Catch a depressed mood the way you catch a cold? Not exactly . . . but similar. Can other people really be a source of the rising rate of depression in the United States? The scientific evidence suggests the answer is yes. Our social lives play a huge role in how we think and feel. After all, none of us are immune to the influence of others, for better or worse. How we react to others, and vice-versa, even has a measurable biological impact on our brain chemistry, as our newest brain research shows us. The evidence is rapidly mounting that depression is about much more than just an individual’s “bad chemistry.” Thinking of depression as a brain disease is proving to be too one-dimensional a perspective.
For attorneys, appreciating the social connection to depression is vital if the person is to be viewed – – and responded to – – realistically. Why are attorneys depressed? Go beyond biology as the cause and consider that law is a profession that:
• Often requires engaging in stressful, conflictual relationships.
• Often pressured by important and inflexible deadlines.
• Often is devalued by the general public and even may be misunderstood by friends and family.
• Often brings you into contact with some of the worst aspects of human nature.
• Encourages hazardous self-sacrifice for “the cause.”
• Encourages deceiving others as well as one’s self, a moral compass, in the push for maximizing billable hours.
• Demands full commitment to making efforts to achieve things one has no control over.
• Encourages rumination, a poor coping mechanism.
• Can sometimes be almost as costly in winning as in losing, increasing uncertainty about what’s best.
• Can be as emotionally high and low as professional sports (“the thrill of victory . . . the agony of defeat.”)
The social aspects of depression have been too long ignored in favor of biological explanations. It would be more helpful to come to terms with the reality that no amount of medication will make potentially depressing situations, like the stressful aspect of practicing law, go away.
The rising rate of depression is not unique to either Americans or lawyers, lending further support to the growing recognition of depression being spread across boarders through social means. Through the studies of cultures, families, and the social lives of depressed people, we have learned a great deal about the social transmission of depression. Negative people can bring us down and good relationships involving an enduring commitment can bring us up. We have also learned how children model their parents in unexpected ways that increase their vulnerability to depression. Thus, in a purely social sense, depression is contagious.
The World Health Organization (WHO) is the international watchdog of health issues around the world. Recently, WHO declared depression the fourth greatest cause of human suffering and disability in the world (behind heart disease, cancer and traffic accidents). The WHO statement tells us how prevalent and how serious depression is right now. Even more troubling, though, is the WHO prediction that by the year 2020 depression will have risen to become the second greatest cause of human disability and suffering. It is a safe prediction for WHO to make, for we already have a half-century worth of data showing that depression has steadily been on the rise for decades.
By focusing on biology alone, as we have done when we talk about chemical imbalances in the brain or calling depression a “disease,” the social dimension has been all but ignored. This allows the social conditions that cause and exacerbate depression in many people’s lives to go unaddressed. Drugs alone cannot address the social factors that underlie depression, a likely reason that drug treatment alone (without additional skill-building) has the highest rate of relapse of any form of intervention. Just as there will never be a pill that can cure our other social issues such as poverty or racisim, there will never be a pill that will cure the depression that is associated with challenging life conditions. This is not to say biology doesn’t matter. It clearly does. But to focus on biology to the exclusion of life’s circumstances, especially the social ones, that lead people in general, and attorneys in particular into depression, is missing a vital target of intervention. Too often, well-intentioned doctors write a prescription for an anti-depressant medication but go no further into treatment. The evidence is growing that this practice is, to put it mildly, less than ideal.
The new understandings about the prominence of social forces in depression require we as mental health professionals to change some of what we do as we try to educate people about depression. The familiar phrasing that suggests “depression is a serious medical illness requiring medication” is an educational approach it that clearly doesn’t work very well. Most of the attorneys who are depressed don’t seek help. For some, it’s because of the stigma of seeking help for an emotional disorder, but for others it’s because they simply don’t think of themselves as “diseased.” They may feel stressed, unhappy, overwhelmed, trapped, or hopeless but they don’t consider themselves “depressed.” In fact, most of the attorneys who suffer depression, still manage to function despite their condition. They show up for work, they give their clients reasonably good legal advice, they get their briefs filed on time, and they participate in family events. But, they are struggling to get through each day. They are what many clinicians refer to as the “walking wounded.”
We can do better than suggest to people they’re diseased and need drug care. Who can do more than continue to push the one-dimensional biological explanation at people for their depression? We can help them understand that depression is caused by many contributing factors of which some are indeed biological, while others are rooted in individual psychology (such as your temperament and style of coping with stress) and social psychology (such as the quality of your relationships and your culturally acquired views). Striving to convince people they’re diseased doesn’t empower them to actively change their lives in meaningful ways. We can teach better relationship skills, better problem-solving skills, better decision-making skills, and better ways to cope with an increasingly complex world. We can teach attorneys-to-be while still in law school how to develop realistic perceptions of life as a lawyer so they won’t get so disillusioned they flee the practice of law so soon after graduating. These are just some of the skills that have not only been shown to reduce depression, but even to prevent it.
Editor’s Note: Michael D. Yapko, Ph.D., is a clinical psychologist and depression expert from Fallbrook, California. He is the author of Depression is Contagious: How the Most Common Mood Disorder is Spreading Around the World and How to Stop It. For more information visit his website at www.yapko.com.
