A New York Times article from a few weeks ago holds enormous potential ramifications for lawyers bent over their desks at big law firms. The tentative conclusion of the piece was simple: if you are dealing with minor depression, or in fact, with anything other than massive, serious depression, popping anti-depressant pills is probably a waste of time. In fact, a placebo might do you more good.
How many lawyers are currently taking anti-depressants? According to the admittedly anecdotal evidence from the lawyers I’ve seen over the years in my private practice, quite a few.
It’s such a lawyerly thing to do. You figure out you’re depressed, so you do something about it – march over to your doctor, or maybe a high-powered shrink with a top reputation, get diagnosed, and get your pills. The whole thing takes a few minutes, and you’re back on the job. No wasting billable hours, no whining and complaining on a therapist’s couch – you take care of the problem and move on. Take a pill and knock it off with the martyr routine.
However, there are a few problems with anti-depressants…
First, like I said, they might not work. Don’t believe me? Here’s an excerpt from the article:
Some widely prescribed drugs for depression provide relief in extreme cases but are no more effective than placebo pills for most patients, according to a new analysis released Tuesday.
The findings could help settle a longstanding debate about antidepressants. While the study does not imply that the drugs are worthless for anyone with moderate to serious depression — many such people do seem to benefit — it does provide one likely explanation for the sharp disagreement among experts about the drugs’ overall effectiveness.
Second, the side-effects. This includes the “sexual side-effects” – which might mean, if you’re a guy, erectile dysfunction, and whichever gender you are, inability to reach orgasm. And there are “regular” side effects, too – like weight gain.
Third, anti-depressants only work while you’re on them. I’ve heard of people staying on anti-depressants for decades, but I have no idea what the long-term effects are because no one knows. If you’d like to experiment on yourself, I’m sure the pharmaceutical industry would be fascinated to find out.
Fourth, to the extent they do work, it’s by erasing feelings. Anti-depressants tend to narrow the bandwidth of what you feel, chopping off the top and the bottom – no more highs, no more lows. That can bring relief, but at a cost.
Fifth, other than the vague explanation that they “affect neurotransmitter levels,” no one really understands how they work. Anti-depressant medications, especially the new generation of drugs, are a relatively recent development, and the exact mechanism that produces the results isn’t fully understood.
Is there another option?
Some lawyers are skeptics when it comes to psychotherapy.
I’ll quote from a comment on AboveTheLaw.com from one of my earlier posts:
This guy [The People's Therapist] gives me even more reason to think that therapists are disgusting creepy slimeballs. They think that they somehow have this unbelievable god-like ability to get inside your mind and make everything all better. They have all the answers, if you’ll just let them in. Gross. These people are god-complex freaks. Would never go to a therapist, ever.
Well…okay. A good therapist welcomes authentic feeling.
And maybe this writer’s got a point. Even if pills aren’t the answer – why would anyone want to visit a slimeball like me?
The short answer is that, while no psychotherapist has a god-like ability to get inside your mind, if he’s properly trained, he will know what he’s doing, and he can help. Psychotherapy is an effective treatment, especially for depression.
Depression is caused by bottled anger. If you are a depressed patient, a psychotherapist will use interventions with you designed to encourage you to talk, and keep talking, in a way that expresses that bottled anger. Before long – I guarantee it – you’ll see affect restored, and a more authentic, happier self emerge.
Just feeling the right to express emotions you didn’t realize you were holding inside can have a strong healing effect.
It’s not a pill, like in Alice in Wonderland or The Matrix. But psychotherapy doesn’t have to take forever, and you’ll probably feel better after the first session.
So ask yourself why you’re so distrustful of someone whose job is to listen to you and actually hear what you’re saying. Would that really be so bad?
Maybe no one’s ever done it before – so you don’t trust anyone ever could.
That’s understandable. It’s something you could work on in therapy.
[Editor's note: this piece is part of a series of columns created by The People's Therapist in cooperation with AboveTheLaw.com. My thanks to ATL for their help with the creation of this series.]
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