I find writing about depression for lawyers a delicate balancing act. On one hand, I don’t want to pull any punches about just how awful depression is or how adversely it can affect your life and career. On the other hand, I want to offer hope and encouragement to those who are in the trenches and deal with it every day. I will try to do both today.
I have been encouraged by some to write only “positive” articles about dealing with depression. But I just can’t do that. To not deal with the more troubling aspects of depression seems to me a form of denial. The other day, I was at my local bookstore checking out the Self-Help section for any new titles on depression. Some of the titles seemed like they were being pitched by used car salesmen: “Overcome Your Depression in 30 Days!” This doesn’t help the conversation about depression because it sets up ludicrous expectations in the minds of those who suffer from it and their loved ones about the speed of recovery. For many with depression, they’re in it for the long haul.
One of the hardest parts about dealing with depression on a daily basis is its seemingly unpredictable nature: When is it going to start again and how long will it last?
Elizabeth Wurtzel, author of the best-selling book, Prozac Nation, gets it right when she wrote:
“That’s the thing about depression. A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it’s impossible to ever see the end. The fog is like a cage without a key”.
Many, many lawyers go into a mode of survival waiting for a depression to end. To me, the degree to which such a depression can create catastrophe in our lives as lawyers seems driven by the episode’s severity: is it a tropical depression or a full blown hurricane?
If it a low to medium grade depression, tools like Cognitive Behavioral Therapy (“CBT”) are very helpful. With CBT, we work in therapy to replace destructive, depressing, negative self-talk with positive, healthy and realistic self-talk. The efficacy of this approach has been studied and documented using PET scans of the human brain. Such scans show that an area in the frontal cortex (the thinking part of our brain) is hyperactive in depressives before CBT and then calmed down after successful CBT treatment. This same area of the brain is activated when people do self-referencing [relating external events, particularly negative ones, to the self] and depressives do too much of this. They spin around in a cycle of negative thoughts and try to use the cerebral cortex to snap out of their depression. With CBT, they learn to decrease their self-reference to the things that are negative. It’s a form of rehabilitation of the cortex where depressives learn to turn the volume down.
This is a critical skill for lawyers to develop. According to psychologist, Martin Seligman, author of the best-selling book, “Authentic Happiness,” lawyers are pessimists. They develop thinking habits which see problems as permanent and intractable. They also feel an overdeveloped sense of ownership or responsibility for such problems. Optimists, on the contrary, see problems as temporary, solveable and not necessarily their “fault”. The important point here is that optimism is a skill that can be developed and practiced. Read Seligman’s chapter, “Why Are Lawyers So Unhappy?”
If it is a deeper depressive episode, more like a trough of despair, CBT won’t work very well. During such an episode, there is the sense that it’s never going to end. Yet, this is the distorted voice of depression talking because for the majority of people with depression, IT DOES END. The trick is to learn how best to weather the storm.
I find that when I am in a deeper depression, I need to go outside my mind and get into my body. Consistently, the things that helped me the most were the following:
1. It’s virtually impossible to feel depressed while exercising and even for a good period of time thereafter. The problem, as most of us know, is getting to the gym or the park. Behavioral prompts can help. Always have your gym gear in your car. Also, be realistic. Remember that it takes at least 21 days to form a habit. So, those first 21 days won’t be the easiest ones. Tell your family and friends about the importance of exercise to you and have them support and remind you about this on a daily basis.
2. Cut off any unnecessary negative input in your life during these times. Don’t listen to any sad music, watch violent T.V. shows or read somber books. This isn’t a forever type of deal. Think of it more as a “timeout”. Some people stop reading the newspaper during an episode as well. Also, the time you’re not doing these activities gives you the time that you’ll need to exercise.
3. See a massage therapist. Touch has a powerful effect on the human body and is known to cause the release of endorphins (the feel-good chemicals). It doesn’t involve any thinking on your part. For busy lawyers, it’s a time to relax and receive something positive for the day.
Remember to be kind to yourself today.