas.

Monkey Mind: A Memoir on Anxiety — Daniel Smith

I first read about Smith’s book in a New York Times article called “Panic Buttons“. This memoir on stress and anxiety is not only informative and insightful, it’s well-written and funny.

The long list of things that, over the years, have made Daniel Smith nervous includes sex, death, work, water, food, air travel, disease, amateur theater, people he’s related to and people he’s not related to, so the prospect of a book review probably wouldn’t seem like a very big deal to him. Or would it?

This fleet, exhausting memoir, is an attempt to grapple with a lifetime of anxiety: to locate its causes, describe its effects and possibly identify a cure. Or, if not a cure, at least a temporary cessation of the worry that’s been plaguing him since his youth.

Check out his website, The Monkey Mind Chronicles, for more interesting stuff.

Hardwiring Happiness: The New Brain Science of Contentment, Calm, and Confidence — Rick Hanson

Rick Hanson, Ph.D. is a neuropsychologist and best-selling New York Times author.

Hardwiring Happiness lays out a simple method that uses the hidden power of everyday experiences to build new neural structures full of happiness, love, confidence, and peace.

In an interview discussing the book, he states:

“So, how do you get good things—such as resilience, self-worth, or love—into your brain? These inner strengths are grown mainly from positive experiences. Unfortunately, to help our ancestors survive, the brain evolved a negativity bias that makes it less adept at learning from positive experiences but efficient at learning from negative ones. In effect, it’s like Velcro for the bad but Teflon for the good.

This built-in negativity bias makes us extra stressed, worried, irritated, and blue. Plus it creates a kind of bottleneck in the brain that makes it hard to gain any lasting value from our experiences, which is disheartening and the central weakness in personal development, mindfulness training, and psychotherapy”.

Check out his website for more information about the book and his suggestions.

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.

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?

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!!!”

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. Check out his website.

A Mindfulness-Based Stress Reduction Workbook — Bob Stahl

The author writes that the key to maintaining balance is responding to stress not with frustration and self-criticism, but with mindful, nonjudgemental awareness of our bodies and minds.

This book employs some of the same mindfulness strategies discussed in Full Catastrophe Living but does it in the format of a workbook. I find this format very helpful because it’s practical and gives me exercises to do to put into practice mindfulness to reduce my daily stress load.

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

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.

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 stress and 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.

What books would you recommend? Hit the comment button and submit your favorites.

Next Steps:

If you are interested in talking to Dan about CLE eligible trainings he offers law firms, call him at (716) 913-6309 or via our contact form. One-on-one coaching is also available for lawyers who need individualized attention. Go to Dan’s website Yourdepressioncoach.com to download his free book and schedule a consultation.

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.

Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness – John Kabat-Zinn, M.D.

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 21^st 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.

Things Might Go Terribly, Horribly Wrong: A Guide to Life Liberated from Anxiety – Troy DuFrene

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

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.

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

HONORABLE MENTION

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.

Lunchtime

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.

Tag: The 10 Best-Ever Depression Management Techniques

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