GPSOLO October/November 2009
I am a 47-year-old lawyer and have suffered from clinical depression for the past seven years. It is my hope that in writing about my experiences, I will reach those who need to get help and those who should not give up.
Depression is not just a problem in our profession—it’s a five-alarm fire. Studies suggest that lawyers suffer from depression at a rate double that of the average American. There have been a variety of explanations put forth to explain these statistics, including the idea that the type of people who go into law are prone to depression. Other theories focus on the external demands on lawyers that leave them stressed out, burned out, depressed, and addicted. I believe that the problem stems from a combination of all these factors and, accordingly, recovery involves a mix of healthy strategies.
What Is Depression?
Depression is not about “feeling blue” or having a tough day. It is an illness. Whether its causes are genetic or environmental, we still end up in the same place: Depression has a dramatic effect on the human body, mind, and spirit. There are seven symptoms associated with clinical depression. You only need four of these symptoms for at least two weeks to be clinically diagnosed:
- Weight gain or weight loss
- Trouble sleeping—either too much or too little
- A slowness and/or heaviness in your physical movements or agitation
- Fatigue or loss of energy
- Feelings of worthlessness or excessive guilt
- Diminished ability to think, concentrate, or make decisions
- Recurrent thoughts of death or suicide, suicidal ideation, or an attempt at suicide.
My own journey with depression began when I turned 40. At that point, I had been a litigator in a high-stress job for 15 years. I had always felt the heat of stress, but I just assumed it came with the territory of the job and helped motivate me to do better. Over time, my fear turned into anxiety. I just couldn’t shut off the fear-provoking thoughts and feelings I had as I ground out my daily workload. Eventually, the anxiety turned into something else. I began feeling tired all the time. I felt like cement was running through my veins. I had sleep disturbance and would overeat, numbing myself in front of the television. I felt sad all the time, with little apparent reason to feel that way: I had a wonderful wife and family and a great job at a good law firm.
I started seeing a psychologist, and when I explained my thoughts, he said, “Dan, that’s the depression speaking.” He suggested I see a psychiatrist, and I did. When I arrived at the doctor’s office, I quickly went to the waiting room, hoping no one would recognize me. The room was huge. There was one elderly man sitting in the corner. I took off my overcoat, slumped into my chair, and sighed. I felt like the loneliest person in the word. The psychiatrist saw me and told me that my fatigue and sadness were owing to the fact that I had depression and would need medication. “It’s no different than suffering from diabetes and needing insulin,” he assured me. There was a biochemical imbalance in my brain. I left content that at least I knew what was wrong with me. I had an illness—an illness that could be treated.
I decided that I had to tell my three law partners that I would need some time off to allow the medication to kick in. I felt guilty about this; after all, I was the managing partner at the firm. I was supposedly a superhero, a problem solver who fixed other people’s lives. I wasn’t supposed to be the one with a problem, the one who felt vulnerable and broken. In a quaking voice, I told my partners about my depression and how serious a problem it was. One partner turned to me and said, “What in the world do you have to be depressed about? You have a beautiful wife, family, and a great job here. Just go on vacation!” His angry and incredulous voice made me feel six inches tall. One of the other partners, smiling, confidently said, “Dan, at 95 percent, you are better than any lawyer I know.” Both of these reactions, I would later learn, are typical. The first partner’s exhortation to remember the good things that I had in my life didn’t help. It just shamed me. His line of thinking was: “If only you were more grateful for what you’ve got in your life, you wouldn’t be feeling this way.” Yet, I had repeatedly told myself how much I had to be grateful for. This technique fell on depression’s deaf ears. The second partner’s reaction was an attempt to minimize the problem. The thinking here was: “Things aren’t so bad. You’ll be a little down, take some time off, and then be back, good as new.” I told him that I wasn’t at 95 percent—I was at 10 percent.
So I took the time off. The drug made me feel numb and zoned out. After a month, I returned to work and slogged through my days for another year. Then I tried changing medications—an experience with which veterans of depression are well acquainted. The new medication lasted about three months. It produced great states of anxiety. I remember driving home from work on a beautiful summer’s day and feeling as though my body was on fire. That led to a third medication. This prescription seemed to do the trick, and I am still on it. It has been supplemented with another medication, but I feel that this cocktail has largely squashed the worst parts of depression. Yet, I sense that the depression is still there. It is as if it calls to me from a great distance, affirming its continued, albeit weakened presence. The medication, however, keeps it at a distance and protects me.
I must say that medication was just a partial answer. It didn’t fix my depression. It did calm my mind and bodily symptoms so that I had the energy to start examining what else was going on in my life that contributed to the depression. In therapy, it became clear that my thinking was garbled. My psychologist calls it “twisted thinking.” A depressive distorts reality with his or her depressive thoughts. Because depression is such an isolating and lonely condition, these thoughts often go unchallenged. We need a skilled and caring therapist to help us confront this negative self-talk and replace it with more healthy, positive, and self-caring thoughts. For example, I used to think—perhaps 50 times a day—“nobody cares about me.” Yet, if I actually looked at my life, this really wasn’t true—not even close. I had to learn to embrace the people in my life that really cared about me. They simply didn’t know about the depth of my pain because I hadn’t let them in to see it. I didn’t give them the opportunity to care about me. Men, in particular, have a hard time expressing themselves, fearing that they will appear as “losers” or “whiners.”
Turning It Around
A lawyer with depression used to call me once a month and tell me about all the problems in his life. This went on for a year. I listened and then the conversation ended. Yet, nothing changed for him. Eventually I said, “Bob, what are you willing to do to change your life?” He seemed surprised by the question. He never called back.
If you want to start thinking about healing, perhaps this is a good place to start: Ask yourself what behaviors you are willing to change or what new behaviors you are willing to engage in to help yourself get better.
In her book Listening to Depression: How Understanding Your Pain Can Heal Your Life (Oakland, California: New Harbinger, 2006), psychologist Lara Honos-Webb presents depression as not just an “illness” but as a wake-up call, a signal that we have been traveling down paths in our lives that have been unfruitful. She encourages us not to see depression as just a disease, but as an opportunity to change our lives. There is something in us, if we would only listen, that is telling us that we are killing ourselves. We often don’t listen, so that voice turns up the volume until we get sick with anxiety and depression. Or heart disease, hypertension, and cancer. As lawyers, we are experts at looking at problems from an analytical angle. When we turn that powerful lens on ourselves, seeking to “solve” our depression, it just doesn’t work. The habits that got us into trouble with depression can’t get us out.
In his book Authentic Happiness ( New York: Free Press, 2002), Dr. Martin Seligman has a chapter entitled “Why Are Lawyers So Unhappy?” He says that one of the reasons is a “pessimistic explanatory style” that lawyers learn beginning in law school. Such pessimists have an underlying attitude that their experiences will usually (or always) be negative, and they also believe failures are their fault. Such pessimistic thinking has been linked to depression. Contrast this with optimists, who believe that positive outcomes are the result of their efforts and that more positive things will happen in the future.
After we have been diagnosed with depression, we can evade responsibility for our own recovery. Some time ago, I was in a great deal of pain. I was crying, telling my therapist that my depression wasn’t going away despite my sincere efforts. I felt punished by my depression. He gently told me, “Dan, you haven’t done anything wrong. You’re doing it to yourself.” This can be a turning point with depression. When we stop letting it victimize us, we take responsibility for getting better and start behaving/thinking in constructive ways. What can lawyers do about their depression?
- Get help. You can’t handle this by yourself. It’s not your fault. It is a problem bigger than any individual person. There are lawyer assistance programs in most states that can get you started in the right direction, provide resources, and help you with referrals.
- You may have to take medication to help you. That’s okay. You may have a chemical imbalance that you need to address. For many, psychotherapy won’t help until they quiet down their somatic complaints so that they can have the energy and insight to work on their problems.
- Whether you need medication or not, you will need to confront your negative thinking with a therapist. You really can’t do this effectively with friends or family alone. A lot of research suggests that cognitive behavioral therapy is a particularly effect form of treatment for depression. Also, I recommend interviewing a couple of therapists before you settle on one.
- Exercise. The value of exercise is widely known: It’s simply good for everybody. For a person with depression, it becomes not just about a healthy habit, but about a critical choice. In his book Spark: The Revolutionary New Science of Exercise and the Brain ( New York: Little Brown, 2008), Harvard psychiatrist John Ratey devotes a whole chapter to the importance of exercise in treating depression. Please check this book out.
- If you have a spiritual practice, do it. If you don’t, think about starting one. This could include anything from a formal meditation practice, going to Mass, or walking in the woods. A lot of research suggests that people who do have a spiritual practice do better with depression. If you believe in God or a higher power (I am Catholic), you can avail yourself of help and support from someone who is bigger than your depression. If you do not believe in God, maybe you believe in some other form of spirituality you can tap into. Spiritual growth and development, in my opinion, are important pillars of recovery.
- Join a support group. I started a lawyer support group in my community, and it has been going strong for two years. It can be invaluable in helping you to see that you are not alone and that others share in the very same struggle.
- Get educated. Read some good books on the topic. As part of your education, learn about the powerful connection between stress, anxiety, and depression. On this subject, I recommend Dr. Richard O’Connor’s Undoing Perpetual Stress: The Missing Connection between Depression, Anxiety and 21st Century Illness ( New York: Berkley Books, 2005). O’Connor proposes that depression is really about stress that has gone on too long. The constant hammering away of stress hormones on the brain changes its neurochemistry. This can and often does result in anxiety disorders and clinical depression. I list a number of other great books on my website, www.lawyerswithdepression.com. The site also offers guest articles, news, podcasts, and helpful links for lawyers.
- Build pleasure into your schedule. As busy lawyers, we have the “I will get to it later” mentality—especially when it comes to things that are healthy for us. We have to jettison that approach. We must begin to take time— now —to enjoy pleasurable things. A hallmark of depression is the failure to feel happiness or joy. We need to create the space where we experience and savor such feelings.
- Restructure your legal practice. Nobody likes changes. Lord knows, I don’t. Yet this pointer falls into the category of “what are you willing to do?” Maybe you will have to leave your job. Stressful? Yes. The end of the world? No. Maybe you will have to change careers. I have spoken to many lawyers who haven’t been particularly happy with lawyering since day one. But they kept doing it because they didn’t know what else to do, lawyering paid a good buck, they didn’t want to seem like a failure, they were in debt, etc. I am not trying to minimize these very real concerns. However, your good health (as I learned the hard way) has got to reestablish itself as a top priority in your life. I changed the nature and variety of my practice and am the better for it. I do less litigation. As a consequence, I have less stress, which has been long known to be a powerful trigger for depression. It can be done.
- Practice mindfulness. In mindfulness meditation, we sit quietly, pay attention to our breath, and watch our thoughts float by in a stream of our consciousness. Normally, we would immediately react to our thoughts (e.g., “ I will never get this brief done”), but through mindfulness meditation we learn—slowly—to let the thoughts and feelings float by without reacting to them. If such an approach to depression seems far-fetched, read J. Mark G. Williams’ compelling book, The Mindful Way Through Depression : Freeing Yourself from Chronic Unhappiness ( New York: Guilford, 2007), for an excellent primer on how you can incorporate mindfulness into your day. The technique has proven to be a very useful way to help with depression.
- Remember to be kind to yourself. It sounds so simple. I tell this to depressed lawyers and they look puzzled. They have rarely if ever thought about it and don’t know how to be kind to themselves. I believe that it first begins with a conscious intention—“I am not going to treat myself poorly anymore.” Such a simple refrain can help us. Depression is often built on poor mental/emotional and physical habits. We must learn to acknowledge that we are worthy of love from ourselves and others and that part of such love involves taking care of ourselves.
Daniel Lukasik is a managing partner at Cantor Lukasik Dolce & Panepinto in Buffalo, New York. He is listed in the publication The Best Lawyers in America and is the recipient of many awards for his work in assisting lawyers with depression. He may be reached at email@example.com or via his website, www.lawyerswithdepression.com.