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Posts Tagged ‘depression’

dan_avatar_small (1)My friend, Dan Lukasik, who created the Lawyers with Depression website, asked me to post some information on his up-coming webinar, on Friday, February 7th, 2014 at 3 p.m. (E.S.T.), for lawyers with depression. I’ll let Dan take it from here:

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Are You a Lawyer Who Has Problems Getting Things Done When Depressed?

If you’re a lawyer who struggles with depression, you’re not alone. Studies show that lawyers suffer from depression at a rate twice (20%) that of the general population. When put in perspective, that means that 240,000 of this country’s 1.2 million lawyers are struggling with depression right now.

These findings are not about sadness, the blues or even burnout, but true clinical depression. According to the Mayo Clinic, to be diagnosed with major depression by a health care professional you need to have some of the following symptoms most of the day, every day:

Feelings of sadness, emptiness or unhappiness

(more…)

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I received a letter regarding trauma and grief:

Can you explain the long term effects of psychological trauma? Four years ago I experienced two deaths in my family, sudden deaths by accident. I’ve never suffered from depression before the deaths of my kids, but truthfully just haven’t really bounced back as much as I’d have liked to.

I’d be interested in hearing what your thoughts are on depression after a traumatic death/grief and if that trauma makes one more susceptible to depression in general, what if any are other factors involved- (a second opinion if you will)? My therapist mentioned medication recently as a possible option since I have experienced two bouts of depression lasting three and five weeks respectively both occurring since Christmastime.

What factors should I be considering in making my decision regarding medication?

Thanks,

J

Here’s my answer:

To submit a question to Ask The People’s Therapist, please email it as text or a video to: wmeyerhofer@aquietroom.com

If I answer your question on the site, you’ll win a free session of psychotherapy with The People’s Therapist.
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Please check out The People’s Therapist’s new book, “Way Worse Than Being A Dentist: The Lawyer’s Quest for Meaning”.

I can also heartily recommend my first book, “Life is a Brief Opportunity for Joy”.

(Both books are also available on bn.com and the Apple iBookstore.) 

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I get asked this all the time:  “What if it’s only chemical?”

Good question.  Why talk to a therapist if you can take a pill and be done with it?

Freud was intrigued by the possibility.  According to Peter Gay, in Freud’s late work, “Outline of Psychoanalysis:”

“[he] speculated that the time might come when chemical substances would alter balances in the mind and thus make psychoanalytic therapy, now the best available treatment for neuroses, quite obsolete.”

It’s appealing to treat mental illness as a chemical problem because chemistry seems clean and precise.  The fundamental functioning of the brain is both chemical and electrical, based on the difference in potentiality between sodium and potassium.  No problem.  You identify an imbalance, add ingredients, stir, and restore order.

But there is a problem.  The brain is also a ball of flesh, soaking in countless compounds we scarcely comprehend.

Injecting a drug – one more chemical – into your bloodstream is a primitive way to fine-tune complex chemistry.

That’s why psychiatric drugs are most effective when blunt, simple results are called for.  They can slow you down.  They can speed you up.  They can numb you or narrow your emotional bandwidth.  If you are bi-polar, they may help stabilize your emotional swings.  If you are psychotic, they may bring you back to reality, or at least closer to it.

For subtler changes in brain chemistry, talk therapy – or maybe talk therapy in tandem with a drug treatment component – produces better results.

How could talking in a therapist’s office affect the chemistry of the brain?

Your emotions are chemicals.  When you feel angry, your amygdala, a region in the center of your brain, releases a chemical signal.  That chemical – or series of chemicals, is what you experience as “anger.”  Joy, fear, sadness – all the emotions you feel as fundamental responses to the world around you – are chemicals.

Your thoughts are also chemicals.  When you admire a sunset, you are releasing chemicals which trigger electrical impulses that race through the circuitry of your brain.

Your thoughts affect your emotions.  So if I can affect  your thoughts, I can affect the chemicals triggering your feelings.

The brain is extremely mutable – neural pathways can be rerouted.  If I can make you aware of your thoughts and feelings, I can reroute the neurons in your brain, so different chemicals are released.

This isn’t as far-fetched as it sounds.  Here’s an example:  If you are depressed and I tell you to go for a run because it will cheer you up, I’m not merely nagging.  Aerobic exercise releases endorphins in your brain.  These chemicals cheer you up, relieving depression.

In the process, you will also create a memory – a piece of stored chemical information – that links depression with going for a run and feeling better.  A faint, newly formed neural link, and a piece of memory supporting that link, have been created.

Here’s another example:  if you are denying your anger – the typical pattern that creates depression – and I arrange during a session of psychotherapy for you to address your father, or your mother, or your boss or your girlfriend, and you feel anger well up and put that anger into words, saying what you’ve kept silent for years…that’s going to have effects on the chemistry of your brain.

When you get the words out, and feel your buried anger, new pathways will form between the ancient regions governing emotion in the center of the brain and more recently evolved cognition areas in the outer cortex.

New thoughts circulate new chemicals, create new memories, and effectively rewire the way you think.

You leave my office realizing you were angrier than you thought, and knowing it felt good to get it out.  You experience a lightening of mood.  Your girlfriend, when you get home, senses that you are less defended – your resistances are down.  This alters her behavior towards you, and she starts to open up to you emotionally to a new degree.  You begin questioning your old responses to her, and your old ways of doing things in general.

Your brain is flooded with new chemicals, and new pathways have been formed, that might, with further talk therapy, begin to replace old ones.

Subtle changes have been made to the chemistry of your brain – to who you are, how you think, and how you behave with others.

That’s what psychotherapy is all about:

Better living through chemistry.

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If you enjoyed this post, please check out The People’s Therapist’s new book.

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It doesn’t make sense.  You hate depression, but feeling sad can be okay – and everyone loves the blues.

That’s because depression isn’t about feeling sad.  And the blues isn’t about depression.

Depression is about regressing into a child’s way of relating to the world.  You become helpless, so you lose touch with your own anger, your ability to protest against conditions that make you angry.  Instead, you accept defeat, and turn the blame, and the anger, in on yourself.

Sadness, on the other hand, is a recognition of impermanence.  It is about accepting that life is a brief opportunity for joy.

It is far from certain that impending death intensifies the experience of living.  If no one ever died, it seems like there would be less suffering and, if certain logistical details could be overcome, things might actually be more fun.

We’ll never know the answer to that conundrum.  You may lodge a protest, but life remains short, and only rushes by faster the older you get.

On the other hand, the natural human response to that set-up is to grab what’s there and enjoy it.  Sadness – the memory of impermanence – intensifies your hurry to drink deep of  good times.  In the process, every drop tastes sweeter.

The blues are songs written about sad subjects.  The levee is gonna break.  My woman done left me. That sort of thing.

One of the saddest songs ever written is a blues song –  Son House’s “Death Letter Blues,” which begins like this:

I got a letter this mornin, how do you reckon it read?
It said, “Hurry, hurry, yeah, your love is dead.”

I could listen to “Death Letter Blues” forever.  It always makes me feel like cryin’.

But I always feel a little better afterward, too.

Why is that?

Because ol’ Sonny is sharing his pain with me.  And that feels good.  Makes us both feel better, or it did, back when Sonny was still kickin’.

Patients spend a lot of time in my office crying.  I once ran out of tissues – something a therapist should never do.  It was one of those panicky episodes, like running out of maple syrup at an IHOP.  People come to a therapist to cry.  I know I always did.

You come to have a good cry because it makes you feel better.  It feels good to open up and share the pain.

There’s another element to blues songs – the reason they’re not about depression.

The Blues fight back.  This is music that came up from African-American communities in the Deep South.  Those people knew oppression – heck, they knew human slavery.  But their souls were never dominated, even when their bodies might have been.

That’s the true history of the blues, and African-American music, period.  It’s subversive – it fights the power, stands up to the pain.  It stands up proudly.

The blues make good times from bad times.  They summon anger from fear and sadness, and in the process defeat depression.

The blues fight back by refusing to stay silent about the conditions the singer endures – poverty, loneliness and oppression.

Sometimes they fight back by refusing to lose their sense of humor. Check out Sonny Boy Williamson in “Fridgidaire Blues”:

No, but that’s alright mama, baby, I don’t like the way you do.
Well, but I been tryin’ two or three days, woman, you know, just to get rid of you.

There’s an obvious lesson here for beating depression.

Express your feelings someplace safe, and own your right to them.  You gotta right to sing the blues.

Don’t lose your ability to laugh at yourself, either.

Now – just in case you thought you didn’t care for the blues… here’s something sweet and lovely to tear up your soul:

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I’ve written a fair amount about lawyers at the office in this column.

Right now a lot of lawyers aren’t at the office.

They’re at home, out of work.

Unemployment is tough on lawyers because they tend to be pleasers – they have to be, to earn the grades to make it into law school.

It’s all about pleasing others at a firm, too. You submit to the whims of a partner and work around the clock.

Like all pleasers, lawyers get used to looking outside themselves for affirmation of their worth.

When you’re unemployed, there’s no one to please but yourself. You’re alone with you – and for a pleaser, that can lead to a plunge in self-esteem.

That’s why, during unemployment, you have to be especially good to yourself.

You can’t afford to fall into a hole right now – you need to stay strong. That means reminding yourself of your achievements – your grades, your degree, your accomplishments at a firm.

If things get truly dire – remember the bottom line: you’re doing your best. That’s all anyone can ask.

This is no time to beat yourself up. Remember to be you – your best self – the person you really are. That’s more than just a lawyer – that’s a person. Spend time with friends, and people who like you. You’re worth something and you know it – and you need all the support you can get.

You also need some time off.

The worst thing about being unemployed, as one of my unemployed lawyer clients put it, is that “when you’re unemployed, you’re always working.”

Unemployment can turn into a 24-hour/day grind. Give yourself permission to relax sometimes. Activity is important – but so is taking time off to get your head together.

Job interviews, in my experience, can be particularly difficult for lawyers.

Pleasers never learn to sell themselves – you just do what you’re told and hope good things happen.

That doesn’t work in a job interview.

You might remember those mass interviews the law school placement departments arranged back in the boom years. They typically consisted of a handshake, a dutiful glance at a resume, and a pointless chat about nothing.

Those weren’t real job interviews. Those firms were hiring your resume. They just wanted to make sure you could dress yourself. The interviewers often seemed as clueless as the candidates.

It’s different now, during a recession. You have to sell yourself actively.

That can be tough for a lawyer. (more…)

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My patient, a senior associate doing IP litigation at a downtown firm, brought me the bad news.

“I got a terrible review last week.”

She seemed calm about it, considering. That’s because she knows how law firms work.

“I’m expensive, and they’re preparing for lay-offs. So they told me I’m terrible. It was ridiculous. They made stuff up off the top of their heads.”

I had to hand it to her. I wish I could have been so cool when the same thing happened to me.

My first year review at Sullivan & Cromwell went fine. Mostly, they didn’t seem to notice me. I wasn’t important enough to review.

Then, in the second year, it was suddenly a horror show. Nothing I did was right. The partners didn’t fool around at S&C – they give it to you with a sledgehammer.

Even then, I remember wondering about that one partner who seemed to like me. Of course, he wasn’t mentioned at the review.

Years later, after I’d given up on a legal career, I realized the truth. They’d probably given identical reviews to ten or fifteen percent of my class that year. We were the ones who left. It was a lay-off. Those terrible reviews were the partners’ way of creating a paper trail in preparation for letting us go – covering their tracks in case we sued.

My patient – an experienced senior associate at her second law firm job – knew how to handle this sort of thing. You don’t let them throw you.

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