MENTAL HEALTH AWARENESS 101:
BATTLING BURNOUT AND
DEPRESSION
Presented by the
American Bar Association
Division for Public Services,
Commission on Lawyers Assistance Programs,
Solo, Small Firm and General Practice Division,
Center for Professional Responsibility,
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This publication accompanies the audio program entitled “Mental Health Awareness 101: Battling
Burnout and Depression” broadcast on April 18, 2016 (event code: CE1604FSS).
TABLE OF CONTENTS
1. Presentation Slides
2. Mental Health Awareness 101: Battling Burnout & Depression
Daniel T. Lukasik
3. Why Are Lawyers So Unhappy?
Martin E. P. Seligman
4. Undoing Depression in Lawyers
Richard O’Connor
5. How to Create a Depression Support Group
Daniel T. Lukasik
6. Dan’s Recommended Books on Depression
7. Dan’s Recommended Books on Stress and Anxiety
8. Dan’s Recommended Books for Lawyers
1
Welcome
Mental Health Awareness 101:
Battling Burnout and Depression
Jeena Cho, Attorney, JC Law Group PC
Tabitha Hochscheid, Principal, Hochscheid & Associates LLC
Roueen Rafeyan, Medical Director, Resurrection Health Care
Daniel T. Lukasik, Managing Partner, Bernhardi & Lukasik PLLC
Register for more FREE CLE
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Presented By:
Daniel Lukasik
Tabitha M. Hochscheid
Roueen Rafeyan
Jeena Cho
Husband, father, lawyer,
compassionate, empathetic,
hard working, businessman,
peacemaker, fixer, and friend
to everyone.
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Depression is a silent epidemic within our
profession.
Everyone knows a colleague, a classmate or
friend who either left the profession because
of mental health, developed an dependency
issue or committed suicide.
It is accepted as it has “always been this way”
or those are “weak people”.
It is time to face these issues head on.
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We are a profession of fixers
Adversarial nature of the law
The lack of control of results
The idealism of right vs. wrong
We are often dealing with high emotions from
our clients and co workers
We do battle with opposing counsel and with
our partners.
We are introspective
Stress and Anxiety is inherit in our profession
Depression is a brain disorder in which
feelings of sadness, loss, anger, or frustration
interfere with everyday life for a longer period
of time.
1 in 10 people suffer depression at any time
in this country.
Lawyers are 3 times as likely to be depressed
than the general population.
Depression costs lives and money
After his death it was clear that Ken had some
of the classic depression symptoms.
 Anxious
 Feelings of hopelessness or pessimism
 Feelings of guilt, worthlessness, or
helplessness
 Irritability, restlessness
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Loss of interest in activities or hobbies once
pleasurable, including sex
Fatigue and decreased energy
Difficulty concentrating, remembering details,
and making decisions
Insomnia, early-morning wakefulness, or
excessive sleeping
Thoughts of suicide, suicide attempts
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Self care – eat well, sleep, exercise, learn
coping skills or techniques to calm stress
Care for others – express concern for your
colleagues if you see someone struggling
offer them help or guidance.
Refer Colleagues to Lawyers Assistance
Programs they are confidential
Be proactive don’t wait until the person has
ethics or substance abuse issues to do
something.
Do provide support; if a person is depressed
they need their friends, visit ask what you can
do to help.
Our industry needs more local resources and
support for lawyers.
The CBA Health and Well Being Committee
was created to provide information and
resources to local attorneys we are here to
help.
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Depression is an illness. It is not a mood, or
a choice. Your brain is ill.
Depressive illnesses are disorders of the
brain. MRI images show differences
Some types of depression tend to run in
families. We all learn ways of coping from our
families some of those may include
depression.
Medication helps many depressed people.
Medication and cognitive behavioral therapy
works even better
Depression symptoms differ depending on
the individual. One may work more while
other one has extended absences.
People with depression can be very strong. It
takes a lot strength to function with
depression
People who are depressed may not label it as
depression. They may focus on the systems
and not put them together as depression.
LAWYERS ASSISTANCE
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Ohio Lawyers Assistance
Kentucky Lawyers Assistance
ABA CoLAP Cafe
ABA Commission on Lawyers Assistance Programs
LEGAL BLOGS OF NOTE
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Lawyers with Depression
Lawyers Well Being
Sober Lawyer
GENERAL MENTAL HEALTH WEBSITES
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National Institute of Mental Health
Substance Abuse & Mental Health Services Administration
American Psychology Association
PsychCentral
Psychology Today
Daniel T. Lukasik
Managing Partner
Bernhardi & Lukasik PLLC
Why Are Lawyers So Unhappy?
One factor is a pessimistic outlook defined not in the colloquial sense (seeing the glass
as half empty) but rather as the pessimistic explanatory style. These pessimists tend to
attribute the causes of negative events as stable and global factors (“It’s going to last
forever, and it’s going to undermine everything.”)
The pessimist views bad events as pervasive, permanent, and uncontrollable, while
the optimist sees them as local, temporary and changeable. Pessimism is maladaptive in
most endeavors.
But there is one glaring exception: Pessimists do better at law. Pessimism is seen
as a plus among lawyers, because seeing troubles as pervasive and permanent is a
component of what the law profession deems prudent. A prudent perspective enables a
good lawyer to see every conceivable snare and catastrophe that might occur in any
transaction. The ability to anticipate the whole range of problems and betrayals that nonlawyers are blind to is highly adaptive for the practicing lawyer who can, by so doing, help
his clients defend against these far-fetched eventualities.
If you don’t have this prudence to begin with, law school will seek to teach it to you.
Unfortunately, though, a trait that makes you good at your profession does not always make
you a happy human being.
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Cluster of Symptoms :
- Fatigue
-Physical Symptoms
-Insomnia
-Poor performance
-Forgetfulness/impaired concentration
- Depression
-Anger/ irritability
-Cynicism and Detachment
-Anxiety
-Loss of Appetite
Is a disease state manifested by
2 weeks of either feeling depressed or anhedonia
along with 5 of the following symptoms:
- Loss of Appetite/ weight Loss
-Insomnia or Hypersomnia
-Psychomotor agitation or retardation
-Fatigue or loss of energy
-Feelings of worthlessness or excessive or
inappropriate guilt
-Diminished ability to think or concentrate or
indecisiveness
-Recurrent thoughts of Death
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Reviewed Symptoms should not be due to
direct effects of drugs and alcohol.
Symptoms should not be as a result of an
underlying medical condition
-Affects approximately 14.8 million American
adults in a given year (6.7 percent of the
population)
-Median age of onset 32
-Twice higher in women. Life time prevalence
rate 20-26% women, 8-12% men
-Leading cause of disability in US for the ages
between 15-44 (2004 data)
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Increase mortality
- Increase risk of suicide , 2/3 of all suicides in
US are due to depression
- For every 2 homicides committed in United
States there are 3 suicides.
-Increase risk of Heart attacks by 4 fold, and
increase risk of death following heart attack.
- Increase incidence of Diabetes
- Increase risk of Cancers
-Increase risk of Strokes
-Increase risk of Substance Abuse
BETTER LAWYERING
THROUGH
MINDFULNESS
1. Understanding Stress & Anxiety
The Stress
Response
In Case of
Emergency
Working With
Stress Response
●
●
●
●
Stop
Take a breath
Observe
Proceed mindfully
2. What is Mindfulness?
What It Is, What It Isn’t.
Big concept
Mindfulness:
Being in the present
moment without
preference or judgment
Your mind
Does it feel like this?
Present
moment?
What does that mean?
Mindfulness
□Paying attention to life =
Increased enjoyment
□Being present: connected to
the here and now
□Basis for insight — provides
clearer vision (“sight”) or
what is within
□React vs. Respond
□Accepting what is
Let’s
Practice
thanks!
Any questions?
You can find me at
Twitter: @jeena_cho
[email protected]
?
Thank you for joining us
Register now for the upcoming program in the series!
Ferguson’s Fault Lines:
The Race Quake That Rocked the Nation
Kimberly Jade Norwood
Washington University School of Law
Monday, May 16, 2016
1:00 PM – 2:30 PM ET
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2
MENTAL HEALTH AWARENESS 101:
BATTLING BURNOUT & DEPRESSION
APRIL 18, 2016
By Daniel T. Lukasik, Esq.
Daniel T. Lukasik, Esq.
Attorney at Law
1230 Delaware Avenue, Buffalo, NY 14209
E-mail: [email protected]
Website: www.lawyerswithdepression.com
Website: www.yourdepressioncoach.com
Dan is a 1988 graduate of the State University of New York at Buffalo School of Law and
litigates personal injury cases throughout Western New York. He is listed in the publication The
Best Lawyers in America and was voted last year by fellow lawyers to the “Elite Top 10: The
Best of the Best” as one of the “most respected attorneys in Buffalo” as reported in The Buffalo
Law Journal and Business First. In 2007, he launched the website Lawyerswithdepression.com,
to help those in the legal community who struggle with too much stress, anxiety and depression.
Dan’s work has been featured in The New York Times, The Wall Street Journal, on CNN and in
many other national and international publications. He is the recipient of the “Distinguished
Alumni Award for Public Service” from the University at Buffalo School of Law, the “Award of
Merit” from the Erie County Bar Association, and the “Roger Stone Advocate of the Year” from
the Mental Health Association of Erie County for the creation of awareness and understanding of
critical mental health issues.
Dan is the Executive Producer of the original documentary, “A Terrible Melancholy: Depression
in the Legal Profession” and lectures around the country to law schools, bar associations, judicial
groups, and mental health organizations. In 2015, he launched a life coaching/consulting
practice to help fellow lawyers develop practical and positive solutions to living with and
overcoming depression. Dan’s services and approach can be found at the website
yourdepressioncoach.com.
2
INTRODUCTON
Are you a lawyer suffering from depression? Do you know a colleague that struggles
with it?
If so, you’re not alone.
Researchers at John Hopkins University found statistically significant elevations of major
depressive disorder in only three of 104 occupations surveyed. When adjusted for
sociodemographics, lawyers topped the list, suffering from depression at a rate of 3.6 times
higher than employed persons generally. i Tragically, lawyers rank fourth in proportion of
suicides by profession. ii
A new landmark study conducted by the Hazelden Betty Ford Foundation and the
American Bar Association Commission on Lawyer Assistance Programs published last month
reveals that 21 percent of licensed, employed attorneys currently qualify as problem drinkers, 28
percent struggle with some level of depression and 19 percent demonstrate symptoms of
anxiety. iii Forty-six percent reported concerns with depression with depression at some point in
their legal careers.
When put in perspective, that means that of the nearly 1.2 million lawyers in the U.S.,
approximately 336,000 are struggling from depression in the past year.
What Is Depression?
Clinical Depression can be mild, moderate or severe in intensity. According to the
National Institute of Mental Health iv, symptoms include:
•
•
•
•
•
•
•
•
•
•
Difficulty concentrating, remembering details, and making decisions;
Fatigue and decreased energy;
Feelings of guilt, worthlessness, and/or helplessness;
Insomnia, early morning wakefulness, or excessive sleeping;
Irritability, restlessness;
Loss of interest in activities or hobbies that were once pleasurable;
Loss of pleasure in life;
Overeating or appetite loss;
Persistent sad, anxious or “empty” feelings; and
Thoughts of suicide or suicide attempts.
Whether or not you’re “clinically depressed: can only be determined by a mental health
professional. To be diagnosed as such, you must have at least five of the above symptoms for at
least two weeks.
2
But many people never get to the point of receiving such a diagnostic evaluation or
treatment because they or others see their symptoms as a “slump,” “sadness,” or even “the
blues”. Perhaps a vacation will cure the funk you’re in, some say. Others take the tough love
approach: “just snap out of it.” But none of this works. It simply falls on depression’s deaf ears.
That’s because depression isn’t sadness. Richard O’Connor, Ph.D., author of the bestselling book, “Undoing Depression,” writes:
The opposite of depression is not happiness, but vitality – the ability to experience a full
range of emotions, including happiness, excitement, sadness, and grief. Depression is not
an emotion itself; it’s the loss of feelings; a big heavy blanket that insulates you from the
world yet hurts at the same time. It’s not sadness or grief, it’s an illness. v
What Causes Depression?
Depression has many causes: A genetic history of depression in one’s family, hormone
imbalances, and biological differences, among others. Certain personality traits, such as low selfesteem, a pessimistic outlook, chronic stress at work or home, childhood trauma, drug or alcohol
abuse and other risk factors increase the likelihood of developing or triggering depression.
Why do lawyers experience depression at higher rates?
According to Patrick Krill, JD, MA, the director of the Hazelden Betty Ford Foundation’s
Legal Professional’s Program:
(The) answer is less straightforward, but the rampant, multidimensional stress of the
profession is certainly a factor. And not surprisingly, there are also some personality
traits common among lawyers – self-reliance, ambition, perfectionism and
competitiveness – that aren't always consistent with healthy coping skills and the type of
emotional elasticity necessary to endure the unrelenting pressures and unexpected
disappointments that a career in the law can bring. vi
According to Martin Seligman, Ph.D., it has to do with a particular style of negative
thinking:
One factor is a pessimistic outlook defined not in the colloquial sense (seeing the glass as
half empty) but rather as the pessimistic explanatory style. These pessimists tend to
attribute the causes of negative events as stable and global factors (“It’s going to last
forever, and it’s going to undermine everything.”) The pessimist views bad events as
pervasive, permanent, and uncontrollable, while the optimist sees them as local,
temporary and changeable. Pessimism is maladaptive in most endeavors.
But there is one glaring exception: Pessimists do better at law. Pessimism is seen as a
plus among lawyers, because seeing troubles as pervasive and permanent is a component
of what the law profession deems prudent. A prudent perspective enables a good lawyer
to see every conceivable snare and catastrophe that might occur in any transaction. The
3
ability to anticipate the whole range of problems and betrayals that non-lawyers are blind
to is highly adaptive for the practicing lawyer who can, by so doing, help his clients
defend against these far-fetched eventualities. If you don’t have this prudence to begin
with, law school will seek to teach it to you. Unfortunately, though, a trait that makes you
good at your profession does not always make you a happy human being. vii
The full text of Dr. Seligman’s article is included below at pp. 8-13
Tyger Latham, Ph.D., a psychologist in Washington, D.C., who treats many lawyers with
depression, writes:
…I’ve come to recognize some common characteristics amongst those in the
profession. Most, from my experience, tend to be “Type A’s” (i.e., highly ambitious and
over-achieving individuals). They also have a tendency toward perfectionism, not just in
their professional pursuits but in nearly every aspect of their lives. While this
characteristic is not unique to the legal profession – nor is it necessarily a bad thing –
when rigidly applied, it can be problematic. The propensity of many law students and
attorneys to be perfectionistic can sometimes impede their ability to be flexible and
accommodating, qualities that are important in so many non-legal domains.” viii
Dr. O’Connor elaborates:
I think this explains a lot about why lawyers are so prone to depression. Because of their
experience with the law, most attorneys have lost their rose-colored glasses some time
ago. (Or else they never had them and chose the law as a career because it suited their
personality). Attorneys know that life is hard, and doesn’t play fair. They’re trained to
look for every conceivable thing that could go wrong in any scenario, and they rarely are
able to leave that attitude at the office. They see the worst in people (sometimes they see
the best, but that’s rare). They tend to be strivers and individualists, not wanting to rely
on others for support. They have high expectations of success, but they often find that
when they’ve attained success, they have no one to play with, and have forgotten how to
enjoy themselves anyway.
The full text of O’Connor’s article is included below at pp. 14-15
What Can We Do About It?
1. Join a Depression Support Group
You can (a) join or (b) start a support group in your community. These groups provide a
place for the depressed to share their struggles and gain the encouragement and support they
need to recover and remain well.
4
a. Join a support group
A depression support group is not “group therapy”. The group is actually run by the those
who attend the meetings. To see if there’s such a group in your city, go to the Depression &
Bipolar Support Alliance’s website at www.dbsa.org.
b. Start a depression support group for lawyers in your community
The fact is there are too few support groups in this country. If there’s not one in your
hometown or the ones’ you’ve attended aren’t a good fit, think about starting one yourself or
with another friend or two.
See my suggestions below on how to create such a group at pp. 16-21
c. Get Educated
There are plenty of great websites to educate you about what depression is and the variety of
ways it can be treated. A great resource can be found at the University of Michigan’s Depression
Center website at www.depressioncenter.org.
See my suggested books below for depression (pp.17-19), anxiety (pp. 20-22), and lawyer
wellness (p. 23)
d. Work with a Lawyer Life Coach
If you would wish to work one-on-one with a life coach, I offer such services
at www.yourdepressioncoach.com. My practice is unique in that I am a fellow lawyer who has
struggled with depression over the years while practicing law. I believe I can help you if you
answer “yes” to any of the following questions:
•
You need someone to listen with a sense of compassion. I am that person. I will care. I
will be in your corner.
•
You need a sense of structure at a time when life may seem pointless and meaningless. I
can be an anchor for you, a safe port in a storm, a place to go and share your deepest
struggles and concerns about home and work.
•
You need someone to educate you about what depression and anxiety are and their
symptoms and causes.
•
You need guidance as you weave through the matrix of treatment options to find a plan
that works for you.
5
•
In addition to treating with a psychologist and/or psychiatrist, you find that you get more
encouragement, insight and support to help you keep moving forward.
•
You suffer from anxiety and depression. If so, you’re far from alone. Studies show that
as much as 60% of all people with depression also suffer from an anxiety disorder.
I will work with you on whatever specific problem most pressing to you. Here are some areas
where depression and anxiety may be causing real pain and trouble in your life:
You need help getting things done at work. You’re falling behind and because of you’re the
depression and/or anxiety. I can help by providing insight, support and exercises to help you deal
with this all too common and critical issue.
You want to leave your job. You’ve been coping with work-related depression and/or anxiety
for some time and decided “enough is enough”. You want to make plans to transition to another
job or career. I can help you develop your game plan to do so and hold you accountable for
following through and take the necessary steps to make this a reality.
You’re A “Depression Veteran”. You might be further down the road in your recovery from
depression and/or anxiety, but still need help and encouragement. Or you’ve been struggling
with off-and-on depression and/or anxiety for years. I will work with you to develop a program
to make sure you do things that will help you recover and stay well. I will hold you accountable
for actually following through with your program. I can help to motivate you to stick with a
healthy game plan.
You are just plain unhappy. Many people, while not clinically depressed, are very unhappy
with their lives. They have too much stress. Aren’t happy in their careers. Or don’t have a sense
of meaning and purpose in their lives. The support and structure I provide for depression
sufferers are easily transferable to getting to the heart of what’s causing your unhappiness. I will
work with you to build a different set of skills and make different life choices to lead a happier
and healthier life.
You need help explaining your depression to others. For loved ones and business associates
that have never been through depression, it’s difficult for them to really understand your pain
because they really don’t have a point of reference for psychic pain someone undergoes with
clinical depression. They mistake it for “the blues” or everyday sadness, which it clearly is
not. I can work with you to develop a language and actions that could help others understand. If
you wish, I would also be happy to talk with others as your work to educate them about what
depression is and ways that might be able to help and support you.
If you relate to any of these issues and think coaching might be a good fit for you, I offer a free
twenty-minute consultation. You can contact me at www.yourdepressioncoach.com to schedule
a meeting. I coach clients around the country via Skype and over the phone.
6
i
See William W. Eaton, et al. Occupations and the Prevalence of Major Depressive Disorder, 32 Journal of
Occupational Medicine, 1079, 1083 (1990)
ii
Why Are Lawyers Killing Themselves? Rose Flores and Rose Marie Arce, CNN, 1/20/14
iii
Patrick Krill, JD, LLM, Ryan Johnson, MA, and Linda Albert, MSSW, The Prevalence of Substance Use and Other
Mental Health Concerns Among American Attorneys, JOURNAL OF ADDICTION MEDICINE, Volume 10 (Jan/Feb
2016)
iv
National Institute of Mental Health
v
Richard O’Connor, Ph.D., Undoing Depression: What Therapy Can’t Teach You and Medicine Can’t Give You
vi
Patrick Krill, JD, Why Are Lawyers Prone to Suicide? CNN, 1/21/14
vii
Martin E.P. Seligman, Paul R. Verkuil & Terry Kang, Why Lawyers Are Unhappy, 10 DEAKIN L.REV. 49 (2005)
viii
Tyger Latham, Psy.D., The Depressed Lawyer, Psychology Today, 5/2/11
7
3
Why Are Lawyers So Unhappy?
Martin E. P. Seligman, Ph.D.
“As to being happy, I fear that happiness isn’t in my line. Perhaps the happy days that Roosevelt
promises will come to me along with others, but I fear that all trouble is in the disposition that
was given to me at birth, and so far as I know, there is no necromancy in an act of Congress that
can work a resolution there.” – Benjamin N. Cardozo, February 15, 1933
Law is a prestigious and remunerative profession, and law school classrooms are full of
fresh candidates. In a recent poll, however, 52% of practicing lawyers describe themselves as
dissatisfied. Certainly the problem is not financial. As of 1999, associates at top firms could earn
up to $200,000 per year just starting out, and lawyers long ago surpassed doctors as the highestpaid professionals. In addition to being disenchanted, lawyers are in remarkably poor mental
health. They are at much greater risk than the general population for depression.
Researchers at John Hopkins University found statistically significant elevations of major
depressive disorder in only 3 of 104 occupations surveyed. When adjusted for
sociodemographics, lawyers topped the list, suffering from depression at a rate of 3.6 times
higher than employed persons generally. Lawyers also suffer from alcoholism and illegal drug
use at rates far higher than non-lawyers. The divorce rate among lawyers, especially women, also
appears to be higher than the divorce rate among other professionals. Thus, by any measure,
lawyers embody the paradox of money losing its hold. They are the best-paid professionals, and
yet they are disproportionately unhappy and unhealthy. And lawyers know it; many are retiring
early or leaving the profession altogether.
The Three Causes of Lawyer Unhappiness
1. Pessimism
First is pessimism, defined not in the colloquial sense (seeing the glass as half empty) but
rather as the pessimistic explanatory style. These pessimists tend to attribute the causes of
negative events as stable and global factors (“It’s going to last forever, and it’s going to
undermine everything.”). The pessimist views bad events as pervasive, permanent, and
uncontrollable, while the optimist sees them as local, temporary and changeable.
Pessimism is maladaptive in most endeavors: Pessimistic life insurance agents sell less
and drop out sooner than optimistic agents. Pessimistic undergraduates get lower grades, relative
to their SAT scores and past academic record, than optimistic students. Pessimistic swimmers
have more substandard times and bounce back from poor efforts worse than do optimistic
swimmers. Pessimistic pitchers and hitters do worse in close games than optimistic pitchers and
hitters. Pessimistic NBA teams lose to the point spread more often than optimistic teams.
Thus, pessimists are losers on many fronts. But there is one glaring exception: Pessimists
8
do better at law. We tested the entire entering class of the Virginia Law School in 1990 with a
variant of the optimism-pessimism test. These students were then followed throughout the three
years of law school. In sharp contrast with the results of prior studies in other realms of life, the
pessimistic law students on average faired better than their optimistic peers. Specifically, the
pessimist outperformed more optimistic students on the traditional measures of achievement,
such as grade point averages and law journal success.
Pessimism is seen as a plus among lawyers, because seeing troubles as pervasive and
permanent is a component of what the law profession deems prudence. A prudent perspective
enables a good lawyer to see every conceivable snare and catastrophe that might occur in any
transaction. The ability to anticipate the whole range of problems and betrayals that non-lawyers
are blind to is highly adaptive for the practicing lawyer who can, by so doing, help his clients
defend against these far-fetched eventualities. If you don’t have this prudence to begin with, law
school will seek to teach it to you. Unfortunately, though, a trait that makes you good at your
profession does not always make you a happy human being.
Sandra is a well-known East Coast psychotherapist who is, I think, a white witch. She has
one skill that I have never seen in any other diagnostician: She can predict schizophrenia in
preschoolers. Schizophrenia is a disorder that does not become manifest until after puberty, but
since it is partly genetic, families who have experienced schizophrenia are very concerned about
which of their children will come down with it. It would be enormously useful to know which
children are particularly vulnerable, because all manner of protective, social and cognitive skills
might be tried to immunize the vulnerable child. Families from all over the eastern United States
send Sandra their 4-year-olds; she spends an hour with each of them and makes an assessment of
the child’s future likelihood of schizophrenia, an assessment that is widely thought of as
uncannily accurate. This skill of seeing the underside of innocent behavior is super for Sandra’s
work, but not for the rest of her life. Going out to dinner with her is an ordeal. The only thing she
can usually see is the underside of the meal – people chewing. Whatever witchy skill enables
Sandra to see so acutely the underside of the innocent-looking behavior of a 4-year-old does not
get turned off during dinner, and it prevents her from thoroughly enjoying normal adults in
normal society.
Lawyers, likewise, can not easily turn off their character trait of prudence (or pessimism)
when they leave the office. Lawyers who can see clearly how badly things might turn out for
their clients can also see clearly how badly things might turn out for themselves. Pessimistic
lawyers are more likely to believe they will not make partner, that their profession is a racket,
that their spouse is unfaithful, or that the economy is headed for disaster much more readily than
will optimistic persons. In this manner, pessimism that is adaptive in the profession brings in its
wake a very high risk of depression in personal life. The challenge, often unmet, is to remain
prudent and yet contain this tendency outside the practice of law.
9
2. Low Decision Latitude
A second psychological factor that demoralizes lawyers, particularly junior ones, is low
decision latitude in high-stress situations. Decision latitude refers to the number of choices one
has – or, as it turns out, the choices one believes one has – on the job. An important study of the
relationship of job conditions with depression and coronary disease measures both job demands
and decision latitude. There is one combination particularly inimical to health and moral: high
job demands coupled with low decision latitude. Individuals with these jobs have much more
coronary disease and depression than individuals in other three quadrants.
Nurses and secretaries are the usual occupations consigned to that unhealthy category,
but in recent years, junior associates in major firms can be added to the list. These young lawyers
often fall into this cusp of high pressure accompanied by low choice. Along with the shared load
of law practice (“this firm is founded on broken marriages”), associates often have little voice
about their work, only limited contact with their superiors, and virtually no client contact.
Instead, for at least their first few years of practice, many remain isolated in a library,
researching and drafting memos on topics of the partners’ choosing.
3. The Win-Loss Game
The deepest of all the psychological factors making lawyers unhappy is that American
law is becoming increasingly a win-loss game. Barry Schwartz distinguishes practices that have
their own internal “goods” as a goal from free-market enterprises focused on profits. Amateur
athletics, for instance, is a practice that has virtuosity as its good. Teaching is a practice that has
learning as its good. Medicine is a practice that has healing as its good. Friendship is a practice
that has intimacy as its good. When these practices brush up against the free market, their
internal goods become subordinated to the bottom line. Night baseball sells more tickets, even
though you cannot really see the ball at night. Teaching gives way to the academic star system,
medicine to managed care, and friendship to what-have-you-done-for-me-lately. American law
has similarly migrated from being a practice in which good counsel about justice and fairness
was the primary good to being a big business in which billable hours, take-no-prisoners victories,
and the bottom line are now the principle ends.
Practices and their internal goods are almost always win-win-games: both teacher and
student grow together, and successful healing benefits everyone. Bottom-line businesses are
often, but not always, closer to win-loss games: managed care cuts mental health benefits to save
dollars; star academics get giant raises from a fixed pool, keeping junior teachers at below-costof-living raises; and multi-billion dollar lawsuits for silicon implants put Dow Corning out of
business. There is an emotional cost to being part of a win-loss endeavor. In Chapter 3, I argue
that positive emotions are the fuel of win-win (positive-sum) games, while negative emotions
like anger, anxiety, and sadness have evolved to switch in during win-loss games. To the extent
that the job of lawyering now consists of more win-loss games, there is more negative emotion in
the daily life of lawyers.
Win-loss games cannot simply be wished away in the legal profession, however, for the
sake of more pleasant emotional life among its practitioners. The adversarial process lies at the
heart of the American system of law because it is thought to be the royal road to truth, but it does
10
embody a classic win-loss game: one side’s win equals exactly the other side’s loss. Competition
is at its zenith. Lawyers are trained to be aggressive, judgmental, intellectual, analytical and
emotionally detached. This produces predictable emotional consequences for the legal
practitioner: he or she will be depressed, anxious and angry a lot of the time.
Countering Lawyer and Unhappiness
As Positive Psychology diagnoses the problem of demoralization among lawyers, three
factors emerge: Pessimism, low decision latitude, and being part of a giant win-loss enterprise.
What can lawyers do about it?
It’s important for lawyers to gain insight into the pervasive dimension-generalizing
pessimism beyond the law – and there are exercises in Chapter 12 of Learned Optimism that can
help lawyers who see the worst in every setting to be more discriminating in the other corners of
their lives. The key move is credible disputation: treating the catastrophic thoughts (“I’ll never
make partner,” “My husband is probably unfaithful”) as if they were uttered by an external
person whose mission is to make your life miserable, and then marshaling evidence against the
thoughts. These techniques can teach lawyers to use optimism in their personal lives, yet
maintain the adaptable pessimism in their professional lives.
It is well documented that flexible optimism can be taught in a group setting, such as a
law firm or class. If firms and schools are willing to experiment, I believe the positive effects on
the performance and moral of the young lawyers will be significant.
As to the high pressure-low decision latitude problem, there is a remedy as well. I
recognize that grueling pressure is an inescapable aspect of law practice. Working under
expanded decision latitude, however, will make young lawyers both more satisfied and more
productive. One way to do this is to tailor the lawyer’s day so there is considerably more
personal control over work. Volvo solved a similar problem on the assembly lines in the 1960’s
by giving its workers the choice of building a whole car in a group, rather than repeatedly
building the same part. Similarly, a junior associate can be given a better sense of the whole
picture, introduced to clients, mentored by partners, and involved in transactional discussions.
Many law firms have begun this process as they confront the unprecedented resignations of
young associates.
The zero-sum nature of law has no easy antidote. For better or for worse, the adversarial
process, confrontation, maximizing billable hours, and the “ethic” of getting as much as you
possibly can for your clients are much too deeply entrenched. More pro bono activity, more
mediation, more out-of-court settlements, and “therapeutic jurisprudence” are all in the spirit of
countering the zero-sum mentality, but I expect these recommendations are not
When a young lawyer enters a firm, he or she comes equipped not only with the trait of
prudence in lawyerly talents like high verbal intelligence, but with an additional set of unused
signature strengths (for example, leadership, originality, fairness, enthusiasm, perseverance, or
social intelligence). As lawyers’ jobs are crafted now, these strengths do not get much play. Even
when situations do call for them, since the strengths are unmeasured, handling these situations
does not necessarily fall to those who have the applicable strengths.
11
Every law firm should discover what the particular signature strengths of their associates
are. Exploiting these strengths will make the difference between a demoralized colleague and an
energized, productive one. Reserve five hours of the work week for “signature strength time,” a
non-routine assignment that uses individual strengths in the service of the firm’s goals.
•
Take Samantha’s enthusiasm, as strength for which there is usually little use in law. In
addition to her plugging away in the law library on a personal-injury malpractice brief,
Samantha could be paid to use her bubbliness (combined with her usual legal talent of
high verbal skills) to work with the firm’s public relation agency on designing and
writing promotional materials. •
Take Mark’s valor, a useful strength for a courtroom litigator, but wasted on an associate
writing briefs. Mark’s signature strength time could be spent planning the crucial attack
with the star litigator of the firm for the upcoming trial against a well-known adversary.
•
Take Sarah’s originality, another strength without much value while combing through old
precedents, and combine it with her perseverance. Originality plus perseverance can turn
an entire domain around. Charles Reich, an associate before he became a Yale Law
Professor, reworked the musty precedents to argue that welfare was not an entitlement,
but a property. In so doing he redirected the law away from its traditional take on
“property,” toward what he termed the “new property.” This meant that due process
applied to welfare payments, rather than just the rather capricious largesse of civil
servants. Sarah could be assigned to look for a new theory for particular case. New
theories hidden among precedents are like drilling for oil – there are many dry holes, but
when you strike, it’s a bonanza.
•
Take Joshua’s social intelligence, another trait that would rarely comes in handy for an
associate engaged in routine assignments about copyright law in the library. His signature
strength could be based around having lunch with particularly prickly clients from the
entertainment field, schmoozing about their lives as well as their contract disputes. Client
loyalty is not bought by billable hours, but by the gentle strokes of the good human
relationship. •
Take Stacy’s leadership and make her head a committee on the quality of life for
associates. She could gather and collate complaints anonymously perhaps, and present
them to the relevant partners for consideration. There is nothing particular to the field of
law in the re-crafting of jobs. Rather, there are two basic points to keep in mind as you
think about these examples and try to apply them to your work setting. The first is that
the exercise of signature strengths is almost always a win-win game. When Stacy gathers
the complaints and feelings of her peers, they feel increased respect for her. When she
presents them to the partners, even if they don’t act, the partners learn more about the
morale of their employees – and of course, Stacy herself derives authentic positive
emotion from the exercise of her strengths. This leads to the second basic point: There is
a clear relation between positive emotion at work, high productivity, low turnover and
high loyalty. The exercise of a strength releases positive emotion. Most importantly,
Stacy and her colleagues will likely stay longer with the firm if their strengths are
12
recognized and used. Even though they spend five hours each week on non-billable
activity, they will in the long run generate more billable hours. Law is intended as but
one rich illustration of how an institution (such as a law firm) can encourage its
employees to re-craft the work they do, and how individuals within any setting can
reshape their jobs to make them more gratifying. To know that a job is a win-loss in its
ultimate goal – the bottom line of a quarterly report, or a favorable jury verdict – does not
mean the job cannot be win-win in its means to obtaining that goal. Competitive sports
and war are both eminently win-loss games, but both sides have many win-win options.
Business and athletic competitions, or even war itself, can be won by individual heroics
or by team building. There are clear benefits of choosing the win-win option by using
signature strengths to better advantage. This approach makes work more fun, transforms
the job or the career into a calling, increases flow, builds loyalty, and it its decidedly
more profitable. Moreover, by filling work with gratification, it is a long stride on the
road to the good life.
Dr. Seligman is the Fox Leadership Professor of Psychology at the University of Pennsylvania,
the Director of the Positive Psychology Network, and former President of the American
Psychological Association. Among his 20 books are the best-selling “Authentic Happiness:
Using Positive Psychology to Realize Your Potential for Lasting Fulfillment” and “Learned
Optimism”
© by Martin Seligman. Reprinted with permission from the author
at Lawyerswithdepression.com and Daniel T. Lukasik, Esq.
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4
Undoing Depression in Lawyers
Richard O’Connor, Ph.D.
There’s some interesting research to suggest that happy people view the world through
certain comforting illusions, while depressed people see things more realistically. For instance,
the illusion of control. You can take a random sample of people and sit them in front of a video
monitor with a joy stick, and tell them their joy stick is controlling the action of the game on the
screen. (But the point of experiment is that it actually doesn’t). Depressed people will soon turn
to the lab assistant and complain that their joy stick isn’t hooked up correctly. Normal people, on
the other hand, will go on happily playing the game for quite some time.
I think this explains a lot about why lawyers are so prone to depression. Because of their
experience with the law, most attorneys have lost their rose-colored glasses some time ago. (Or
else they never had them and chose the law as a career because it suited their personality).
Attorneys know that life is hard, and doesn’t play fair. They’re trained to look for every
conceivable thing that could go wrong in any scenario, and they rarely are able to leave that
attitude at the office. They see the worst in people (sometimes they see the best, but that’s
rare). They tend to be strivers and individualists, not wanting to rely on others for support. They
have high expectations of success, but they often find that when they’ve attained success, they
have no one to play with, and have forgotten how to enjoy themselves anyway.
All this makes it hard for attorneys to get help with their depression. They tend not to
recognize it as such; they just think it’s stress, or burn out, or life. They don’t expect that anyone
is going to be able to help. Most of my attorney-patients have contacted me because their
relationships are falling apart, but they don’t see that it’s depression that makes them such a
lousy partner – tense, irritable, critical, joyless, tired all of the time, relying on alcohol or other
drugs. If they’d gotten help for the depression a couple of years previously, their spouse
wouldn’t be moving out now.
The truth about depression is that it not only makes you feel horrible; it wrecks your
life. And that’s why I wrote the book, Undoing Depression, in the first place. I was running an
outpatient clinic, and grew exasperated with seeing the people whose lives wouldn’t have been
so ruined if they had got some help when they first needed it – before they alienated their
children and spouse, got fired, went into debt, developed a substance abuse problem, etc. I
thought there was a need for an intelligent self-help book, one that points out all the bad habits
that depression engenders and which, in a vicious circle, keeps reinforcing the disease. But the
truth is that self-help isn’t nearly enough for most depression sufferers. It’s as if you stepped
over an invisible cliff, and you can’t find your way back doing what you normally do, because
that’s what led you over the cliff in the first place. Depression is the original mind/body disease;
your physical brain is damaged because of the stress in your mind, and you’re unlikely to undo
that damage without help.
Depression is highly treatable, but if you want a lasting recovery you have to change your
life. The ugly fact is that depression is very likely to reoccur. If you had one episode of major
depression, chances are 50:50 that you’ll have another; if you have three episodes, it’s 10:1
14
you’ll have more. But you can improve those odds if you get good professional help, with
medication and with talk therapy. We won’t put your rose-colored glasses back on, but we can
help you see how negative thinking and the negative acting is contributing to your disease.
Richard O’Connor, Ph.D., is the author of two noteworthy books, “Undoing Perpetual Stress:
The Missing Connection Between Depression, Anxiety, and 21st Century Illness” and “Undoing
Depression: What Therapy Doesn’t Teach You and Medication Can’t Give You.” He is
a practicing psychotherapist with offices in New York City and Canaan, Connecticut. He has
suffered from clinical depression and is a member of a depression support group.
Copyright, 2016, Lawyerswithdepression.com and Daniel T. Lukasik
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5
HOW TO CREATE A DEPRESSION SUPPORT GROUP
1. Be clear about what a support group is.
A support group is a regular gathering of folks suffering from depression who share their
struggles with fellow sufferers to gain insight, strength and hope. These meetings are less
structured and more open-ended and the content doesn’t come from a mental health professional.
In contrast, group therapy is more structured, focused on teaching, and has a clear outcome that
the group is trying to reach. They’re led by a therapist.
2. Picking a place.
I suggest you seek out a place to meet at a school, college, church, community center,
library or other free space in your community. I guess you could have it in your home. I have
never done that. I don’t know anyone else who has. In my view, the problem with this spot is
that you must be prepared to have it there every single time. It may put a lot of responsibility on
you. What happens if you’re sick or on vacation and can’t host the gathering? I also don’t
suggest rotating the location of the meetings to different members’ homes. This doesn’t work
because it becomes just too complicated for people to remember where the meeting is being
held. Pick one place and stick with it.
3. Determine a schedule.
With the help of initial support-group members, decide how often to meet and for how
long. For example, every two weeks for 60 to 90 minutes. My experience has been not to fiddle
with the day and time you ultimately pick. Members in my group know, come hell or high water,
meetings start at 12:30 sharp and end at 1:30 every single Friday. They need not think about
it. If they miss some meetings, they’re not left hanging about when the next meeting is.
If others tend to come late to the meeting, always start it on time anyways. My experience is that
people appreciate this. Everyone has busy schedules and other things to do. Meetings should be
no less than once every two weeks because interest can wane if the group doesn’t meet often. If
the meetings are too far apart, people forget each other’s stories.
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4. Talk with your therapist.
If you’re in therapy, talk with him or her about what you plan on doing and why. They
know you well and can offer some suggestions. They’ve either run groups and/or been trained in
how to do so. Get some ideas.
5. You don’t have to rebuild the wheel.
Depression support groups happen everyday around the country. They’re run by various
organizations such as the Depression and Bipolar Support Alliance Check out their website at
www.dbsa.org to see where these groups meet in your community and go to a few to see how
they function.
6. How Do I find support group members?
You need to get the word out. Develop a flyer that briefly describes your group, where
and when it meets, and contact information. You may also want to contact other support groups
and ask if they can refer people to you or market your group on Facebook and other social
networking sites. One thing I did was to write columns in my local paper about my own
experiences with depression and the support group. This helped enormously. People connect
with personal stories. It also helps people overcome the stigma of attending a meeting. If you’re
comfortable with it, ask to speak at your local church or other social organizations you might be
a part of. Another way to find members is to search for therapists who have offices within a 10mile radius of where the meetings are going to be held. I’d send them flyers so that could refer
people in need of support. Most therapists aren’t even aware of such groups. So educate them!
7. Have and opening and closing ritual.
Early on, our group crafted an opening that we read before every meeting. I have typed
out the opening we use at my group at the end of this blog. Towards the end of the meeting, I
will say, “We’ve got about ten minutes left, is there anyone who hasn’t shared that would like to
speak?” I’ll then conclude, “See you all next Friday at 1:30.” A consistent structure to the
meetings helps a lot.
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8. Arrange for refreshments.
Ask support-group members to take turns providing snacks and drinks if desired.
9. Create a confidential list-serve.
It’s a good idea to get everyone’s email address to communicate with the group in the
event of a meeting cancellation due to the weather or other problems. Sometimes, your usual
location needs to be changed on a particular date because the building is closed for the holidays,
etcetera. Send out an e-mail the day before the group meets to remind them there’s a gather the
next day. People get busy and like these little pokes. I also forward onto members of group
activities – sometimes we meet for dinner or breakfast. I also pass along depression blogs or
news I’ve come across that might be interest. A confidential list-serve is easy to create. To
make it confidential, I e-mail myself notices and blind copy the rest of the group. It works.
10. Leaders.
A support group leader(s) is responsible for maintaining the structure of the group and
keeping the group on topic. Leaders also set up meetings and clean up afterwards. They must be
a bit assertive; if you are not comfortable being assertive, look for this quality in a co-leader.
11. Asking others to join the group – be sensitive to their concerns.
Because of the stigma associated with depression, people are sometimes resistant to join a
support group. They don’t know what to expect. “Will other people attending the group know
me? Will this be embarrassing? Would this really help?” Then there are others who have
attended other depression support group meetings and found them lacking. One of the most
common things I hear is that many of the folks who attend these meeting aren’t working, are on
disability and aren’t planning to go back into the work force. Let me be clear on this point: in no
way am I criticizing people who are in this situation. In fact, I feel deep compassion for
them. But for people who are in the workforce or those temporarily out of it who want to get
back in, it isn’t always good fit. Be aware and sensitive to this issue. If I sense that people would
like to come to the group, but are apprehensive, I meet them for coffee. Believe me, it helps to
reassure them. Maybe a perspective member might not be a good fit for your group. If so, be
honest with them and refer them to another.
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12. Remember that it takes time to start and keep a group going.
I have known other people who have felt the passion and courage to start groups only to
see them fizzle out because of a lack of members or organization. That can be discouraging, no
doubt. When I first started the group, I’d worry about how many people would come. For
example, I’d be disappointed if 4 people came. I somehow felt like a failure (why can’t I get
more people to come?) or a big success if 15 came (“Wow, this is great. People think this is
important!”) But in the past seven years of running my group, I learned that numbers don’t count
for much. It’s the quality and depth of sharing that counts. Some of the best meetings I’ve
attended have been with small numbers of people. It allows more time for each person to share
more details of their struggles that they otherwise may not been able to do in with a larger group
setting because of time constraints. Commit to keep the group going for at least one year. It will
have its ups and downs. You need to be persistent.
13. Remember to stay on topic.
You’ll notice some participants drift into other topics like buying a new car, gossip or
recent things in the news. Help keep the group focused and on task. It’s a depression support
group, plain and simple. The majority of people are there for that reason. It’s simply not fair to
others who need the support to listen to others who want to talk about things other than their
depression-related issues. If people want to talk about these issues, they can do so before or after
the group.
14. Be careful not to let someone dominate the talk.
This is a common and tricky problem I’ve had to deal with over the years. We address
this in the opening ritual, but people need to be reminded of this for the benefit of the group. An
individual member may sometimes need a bit more time to talk than usual. That’s okay. But if it
becomes a chronic issue, take the person aside after the group and gently address it with them.
15. Share resources.
Many people who come to groups have read books about depression that have “spoken”
to them in a meaningful way. Group members can create such a list and distribute it. From time
to time, my group has also come up with a list of recommended therapists and psychiatrists in
19
our area. Again, a very helpful thing for people who don’t have one or are thinking of switching
(a very common issue).
16. Hire a therapist to attend the group.
Our group has hired a therapist to facilitate our meetings during different times in our
history. It’s absolutely not necessary to have successful group, but may be helpful. How to find
one? Send out a letter to local counselors that you are a group looking for one. How do you pay
for it? Take up a collection from the group. For example, if you have 10 people (an ideal
number of members for a support group, by the way, is 8 to 10 folks), ask that they each kick in
$10 per group meeting to pay for the therapist. The psychologist in our group didn’t talk much
during the meeting, except at the end. He would sum up some of the themes he heard and offer a
few helpful tips and observations. I thought this worked well and was a real benefit to the group.
You can also ask a local therapist to volunteer their time to this worthy effort.
17. Get trained as a peer support person.
There are different organizations that offer such training. Check out the Depression and
Bipolar Alliance website. Attend other depression support groups in your community to see how
they run it.
18. Commit to confidentiality.
Make sure everyone in your group understands that what’s shared in the support group
stays within the group. I can’t stress this issue strongly enough. People need to feel
safe. Without that, the group just won’t succeed.
19.
Opening ritual statement for a depression support group.
Here’s the ritual opening we use for our depression support group meetings:
Welcome to the {insert group name] support group for people coping with depression.
Depression is a bio-psychosocial phenomenon meaning that it affects people in their biological,
psychological, and social areas of daily function. Depression is a health problem that does not
discriminate by gender, race, religion, occupation, or intellectual ability. It is not a moral
weakness any more than asthma, diabetes, or hypertension are. But, similar to these other
20
illnesses, depression is highly treatable and can be managed effectively. Interpersonal support is
an important part of depression management.
This group is anonymous and confidential. Here is a forum to share your stresses and
your experiences in coping with depression. We ask that group members suspend judgment of
others, refrain from direct advice giving, and allow adequate time for all participants to share
their respective stories.
We seek the serenity to accept the things we cannot change, the courage to change the things we
can, and the wisdom to know the difference.
It’s helpful to rotate the reading of the opening ritual statement. Encourage everyone to
participate.
By Daniel T. Lukasik, 2016
21
6
Dan’s Recommended Books on Depression
Undoing Depression: What Therapy Doesn’t Teach You and Medication Can’t Give You –
Richard O’Connor, Ph.D.
This is the best book I’ve read on depression. Perhaps it’s more compelling than most books on this subject because
Richard O’Connor, a therapist in New York City, has gone through major bouts of depression himself. Depression
has often been compared to heart disease; an illness fueled by complex and interrelated factors: genetic,
biochemical, environmental. In this book, O’Connor focuses on an additional factor often overlooked: our own
habits. Unwittingly, “we get good at depression”. This book teaches us how to replace depressive patterns with a
new and more effective set of skills. We already know how to “do” depression. And we can learn how to “undo” it.
With a truly holistic approach that synthesizes the best of the many schools of thought about this painful condition,
this book offers new hope, and new life, for depression sufferers.
The Noonday Demon: An Atlas of Depression – Andrew Solomon
Winner of The National Book Award following its release a decade ago, this beautifully written book by depression
sufferer, Andrew Solomon, draws on his own struggles with the illness and interviews with fellow sufferers, doctors
and scientists, policy makers and politicians, drug designers and philosophers. Solomon reveals the subtle
complexities and sheer agony of the disease. With uncommon humanity, candor, wit, and erudition, he not only
helps us understand depression, but also the human condition.
The Mindful Way through Depression: Freeing Yourself From Chronic Unhappiness – J.
Mark Williams, Ph.D.
Mindfulness, a simple yet powerful way of paying attention to your most difficult emotions and life experiences, can
help you break the cycle of chronic unhappiness once and for all. It seems like every few days, there is a new book
or article out on the power of mindfulness. Here, four uniquely qualified experts explain why our usual attempts to
“think” our way out of a bad mood or just “snap out of it” lead us deeper into the downward spiral. Through
insightful lessons drawn from both Eastern meditative traditions and cognitive therapy, they demonstrate how to
sidestep the mental habits that lead to despair, including rumination and self-blame, so you can face life’s challenges
with greater resilience. Jon Kabit-Zinn gently and encouragingly narrates the accompanying CD of guided
meditations, making this a complete package for anyone seeking to regain a sense of hope and well-being.
Listening to Depression: How Understanding Your Pain Can Heal Your Life – Lara HonosWebb, Ph.D.
I first read this book five years ago and was struck by its originality: depression isn’t just a disease to be fixed with
medication and therapy, but a powerful warning signal that our lives are off track and needs to be healed. In this
sense, depression and its painful symptoms is a sort of unwelcome wisdom. Dr. Honos-Webb argues that we too
often try to cut off or numb our feelings of depression instead of listening carefully to what they are telling us about
our lives. Listening to Depression offers insightful ways to reframe our depression as a gift that can help you
transform your life for the better.
Lincoln’s Melancholy: How Depression Challenged a President and Fueled His Greatness –
Joshua Wolf Shenk
I am a little biased here. I am a lawyer and Lincoln is my hero. He not only was a great trial lawyer, but also
struggled with depression his entire life. Giving shape to the deep depression that pervaded Lincoln’s adult life,
Joshua Wolf Shenk’s Lincoln’s Melancholy reveals how this illness influenced both the president’s character and his
leadership. Lincoln forged a hard path toward mental health from the time he was a young man. Shenk draws from
historical record, interviews with Lincoln scholars, and contemporary research on depression to understand the
nature of his unhappiness. In the process, he discovers that the President’s coping strategies—among them, a rich
sense of humor and a tendency toward quiet reflection—ultimately helped him to lead the nation through its greatest
turmoil.
Unstuck: Your Guide to the Seven-Stage Journey Out of Depression – James S. Gordon,
M.D.
One of our country’s most distinguished psychiatrists and a pioneer in integrative medicine, Dr. Gordon believes
that depression is not an end point, a disease over which we have no control. It is a sign that our lives are out of
balance, that we’re stuck. It’s a wake-up call and the start of a journey that can help us become whole and happy,
one that can change and transform our lives. Unstuck is a practical, easy to use guide explaining the seven stages of
Dr. Gordon’s approach and the steps we can take to exert control over our own lives and find hope and
happiness. Unstuck is designed for anyone who is suffering from depression, from mild subclinical depression (“the
blues”) to its severest forms.
Unholy Ghosts: Writers on Depression – Nell Casey
The only book of its kind, Unholy Ghost is a unique collection of essays about depression by writers. Unlike any
other memoir of depression, however, Unholy Ghost includes many voices and depicts the most complete portrait of
the illness. With an introduction by Dr. Kay Redfield Jamison, Unholy Ghost allows the bewildering experience of
depression to be adequately and beautifully rendered. The twenty-two stories that make up this book will offer
solace and enlightenment to all readers.
Depression is Contagious – Michael Yapko, Ph.D.
Dr. Yapko has identified the types of relationship patterns that lead to negative ways of thinking, feeling, and
relating to others and culls from the latest findings in neuroscience, social psychology, epidemiology, and genetics
to provide a practical, proven plan for developing the skills and insights you need to forge stronger, healthier social
connections and enjoy an enriching, interconnected life. While commonly prescribed drugs address some of
depression’s symptoms, they cannot change the social factors that cause and perpetuate the disorder. By treating a
social condition as though it’s a disease, the problems compound rather than diminish. The foundation for recovery
is to build a healthy social life based on understanding what to expect from our relationships, what we should give,
and how to relate to and accept others — skills that have been neglected by modern society. Dr. Yapko’s
groundbreaking plan of action — filled with skill-building emotional and mental exercises, anecdotes, and
illuminating explanations.
I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression –
Terrence Real
Depression is a silent epidemic in men who hide their condition from family, friends, and themselves to avoid the
stigma of depression’s “un-manliness.” Problems that we think of as typically male — difficulty with intimacy,
workaholism, alcoholism, abusive behavior, and rage-are really attempts to escape depression. And these escape
attempts only hurt the people men love and pass their condition on to their children. Real reveals how men can
unearth their pain, heal themselves, restore relationships, and break the legacy of abuse. He mixes penetrating
analysis with compelling tales of his patients and even his own experiences with depression as the son of a violent,
depressed father and the father of two young sons.
What to Do When Someone You Love is Depressed – Mitch Golant and Susan Golant
There are few circumstances in life as hard and at the same time as important as being a friend to a person who is
suffering from depression. What to Do When Someone You Love Is Depressed offers guidance to the friends and
family of a depressed person on how to keep one’s own spirits up and at the same time do what is best to help a
loved one get through a difficult time.
The Zen Path through Depression – Philip Martin
Extremely accessible to people with little or no Zen experience as well as to longtime students of Buddhism, The
Zen Path through Depression shows how the insights and exercises of Zen offer relief for those suffering from
depression
Get it Done When You’re Depressed –Julie A. Fast and John Preston, M.D.
When a depressed person can’t meet the expectations of society, the depression becomes worse and a vicious cycle
begins. The goal of Getting Things Done When You’re Depressed is to break this cycle. Readers will learn how to
prepare themselves mentally for working while depressed, how to structure their environment so they can work
more easily, how to work with others and how to prevent depression.
The 10 Best-Ever Depression Management Techniques – Margaret Wehrenberg, Ph.D.
What I like about this book is that it provides an overview of the some of the best techniques out there that scientists
and therapist are using to help and heal people from depression. As Margaret Wehrenberg explains, you must first
understand your brain. Drawing on cutting-edge neuroscience research presented in a reader-friendly way,
Wehrenberg skillfully describes what happens in the brain of a depression sufferer and what specific techniques can
be used to alter brain activity and control its range of disabling symptoms. Containing practical, take-charge tips
from a seasoned clinician, this book presents the ten most effective strategies for moving from lethargy into action,
taking charge of your brain, and breaking free from depression to find hope and happiness.
7
Dan’s Recommended Books on Stress and Anxiety
Why Zebras Don’t Get Ulcers: An Updated Guide to Stress, Stress-Related Diseases and
Coping – Robert Sapolsky, Ph.D.
Why don’t zebras get ulcers–or heart disease, clinical anxiety, diabetes and other chronic diseases–when people do?
In this fascinating look at the science of stress, Stanford biologist Robert Sapolsky presents an intriguing case, that
people develop such diseases partly because our bodies aren’t designed for the constant stresses of a modern-day life
- like sitting in daily traffic jams or racing through e-mails, texting and running to pick up our kids after a tough day
at work. Rather, humans seem more built for the kind of short-term stress faced by a zebra–like outrunning a lion.
This book is a primer about stress, stress-related disease, and the mechanisms of coping with stress. How is it that
our bodies can adapt to some stressful emergencies, while other ones make us sick? Why are some of us especially
vulnerable to stress-related diseases and what does that have to do with our personalities?” Sapolsky, a
neuroscientist, concludes with a hopeful chapter, titled “Managing Stress.” Although he doesn’t subscribe to the
school of thought that hope cures all disease, Sapolsky highlights the studies that suggest we do have some control
over stress-related ailments, based on how we perceive the stress and the kinds of social support we have.
Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain,
and Illness – John Kabit-Zinn, M.D.
Chronic stress saps our energy, undermining our health, and making us more vulnerable to anxiety, depression, and
disease. The heart of the book is based on Kabit-Zinn’s renowned mindfulness-based stress reduction program at
the University at Massachusetts Medical Center. The author takes the phrase “full catastrophe living” from book and
movie Zorba the Greek. If you’ve never seen it, an Englishman Basil, who is half-Greek, inherits a run down mine
in a small Greek town. To help him restore it, he hires a local character named Zorba to be the foreman of the local
laborers. Zorba, full of the zest of a life truly lived, is asked by Basil, “Do you have a family?” Zorba responds
“Wife, children, house – the full catastrophe!!!”
The Mindful Way through Anxiety: Break Free From Chronic Worry and Reclaim Your
Life – Susan M. Orsillo, Ph.D.
Anxiety isn’t the same thing as stress. You can’t just “get over” anxiety. In fact, the very things most people do to
try to feel better–avoiding feared situations, pushing worry out of mind–only make the problem worse. This book
presents a powerful new alternative that can help you break free of anxiety by fundamentally changing how you
relate to it. Mindfulness, a simple yet powerful way of paying attention to your most difficult emotions and life
experiences, seems like it is everywhere these days and being offered as a solution to much of the mental distress
that ails modern society. Yet, in my own limited experience, it is worthy of such attention because it works.
Undoing Perpetual Stress: The Missing Connection Between Depression, Anxiety and
21st Century Illness – Richard O’Connor, Ph.D.
Author of my favorite book on depression, “Undoing Depression”, Richard O’Connor, Ph.D., has written another
simply brilliant book on the consequences of “perpetual” stress in our lives – the alarming and escalating rates of
clinical anxiety and depression. This was the first book I read that made clear to me the connection between stress,
anxiety and depression. The human nervous system was never meant to handle this many stressors. It’s as if the
circuit breakers in our brains are blown by too much stress running through our brain’s circuitry. This book is a
perfect fit if you want to learn a lot about the brain and physiology of stress – I found it fascinating. If you’re
looking for a quick read and pick-me-up, this isn’t it.
The 10 Best-Ever Anxiety Management Techniques – Margaret Wehrenberg, Ph.D.
Medication, once considered the treatment of choice, is losing favor as more and more sufferers complain of
unpleasant side effects and its temporary, quick-fix nature. Now, thanks to a flood of fresh neurobiology research
and insights into the anatomy of the anxious brain, effective, practical strategies have emerged allowing us to
manage day-to-day anxiety on our own without medication. Addressing physical, emotional, and behavioral
symptoms, Margaret Wehrenberg, Ph.D., a leading mental health clinician, draws on basic brain science to highlight
the top ten anxiety-defeating tips. Everything from breathing techniques to cognitive control and self-talk are
included. I really like that the 10 chapters are highly readable and short.
Things Might Go Terribly, Horribly Wrong: A Guide to Life Liberated from Anxiety –
Troy DuFrene
This book approaches the problem of anxiety a little differently than most. Instead of trying to help you overcome or
reduce feelings of anxiety, it will help you climb inside these feelings, sit in that place, and see what it would be like
to have anxiety and still make room in your life to breathe and rest and live, really and truly live, in a way that
matters to you. This approach is based upon a research-supported form of psychotherapy called “Acceptance and
Commitment Therapy”, also known as ACT which starts with the assumption that the normal condition of human
existence is suffering and struggle, ACT works by first encouraging individuals to accept their lives as they are in
the here and now. This acceptance is an antidote to the problem of avoidance, which ACT views as among the
greatest risk factors for unnecessary suffering and poor mental health.
Get Out of Your Mind and Into Your Life – Steven C. Hayes
This is another book that uses the ACT approach. It’s different than the book above because it offers a five-step plan
for coping with painful emotions such as anxiety and depression. How I love plans! I also liked the wisdom
contained here: the recognition that painful feelings cannot be controlled will open you to the possibility of fully
emotional living. When anxiety arises in our bodies and minds, we erroneously believe that we have the power to
rein these in, stop them and thus effectively eliminate it. However, this approach only leads us further down into the
well of panic. Anxiety is not the problem. It is our attempts to squash and control it that strengthen anxiety and
prevent us from coping with it effectively. Learn what steps you can take to approach anxiety differently.
The Worry Cure: Seven Steps to Stop Worry From Stopping You – Robert L. Leahy, Ph.D.
For “highly worried people,” or those who suffer from the “what-if disease,” this book presents a systematic,
accessible self-help guide to gaining control over debilitating anxiety. Leahy is an expert in changing thought
processes, and he walks worriers step-by-step through problems in the way they think, with pointers on how to
change these biases. The author then outlines a seven-step worry-reduction plan (remember, I love plans!) beginning
with identifying productive and unproductive worry, progressing to improving skills for accepting reality,
challenging worried thinking and learning to harness unpleasant emotions such as fear or anger.
The Anxiety and Worry Workbook – David A. Clark, Ph.D.
Like many of the other books I’ve recommended, this one is also grounded in cognitive behavior therapy. I like this
book because included in it are carefully crafted worksheets, exercises, and examples that reflect the authors’
decades of experience helping people who really, really struggle with anxiety. Learn practical strategies for
identifying your anxiety triggers, challenging the thoughts and beliefs that lead to distress, safely facing the
situations you fear, and truly loosening anxiety’s grip–one manageable step at a time. Like depression, coping
effectively with anxiety involves learning helpful new and constructive ways of thinking about the problems we all
face. So often, it isn’t the reality of a situation that makes us anxious, but the stories we tell ourselves about the
events that happen moment-to-moment.
Self-Coaching: The Powerful Guide to Beat Anxiety – Joseph J. Luciani, Ph.D.
This is a good book for those who don’t want to see a therapist or, if they do, need extra doses of encouragement and
practice to overcome their anxiety. The author advises readers to identify themselves as specific personality types
(e.g., “Worrywarts,” “Hedgehogs,” “Perfectionists”) and then gives specific instructions on how to change the
particular thought patterns associated with this type of personality. So many people who struggle with anxiety never
got what they needed while growing up – – enough love, encouragement and affirmation. Lacking these core
experiences, we develop can develop particular maladaptive strategies to cope with people and situations that push
our buttons. This is the only book that I’ve read that pairs specific coping recommendations with particular
personality types.
Healing Anxiety and Depression — Daniel Amen, M.D.
Dr. Amen is a true pioneer in uncovering the connections between the brain and behavior. In this excellent book, he
provides an overview of how the brain works and how medication, diet, supplements, exercise and social and
therapeutic support can help anxiety. As science’s understanding of how anxiety and depression work has grown,
there is an emerging picture that both of these conditions are “whole body” problems that demand whole body
solutions. Like depression, we can’t just take a pill. Rather, we need to look at every aspect of our lives so that we
can address anxiety on multiple levels.
8
Dan’s Recommended Books for Lawyers
The Happy Lawyer: Making a Good Life in the Law – Nancy Levit and Douglas O. Linder
The Reflective Counselor: Daily Meditations for Lawyers – F. Gregory Coffee and Maureen
Kessler
Lawyers, Anger, and Adversity: Dealing with the Stresses of the Legal Profession – Rebecca
Nerison, Ph.D.
Stress Management for Lawyers: How to Increase Personal & Professional Satisfaction in
the Law – Amiram Elwork, Ph.D.
The Upward Spiral: Getting Lawyers from Daily Misery to Lifetime Wellbeing – Harvey
Hyman, J.D.
Lawyer Wellness is NOT an Oxymoron: Why Today’s Top Lawyers Must Embrace
Wellness – Andy Clark, J.D.
The Anxious Lawyer: An 8-Week Guide to a Joyful and Satisfying Law Practice Through
Mindfulness Meditation – Jenna Cho & Karen Gifford (Coming out June 7, 2016)