Where Are the Depressed Lawyers? #imnotashamed

The Numbers Say We’re Out There

Lawyers suffer from extremely high rates of depression and other mental health disorders. Estimates for the rate of depressed attorneys range from 2 to 3.6 times the national rate of depression in the U.S. A recent study of lawyer mental health in the Journal of Addiction Medicine found that 28% of respondents were experiencing symptoms of depression and 19% were experiencing symptoms of anxiety. Male lawyers are twice as likely to commit suicide as the general population.

I’ve seen the numbers.  I’m a lawyer. Research is what I do. So you can imagine how confusing it was last summer when I became depressed and my colleagues behaved as if they had never seen anything like this before in a law firm. They had no idea what to do with me. They kept turning to me to figure out all of the potential accommodations.

Not exactly easy to do while you’re in the throws of a moderate depressive episode. (Skip to the end of this page for a list of resources.) Continue reading

Anxiety Running Your Life? Don’t be Ashamed to Get Help #imnotashamed

I remember the precise moment I decided it was time to go on anxiety medication. It was at the end of what I’ll refer to as a month’s long, anxiety bender.

Life With GAD. Business As Usual.

If you have generalized anxiety disorder (GAD) I suspect it’s quite common to not really notice that there is something wrong. You have probably been the one friends and family say “thinks too much” for as long as you can remember. You may even view this as somehow making you superior to your peers.

I rarely viewed my anxiety as problematic. In fact, I viewed it as my secret sauce for success: my anxiety motivated me to give a damn.

When I was experiencing panic attacks in college I started to suspect that something was wrong, but that only went on for a semester or two. Many of the panic attacks involved me panicking about how I would fail at life if I stopped being anxious. Without the anxiety to motivate me I would surely fail!

Don’t ask.

Continue reading

Want to Make Your Brain Less Anxious? Try Optimism

busybrain

The human brain is marvelous. Research is showing that there may actually be feedback loops between what we think/do and the physical structure of our brain. Astonishingly, those structural changes could affect the way we think going forward.

Your brain keeps changing. It may be possible to harness that power for good!

Neuro-Acrobatics?

Ever since childhood I’ve been awe struck by the adaptability of the human brain.

My mother’s Multiple Sclerosis exacerbations and subsequent complete (or near complete) recovery always blew me away. One month she would lose her sight, be unable to use her left side, have difficulty speaking, feel that her legs were leaden. Then, a few months later, following a course of medicine and therapy, she was good as new.

I learned that her autoimmune disorder caused her body to attack and destroy the insulation for her nerves thereby weakening or completely disrupting signals from her brain to her body. But with time, her brain would find new ways to get the message out. The scars on her brain remained, but she recovered.

Incredible!

This is but one example of the brain’s neuroplasticity.  Continue reading

This Is Your Brain On Stress and Depression. Any Questions?

Remember those “brain on drugs” commercials? I think it’s about time for a discussion of your brain on stress.

Chronic Stress and Your Brain

While trying to understand how dopamine works in depression and whether there’s any useful research on anhedonia reversal (little to none), I learned that the chronic stress I experienced throughout childhood and to this day (thanks BIGlaw) has been destroying my brain. Through processes as of yet unproven and partially unknown, the brain of the chronically stressed experiences significant malfunction over time in the hippocampus (atrophy), amygdala and neuron production, which are related to anxiety, mood disorders and memory problems. The same malfunctions are observed in patients experiencing chronic depression.

If you’re one of those depressed people who has responded positively to antidepressants and/or exercise — even if not completely — then maybe the research that I’ve been reading lately will be helpful to you too.

How Do SSRIs Work?

It turns out the popular theory of SSRIs — that they essentially keep serotonin accessible in the brain longer to keep you calmer and happier — was largely debunked nearly 10 years ago. Instead, SSRIs may actually be helping the brain to heal itself, create new neurons and stop, and even reverse, atrophy of the hippocampus by helping the body create more of a protein called brain-derived neurotrophic factor (BDNF). That’s why it takes weeks to improve after you start an SSRI, rather than days (despite increased serotonin availability within hours).

What Does This Mean?

Why does this matter? Because the research also suggests that there are many ways to halt and even reverse this atrophy! It appears voluntary exercise, calorie restriction, intellectual stimulation, cumin, antidepressants and electroconvulsive therapy could all work to increase BDNF expression in the brain. Am I crazy for thinking that it’s about time I start working out daily, going on a calorie restricted diet made up of 30% Indian food and reading more interesting books?

The important thing to note here is that the jury is still out. It is not clear whether this is a cause-effect relationship or simply a random correlation. Further, it is certainly clear that too much calorie restriction, for instance, can actually lead to lethargy and depressed mood, orthorexia and other unhealthy food relationships. But in my n=1 experience, I do feel better when I exercise nearly daily, limit my food intake so that I’m never stuffed/eat when actually hungry and do work that stimulates my brain. I have had rather positive experiences with intermittent fasting as well. And look, I will take any excuse to eat Indian food. (Pass the naan!)

What Else Can We Do?

But there is something else. Something that’s potentially more important for mental health over the long haul. If the cause of these troubles is chronic stress — which I’m still struggling to manage — then the highest long-term priority of those suffering from depression should probably be to learn and utilize better coping strategies. Learning to both minimize stress where possible, and process it and expel it from the body in effective ways may be protective against future depressive episodes.

Maybe stress management and increased BDNF production are the keys to recovering from depression now and helping to prevent its recurrence — for good.