Sometimes the ache is dull, other times sharp. It can last a few hours, days, or weeks.
This is ground zero for depression sufferers. What can I do to feel better?
The answer is often elusive. Many don’t know where to get help, let alone walk the path of healing. Recovery starts and sputters for others: they feel better on a med, then it stops working. Or, they start a bold new exercise regimen, only to see it fizzle.
What to do?
There is no one-size-fits-all cure for depression. That what makes it so exasperating. It isn’t like having a bad cold where Nyquil will do the trick for most. Rather, depression is an illness of the body, mind, and soul that doesn’t lend itself to simple fixes. Because we’re all humans with bodies and brains, some things will generally work for everyone; exercise comes to mind. But because we’re also unique, we need a tailored recovery plan to get and stay better.
Medical News Today reports on a series of new studies bring yoga one step closer to becoming a recommended treatment for depression, after finding that the practice can help to reduce symptoms of the condition. Read the article. Read the article.
I’ve struggled to write this blog, just like I’ve struggled to do most things for what amounts to a very long time now-so long that it feels like a lifetime and what came before only fragments of a not well remembered dream. In actual temporal time, it’s only a few years of melancholy and moderately severe major depression. But in the life of the mind, there is an unbridgeable chasm between the person I am now, who I once was, and who I want to become. I am so lost in my isolation that my only refuge is in turning inward; a strategy which offers no solace at all-only shame and regret.
I feel so isolated. I suppose that is one of the hallmarks of mental illness – detachment – that it seems impossible to relate to anyone. Furthermore, I’m not an attorney, just someone who has lived the hells and wonderful peaks of manic depression. My exposure to the law is through my father, my uncles, my cousins, and Dan Lukasik. I hope to go to law school one day, but I need to retake the LSAT first. So why write a blog? What good could it possibly do? Hopefully, some of the sentiments I describe will resonate with you. But hope is fickle; a thinly stitched veneer stretched tautly over an ever-widening mire of unfulfilled promise. When I look back at what I hoped for, most of it has faded into the mists of time with barely even the trace of memory or, worse yet, has been completely buried beneath the scars of regret.
In the face of my futility, my stupidity, my selfishness, my demons, hope that I can one day return the love and support that has been given me has allowed me to trudge on, kept me from giving up. Even if it flies in the face of all rational thinking, experience, and who you believe you are the sole advice I would deign to give is to no never give up hope that you can bring yourself to a better place and can make yourself into the person you wish to become. Though there be no reason to believe, allow belief to inspire you all the same.
“I can only stand apart and sympathize/ For we are always what our situations hand us/ It’s either sadness or euphoria.”
The above is a stanza from Billy Joel’s song “Summer, Highland Falls” that has always resonated with me. The song itself captures the sense of helplessness, at times even ironic apathy, I have felt towards a disease (or mental illness or whatever I should call it) that has allowed me to leap through the heights of “euphoria”, and to spiral down into the depths of suicidal depression, seemingly completely independent of any of the external aspects of my life.
I once told a friend that in the past three months I had had at least 45 “perfect days” (i.e., days that I could not imagine being any happier in), but that 45 was a conservative estimate and it was probably more. I’ve also spent weeks on end consumed by vivid images of ways in which I could gruesomely kill myself. And both of these emotions, which at the time feel so pervasive and all encompassing, occurred while living on the same college campus and surrounded by many of the same people. So it’s hard not to “stand apart and sympathize” with the fact that regardless of daily accomplishments or minor setbacks, or even in the face of significant change, it doesn’t matter what you do. That because of who you are, in a very intimate and fundamental sense, you are going to experience “either sadness or euphoria,” and you have little say in how intensely you are going to experience that emotion, or for how long (so let’s hope its euphoria, and it lasts forever).
This complete lack of control has always weighed on me as a moral failure because I’ve recognized what I consider the best version of myself-productive, engaged, intelligent, charming and yet, due to an inherent weakness, have been unable to maintain that persona consistently.
Instead I, and I would like to emphasize the contradiction and confusion surrounding a feeling at once of helplessness and simultaneously of complete responsibility for being who I am, have eventually always succumbed to periodic bouts of anxiety, negativity, and self-doubt. These periods have always been characterized by an intense sense of isolation in which almost palpable barriers are restricting me from coming into touch with the people and events surrounding me while at the same time engaging/suppressing the most endearing aspects of who I would hope to be as a person.
There are two types of sadness which result from this frustration and alienation.
There is a horrible, painful sadness. For me, this type of sadness is expressed through intense suicidal ideation-constant mental images meant to shock the senses into an acknowledgment of how base you are. Brutal beatings, stabbings, gouging’s, hangings. It consumes you until the idea is all there is and it takes every ounce of energy you have to beat it back. And it breaks your heart to see someone you love not to be able to say that this is how you feel, and it’s not their fault, but you are worlds away and mired in a sadness/loathing that is impossible to understand for those who have not yet experienced it. And they love you, so they are trying to understand, but, how could they? And this breaks your heart even more.
And there is also a beautiful, cleansing sadness. For me, this beautiful sadness feels more real than anything in the world. When I have been at the height of mania-during the happiest times of my life, I have still felt intimately in tune with songs that deal with regret-juxtaposing the inadequacy of the self with the intrinsic sublimity of some other-which you have failed.
There is a powerlessness to this beautiful sadness, an inevitability. It is real because it exists at the core of our most vulnerable selves, and therefore its expression comes out at a time when we are “most alive” and most in tune with our emotional intuition-when we are most ready to admit to and grasp on to that which we truly hope for and believe in. This sadness is not manifested in horrifying suicidal ideations but rather in the awe-inspiring idea that we are not worthy of the wonderful phenomena we call life. That we are ashamed of our ugliness amidst so much beauty and yet, in spite of our baseness, we have the opportunity to exist within as well as work towards some greater good.
In many senses, for me, the mania of bipolar has been synonymous with stripping away the debilitating fear and anxiety which were so constricting for so long, and a constant struggle has been not to glorify it. My Mom is taking a wonderful self-help course entitled “Fearless Living” and those two words, again from my experience, imbibe what it means to be manic or hypo manic; imbued with amazing amounts of self-confidence and gratitude, it’s unbelievably easy to live a carefree, upbeat, happy-go-lucky lifestyle, all the while being extraordinarily productive. Thus thinking in the binary can be dangerous-there is a natural tendency to see every aspect of the mania as better than every aspect of the depression.
However, beyond the fact that I have never been able to sustain mania, there is also a depth of feeling engendered by the sincere melancholy of depression that I have never encountered in the euphoric whirlwinds of mania. And I think the small silver lining to what is a dark cloud is the depth of meaning such great sorrow can expose you to-in a way an almost redemptive suffering. At the very least, though depression has taught me to hate myself many times over, it has also taught me to love life. The sad beauty of such a self-effacing distinction, to hate your being while loving your existence, is something to be thankful for and, hopefully in time, something to build off of for the future.
I would like to close this blog with what have for me been some solid building blocks for sheltering myself from, coping with, and eventually recovering from depression.
When there seems to be nowhere to turn and the prospect of getting through the day seems unbearable, working out and (especially) yoga exercises are blocks of time where you don’t have to interact with other people, can be totally in your head, and when you’re done you feel a little better physically, even if not mentally. Really any small thing that you can do consistently and through which you can mark progress-I’m getting stronger, better endurance, or greater flexibility-is a wonderful way to establish extrinsic markers of success-I’m better at this than I was a few weeks ago, which, in turn, can catalyze good feelings about yourself as a person.
Think of something you’ve always wanted to do or be good at, and then identify manageable steps that you can take on a consistent basis that gradually takes you towards your goal. Don’t say I need to be as good as someone else or make an arbitrary benchmark-rather say I want to get in better shape relative to how I am right now, so I’m going to run or go to yoga more often. Or I’ve always wanted to know how to tie my flies, shuffle a deck of cards, play an instrument, or speak a foreign language, so I’m going to work on this task a few minutes each day as opposed to watching TV or surfing the web.
Taking little steps like these that are working towards longer goals, even if you are not aware of any specific professional or extrinsic benefits to achieving those goals, can be inherently rewarding in and of themselves. If you’re better at an activity, any activity, then you were a few weeks ago, that can be one small thing that you feel good about, even as the rest of your world remains shrouded in darkness. It can help motivate you to get through the day, can serve as a spring towards other “productive” behavior, and eventually be something you can hang your hat on. However, it’s important not to beat yourself up after a day in which you failed to take your positive “step”-rather have a little self compassion and say tomorrow is a new day, and it’s not the end of the world, indeed its completely ok, that I wasn’t able to do anything “productive” today.
Finally, reading and writing can be extremely cathartic. Reading great literature can give you an emotional connection to characters, ideas, and feelings during a time when you felt completely isolated and estranged from the outside world. Fiction and non-fiction distract you from the constant stream of negative and self-critical thinking that can paralyze you. And, in a way similar to the steps discussed above, finishing a book you’ve always wanted to read or one on a subject that you’ve wanted to know more about, can generate a (no matter how small) sense of accomplishment that, no matter how insidiously it attempts to, the depression cannot take away.
On the other hand, for me, writing is more of a risk. I can be very critical of myself as a writer-a case in point is this blog which has been taxing at times-and sometimes end up feeling worse after sitting down to write. At other times, writing has been akin to therapy in that it has helped me to sincerely articulate-in the best way I know how the complex matrix of emotions enmeshed within me. Even if journaling or poetry don’t make sense to a single other person, the fact that they make sense to you can temporarily relieve part of the burden imposed by self-guilt and personal shame. It can be an outlet for your anguish, space where you can be authentically yourself. Sometimes, you can be so overwhelmed by your depressive thinking that you need some way to release that thinking-writing can be an effective way to do this.
In any case, don’t immediately sit down and assume that because of your depth of feeling you’re going to write the next great American novel. Rather start with a paragraph or a poem. It might end up being useless junk that you never look at again, and that’s ok, because part of what depression is, is a needless anguish and self-doubt that is inhibiting you in your quest to live a full life and should be discarded as soon as possible. But amidst the uselessness you may stumble upon small snippets of truth-a rhyming couplet here, a few sentences there-that satisfactorily express for you one of the tragic and meaningful aspects of your condition (or symbolically the human condition more generally). These small snippets are worth holding onto as they reflect the deeper truths embedded within a malaise that so often brings us to our knees and which, on sublimely rare occasions, reveals insights that one (I believe) can only obtain through suffering.
New research finds that a breathing-based meditation practice helped alleviate severe depression in people who did not fully respond to antidepressant treatments. Investigators from the Perelman School of Medicine at the University of Pennsylvania discovered breathing practices associated with Sudarshan Kriya yoga significantly improved symptoms of depression and anxiety. Read the Story.
Depression blogger, Therese Borchard makes a great list of things you can do in addition to therapy and medication, such as yoga, alternative forms of medication, and eliminating foods and substances that trigger inflammation. Read her Blog
Carrie: I felt that the solutions out there for people with anxiety and depression were partial solutions, incomplete remedies. The way we live now causes stress for many people – the pace, the lack of rest or leisure, the relentless striving. Our technological, cerebrally focused culture has taken us out of our bodies and ourselves. Addiction to devices causes an imbalance and a malaise. When you are tied to a device 24-7 you may not be experiencing the fullness of all 5 senses, the things that make you feel energized. The primal satisfaction of making things and using the hands are slowly slipping away from us. For wellbeing, we have to make a conscious effort to maintain them. When my patients make and fix things, they feel better. Research shows that manual effort and creativity are antidotes for malaise. The Creativity Cure was written to help people find another way.
Dan: I deal with lawyers with depression and other professionals that are on their phones and computers a lot. What kinds of things would you recommend that they do with their hands for physical?
Carrie: It’s about getting out of your head. There are many cerebrally oriented people, but “ I think therefore I am” (Descartes) may not be the answer in the current culture. It is really becoming I think therefore I’m not. Too much thinking at the exclusion of physical and manual activity can make us depressed. Physicality, creativity and using your hands – – cooking or washing cars or crafting, painting walls or using watercolors — honor anatomical intent. Long ago manual action in everyday life was necessary for physical survival. Now we need these actions for psychological survival.
The need to create is primal. Paint a wooden board or do Legos with your child. Do that thing you were always drawn and do it clumsily, imperfectly. You don’t have to have any experience as an artist or a maker of things. You don’t have to have a fine result. You can just explore, begin and build. The beauty is in the inner experience. Research has shown that meaningful hand use decreases depression.
Dan: In your book, write about the unconscious mind. What do you mean by that?
Carrie: The unconscious mind, the deepest most hidden layer of our mind houses our , primal self, our instincts, our intuitions and our truth. The unconscious is a treasure trove of clues about our natural self, our unique self. We can get in touch with the deepest layer of our mind via dreams and seemingly random thoughts. Noting where our minds naturally drift helps us learn about where we need to be and what we need to do. The unconscious is a very powerful resource.
Dan: What is our unconscious trying to tell us for people who suffer with anxiety and depression?
Carrie: Depression can have many different causes: biological, situational, genetic or hormonal. It can also be the result of trauma. Self-knowledge and insight – knowing what resides in your unconscious mind – helps with depression because as the saying goes, the truth sets us free. Talking to a pastor or a mental health professional can elucidate information that moves you forward. Understanding yourself: who you really are, what your instincts are or what you are actually upset about is key for positive change. Sometimes you think your concern is one thing and your deeper self tells you that it is another. Following unconscious clues helps you live more truthfully and happily.
Dan: You mentioned “clues” from the unconscious. Can people that are dealing with anxiety and depression unearth these clues themselves? If a person did receive such clues, how would a person know, without talking to a therapist, know what to make of these clues?
Carrie: Writing is helpful. Keep a journal. Take walks, try yoga, breathe, self-reflect, fiddle with paint, doodle, just let. Important material bubbles up when your mind slows down. Be curious and wonder, “Who am I that I love that, what does this leaning say about me, how can I this passion be part of my regular life?” Paying attention to the feeling that accompanies certain thoughts can help you. Certain involvements can make you unhappy but they are habitual so you just keep on. Acknowledging your true inner responses enables you to change. Breaking through denial is key.
Dan: In my work helping lawyers with burnout, anxiety and depression, many of them that seem to contact me are middle-aged. Do you find that a lot of the people, the clients you see are coming to you in midlife?
Carrie: Yes, and midlife can be the best time of life. Loss and disruption, while initially causing depression or anxiety, can lead to positive inner transformation. If we learn to seek pleasure, solace or a feeling of elevation from friendships, family, creativity, and tending to those we love, we are empowered. If you are dependent on an outside institution for your self-esteem, you are less in control of your life and more vulnerable. Define yourself; don’t let it come from the outside.
Dan: I’d like to follow up on a point you make in your book when you talk about people not being in contact with their physical bodies and a visceral since of being alive. I spoke recently with Richard O’Connor, a psychologist in New York City who wrote the book Undoing Depression. He said that depression really wasn’t really about the emotion of sadness – – but about the absence of all emotion. Is that something that you see with the depressed patients you treat?
Carrie: I think it was Andrew Solomon, author of The Noonday Demon: An Atlas of Depression, who offered that beautiful juxtaposition: the opposite of depression is vitality – – not happiness. That really captures it.
Dan: In your book you make a distinction. You indicated that The Creativity Cure is a good fit for people with mild to moderate depression anxiety, but maybe not major depression. Why?
Carrie: For those who suffer from major depression and feel that their depression is well managed, The Creativity Cure is a great option for finding more vitality. Those who at baseline have mild to moderate depression and find that meds do not help enough can discover ways to unleash creativity and happiness in the book. It takes some motivation, but once you get going, you will have more energy and a greater number of happy moments.
Dan: What percentage of your patients would you say depression plays a role in their maladies for which they’re seeing you?
Carrie: Eighty percent.
Dan: Wow – -that many. And to actually put The Creativity Cure into effect, how long do you generally work with somebody to get to the point where they can do it on their own?
Carrie: We start right away by finding out as much as we can about who that person is and what makes him or her feel alive. We think about what is working and what is not, why certain choices were made and ways to redirect the self. Through the Five Part Prescription: Insight, Movement, Mind Rest, Using Your Own Two Hands and Mind Shift people can uncover their true leanings and find more vigor, inspiration, passion. For positive change, integrate the methods into your lifestyle over several weeks. Little steps! True change is all about a little at a time and building.
Dan: In your career as therapist, have you treated lawyers with depression?
Carrie: Yes, yes.
Dan: Have you found anything about their life style that contributes to their depression?
Carrie: I think its three things for lawyers, especially those in high-pressure positions. My client Marnie comes to mind. She is a 28 year-old lawyer who has to give up her personal life at the drop of a hat when she is needed. It is tough. Number one, she is often exhausted because 17 -hour days are not uncommon. Number two, there is a lack of autonomy because this 17 -hour day can be thrust upon her at anytime and continue for weeks. Marnie, professional, committed and with good attitude, has to be available in the moment, late nights, on weekends.
But, compliance takes a toll. It makes her depressed to be in the office and not see sunlight. Not being in control of her time is hard. Even if the work is interesting, she has to give up other important involvements. Marnie feels lonely and isolated because she has little opportunity to be with old friends or to develop new ones. We are working on ways she can maintain friendships, even in text message or email shoot-outs if an in- the- flesh visit must be delayed.
Number three is that living in your head all the time, no matter how brilliant you are, is not healthy. Smart as a whip with facts and numbers, Marnie garners much more pleasure from aesthetics. She likes design but has not felt free enough to develop this interest. Colors, shapes, proportions – thinking about these things makes her happy. It is a sensual, visual way of moving through the world. A big part of the treatment is making her interest in design part of her ongoing life.
I think lawyers in general are really smart people who are great at using their minds. They have been reinforced for this all their lives, but for a richer, higher, happier state, many of these cerebral people need to get out of their heads and start using their hands. Go into a creative world. Balance mind, hands and body.
Dan: I have given many talks around the country on the topic of lawyer and one of the things I like to say is that lawyers have the most active fantasy lives of most professionals I’ve ever spoke to, where they dream of doing something else than lawyering. Can those be clues that would fit in with The Creativity Cure?
Carrie: Fantasizing is a sign of mental health. It’s a good thing. Learning about your inclinations through daydreams might lead you to change your life in a big way or make it better in small ways. Tiny steps allow for big changes because they foster consistency and this builds a new self in a solid way. If you’re interested in learning how to make beautiful cupcakes you can do that for an hour on the weekend. Play guitar, write poems, tend tomatoes in a vegetable garden and do it for a few minutes a day. Start small and make it part of you. Keep dreaming and keep doing. Contentment is about maintaining an identity that integrates your creative
Depression blogger, Therese Borchard writes about her recent visit to a holistic health fair and concludes that while holistic doctors and naturopaths offer valuable advice and treatment, it’s only part of a very complicated puzzle of what works for each individual. Read the Blog