Friday, October 30, 2009

Taking on Depression: Part 3: Gratitude

The “practice” of gratitude is one of the most powerful things you can do to overcome depression. Genuine gratitude includes both a thought and its emotional correlate. Thoughts usually carry an emotional valence: it’s a nice day, you feel glad; the partner likes your work, you feel competent; your child earned good grades, you feel proud; you’re going skiing, you feel excited; a snowstorm is coming, you feel annoyed. Because gratitude is a positive thought, it always carries a positive emotional valence.

Your thoughts and their emotional correlates do not occur in a vacuum. They occur in your body and influence biochemical processes. The mind-body connection is a well established fact. The most obvious examples are the connection between a happy, purposeful, socially connected life - and health and longevity; the connection between stress - and heart disease; the connection between the practice of meditation – and improved mood, concentration, and general health; the connection between the belief that you can’t do something - and attempts to do it that somehow fail.

You are energized or enervated by your thoughts. Prove it to yourself. Think back to a time when you felt really grateful for something. How is that thought affecting you physically right now? Do you feel a relief of tension? Increased energy? Greater lightheartedness? How about emotionally and mentally? Are you, even briefly, less anxious or worried? More hopeful? Happy? Joyful? More emotionally available? Prove it further: tell yourself right now, “I am grateful that I am loveable and competent.” Repeat it several times, letting the meaning sink in. How are your mood and your body responding?

Gratitude is as automatic for some as negative, depressed thinking may be for others. The automatically grateful perhaps have had life experiences that gave them sufficient reason to believe that they were good and deserving and that life would unfold favorably enough if they just did their part. Lucky them. For others, life experience may have tipped the balance toward less optimistic beliefs and expectations, against the odds of which they seem to continually struggle in order to achieve at least partial success and happiness. We are all somewhere on that continuum, and those for whom gratitude is not automatic may have to work harder, with real commitment and determined practice.

If you are not among the group of “automatically grateful,” how do you become more grateful?

· Commit yourself to practicing gratitude. (If you pray, pray for the gift of gratitude.) Making the commitment alone begins to change your energy and your ability to follow through. There are an infinite number of things, past, present and future, for which you can be grateful.

· Short-stop negative thoughts with statements of gratitude, ideally, a statement that reformulates the negative thought into a positive thought. Example: “I wish I didn’t have to get where I have to go by walking in the rain.” Re-formulation: “Thank you that I have two legs and the ability walk. Thank you that I can see where I going. Thank you that I have an umbrella and a hand to hold it. Thank you for water. Thank you for the way rain enriches the colors of nature. Thank you for the sun and its eventual return. Thank you for the opportunity to practice gratitude.” Another example: “At this rate, I’ll be broke before I find a job.” Re-formulation: “Thank you for the job I last held, and for all the jobs I’ve held previously. Thank you for all the knowledge and experience, friends or mentors I acquired through them. Thank you for all my opportunities for education and training, and for my many abilities. Thank you for the people who come into my life who contribute to my search. Thank you for the creative ability to make the most of what I have now. Thank you for ‘the sun in the morning and the moon at night.’”

· Reinforce gratitude by keeping a gratitude journal. Write down the things for which you are grateful (and notice what happens to your mood and body in the process).

· Make a mental list as you go to sleep of the things for which you are grateful that day (and notice how quickly you fall asleep). Do the same when you awake, before getting up. If you awake at night and have trouble returning to sleep, resume thoughts of gratitude, perhaps beginning with having a safe, warm place to sleep and the ability to relax into it and enjoy it whether or not you’re sleeping, for the ability to breathe unassisted, for a comfortable pillow, etc. etc., etc.

· Remind yourself to be grateful. One person (referenced in the very helpful book, The Mindful Way through Depression) did this by carrying a small smooth stone in his pocket to remind him throughout his day to think grateful thoughts, setting it next to his bed at night, ending his day and beginning his next day with grateful thoughts.

· Practice. It does take practice to develop any new habit, including a mental habit. Making a habit of gratitude is a great on-going, practically failsafe defense against depression; the two cannot co-exist for long. This “attitude of gratitude” is a key element practiced by 12-step program members who over time find themselves surprisingly and wonderfully transformed. You will, too.

The practice of gratitude is a deliberate mental practice that carries a positive emotional valence which helps correct negative thinking, relieves potentially damaging stress to the body and generates increasing levels of energy, enabling you to see and respond to new previously unnoticed possibilities. As it builds, with your continued practice, you will find yourself regaining and consolidating your power, and depression losing its grip.

Friday, October 16, 2009

Taking On Depression: Part 2: Change Your Thinking

As I’ve stated before, in order to overcome depression something has to change. More accurately, you have to change something, because what you have been doing is clearly not working for you if you are depressed. One of the most important, effective, and perhaps most challenging changes you can make is in your thinking. What does your thinking have to do with how you’re feeling? Everything! While many believe that pleasant thoughts flow when you’re feeling good, the reverse is also the case: positive thoughts generate positive feelings. When immersed and perhaps feeling trapped in depression’s hallmark feelings of helplessness, hopelessness and worthlessness, you have first succumbed to thoughts that create a sense of helplessness, hopelessness and/or worthlessness.

I say ‘succumbed’ because you are unconsciously complicit with, or acquiescing to, negative thoughts, something easily done because they are often automatic, non-stop, and not usually subjected to our scrutiny. If we did examine them, we would find that they are also frequently unencumbered by reality and capital ‘T’ Truth. Our wakeful but unobserved thinking can carry a lot of mood deflating content consisting of fact-less opinions, invalid assumptions, skewed perceptions, misinterpretations, suppositions, pessimistic expectations, etc., aptly referred to by 12-step programs as “stinkin’ thinkin.” It is a disempowering, disabling cascade of subliminal thoughts that may begin with such phrases as, You never… I can’t…, I’m not…, I don’t…, If only…, which foreclose on all the possibilities lying just beyond worst case scenarios and a constricted imagination. Such thinking not only generates depression but shows up sooner or later in minor or major depleting, self-defeating, irrational, offensive or anti-social behaviors, and sometimes in quite significant emotional pain, as well. It can muck up our plans, screw up our relationships, interfere with our performance, and sink our mood.

But, just as 12-step participants learn to change their thinking in order to free themselves from their addictive behaviors, those with depression can do the same. You can exercise your option to become more aware of your thoughts, evaluate their truth and validity, and reject the distorted thinking that lurks behind and gives rise to every depression. And then you can substitute more accurate and positive thoughts that reflect reality, generate new energy, and inspire action.

Observing and changing what you think appears so simple and elemental a strategy that it may seem to trivialize the painful and debilitating experience of depression. However, simple does not mean easy. Anyone who makes the effort to change his/her thinking is quickly disabused of the belief that it is easy. It is a skill that is learned over time with practice, supported and reinforced by commitment and perseverance, and ideally, professional help.

Why is it so difficult? In order to begin to observe your thinking, you must slow down, quiet the noise and distraction, and listen to yourself. Part of the difficulty, therefore, lies in shifting one’s focus inward, and being willing to go against the grain of the dominant culture that values speed, productivity, constant stimulation, acquisitiveness, and conformity. Lawyer culture, in particular, emphasizes devoting precious hours to tangible productivity.

The other part of the difficulty lies in the nature of our thoughts and thinking. When not fully engaged in concentrated mental activity, or in a meditation practice, our minds usually roll along in subliminal, rapidly shifting, fragmented and unformulated thoughts, assumptions, opinions, wishes, memories, plans, often with attached feelings, much of which we are quite unaware of within nano-seconds of their occurrence, if at all. They are reactive to all forms of stimulation, may be habitual, and may represent components of defenses against unresolved painful emotional experiences. In addition, thoughts that seem particularly resistant to our efforts to change may be rooted in deep-seated false beliefs that were formed early, perhaps even at a pre-verbal stage of development.

In addition, becoming an observer of your thoughts eventually leads to also observing your behavior, augmenting the process of self-discovery that inevitably contains the good, the bad and the ugly, and sooner or later, a closer encounter with your own vulnerability. So, besides moving away from cultural norms, you risk seeing yourself through a wider angle lens. But the ensuing awareness and acceptance of your thoughts, feelings and beliefs form the springboard for volitional change, and the opportunity to lose the depression and feel more alive.

Here are steps you can take to become a better observer and manager of your thoughts:

  • Prime the pump by holding the intention to observe your thinking with objective interest and without judgment. This helps to summon, mobilize and focus new energies.
  • Journal. Frequently. The process of formulating unedited thoughts and feelings into more or less coherent words and sentences is clearly consciousness raising.
  • Tell it to someone. Speak your thoughts and feelings to a skilled and trusted therapist (or friend, or clergyperson) who functions as a sounding board, a source of feedback and perspective, an asker of questions you might not think to ask yourself. Scheduling regular appointments is one way to create a time and space for you.
  • Begin a daily spiritual practice, i.e., something that helps you slow down and listen to yourself. This may be a walk on the beach or stroll in the woods, attending church or temple or a good 12-step meeting, meditation (alone and/or in a group), listening closely to beautiful music or visiting an art museum, reading poetry or spiritually inspiring literature, journaling, drawing, or other solitary creative activity, etc.
  • Tag and correct negative thoughts. Substitute a corrected thought that specifies what you want. Reinforce the corrected thoughts with repetition, and don’t get discouraged when they recur; stay the course until they weaken and fade.
  • Identify and visualize what you want. Depression short-circuits thoughts about what you want and what you can do to achieve it. Begin to move toward “the unachievable” in little steps. Dreams can come true one little step at a time.
  • Cultivate self acceptance. “If your compassion does not include yourself, it is incomplete.” (Siddhartha Gautama) When you are feeling down on yourself, identify the reason/thought, e.g., for “I’m too depressed to get anything done,” use this “mantra” to re-focus yourself: “Even though I feel so depressed, I deeply and profoundly love and accept myself.” Say it repeatedly until you feel it. Modify it to suit other forms of perceived personal failings or troublesome feelings. (Notice that working this thought effectively demonstrates how positive thoughts generate positive feelings.)

Loving, compassionate self-acceptance is a condition for change and for beating depression.

Changing your patterns, especially well-established thought patterns, is challenging. Meeting that challenge means taking responsibility for your own well-being and is the antithesis of depression because it is proactive, empowering, and enlivening. Changing your thinking is a powerful strategy. Does depression ever gradually or spontaneously remit without your active participation? Yes. Agreeable external events may occur that restore confidence, a sense of personal worth, raise expectations, or inspire new positive thinking and behaviors. However, passive waiting for “things to get better” is much more likely to result in more of the same, i.e., continuing or worsening depression. When you take charge of your own journey and take charge of your thinking, expect to feel more alive. Depression and aliveness are mutually exclusive states.

Next time: What Do You Want?

Friday, October 9, 2009

Taking on Depression

What do you do when you feel utterly uninspired? When your usual sources of joy and pleasure cannot rouse you from an immobilizing, listless dullness? When you may not have anything to feel bad about, but also can’t find anything to feel good about? When you can’t depend on your usual ability to focus and concentrate? When you are easily annoyed and generally irritable, or when you find yourself in a sudden outburst of anger that is just not you? When you’re tired but can’t sleep, or you sleep too much. When you’ve lost your appetite, or eat too much. What’s going on?

Those of you who have been there would recognize this description of depression, and in the absence of a diagnosable physical cause, that is probably what you’re experiencing. Depression can seem to strike suddenly, or it can be a subtle and gradual process that we’re barely aware of, if at all, until its persisting effect on health, job, relationships and general functioning is no longer tolerable to us and/or others, and we are forced to address it as the problem it is.

Most of us have experienced at least mild depression. It can be regarded as part of the human condition, a fact of life. Some are more vulnerable, some less, for reasons that can be biochemical, circumstantial, genetically determined, even socio-cultural. The triggers setting off an episode of depression are many and sometimes easily identifiable, such as an external event: a blow to the ego (a perceived slight ignites an old vulnerability); a major loss (of a loved one, a job, income, home; even a personally treasured object, a dream, or a social role); a personal or professional failure (divorce, failing the bar exam, losing an important case).

Sometimes the source of depression is not immediately apparent. We may feel awful, begin to realize we have felt awful for too long, and have no clue as to where this encroaching lethargy came from, and only with some (perhaps professionally assisted) digging and soul searching begin to discover a myriad of intersecting events, conditions, memories, unresolved losses and more that affect us at a core level, leaving us with those three major emotional earmarks of depression: feeling helpless, hopeless, and worthless.

Much has been written about what some authors call the “epidemic” of depression in this country, even among children. If the incidence of depression is escalating, we can suspect that something may be going on in the culture, even in the collective psyche, as well as in or within our own personal lives. Times like these, of unpredictable economic, political and financial events, fractures and polarizations in the sense of national unity, etc., can contribute to depression by diminishing our sense of control over our lives, eroding self-confidence, overwhelming one’s usual coping strategies and bringing on fear and doubt. To recognize that a co-occurring wider phenomenon may be taking place may offer a useful context and perhaps perspective. However, personal responsibility for one’s own sense of well-being still obtains.

Lawyers are disproportionately over-represented among the depressed, due in part, as many have noted, to the adversarial nature of their work, the constant stress of managing details, deadlines, and demanding clients (or partners), the need to present themselves as always competent, in control, and able to deliver the answers and solve the problem. Add to that the tendency to over-prioritize the clients’ needs to the neglect of, or even disconnection from, their own needs, and the burden reaches critical mass.

Lawyers’ struggles to meet such demands of the job, without adequate self-care, may be inimical to the very things that really count, that make life worth living, that give pleasure, and that support physical, mental, and spiritual well-being and balance, i.e., that prevent depression. Depression is a sign that balance has been lost and some action is necessary to restore it. The good news is the right actions will restore balance and vitality. Because depression can be so disempowering, enervating and immobilizing, discovering the source(s) of depression and identifying and prioritizing appropriate actions may require, or is at least expedited by, professional assistance. No matter how smart and savvy you are, negotiating the slippery slope of your own mind can be tricky, can amount to missing the forest for the trees. What is most helpful is someone who can compassionately mirror back to you what you yourself can’t (yet) see, and who can help you figure out what you are willing to do, so that you can make the changes necessary to feel better.

Overcoming depression is all about getting your power back - power over your own life, your own self, your own mind and spirit. Overcoming depression is not about controlling or exercising power over other people, places or things. Overcoming depression is not achieved by changing anyone but yourself, anyone’s behavior but your own, anyone’s thinking but yours. You may notice, however, that self-empowering actions you take to combat your depression may evoke positive and self-reinforcing changes in others’ responses to you. Self-change is where your true power resides, and as you begin to exercise that power with increasing confidence and skill, you need never succumb to debilitating depression again. Depression may recur, but you will be able to successfully deal with it.

Yes, you have to change, change your thinking and change your behavior. And you are the only one who can do that. What’s good about that is you don’t have to wait for anyone else, or depend on anyone else in order to make changes that will help you begin to feel better. That’s the good news. There is no bad news, unless taking up the challenge in your own behalf is not what you had in mind. Realistic expectations of professional assistance and family or close friends may be an important part of the process of taking up the challenge; for some it makes all the difference. Depression will not be remedied by magical thinking, longing, or mere wishing that things were different. It may require determined, persistent work, and in the case of certain intractable depressions that don’t respond immediately to your best efforts, the use of medication for a period of time may be very beneficial. The important thing is to never accept defeat, and never accept victimhood.

In subsequent blogs, I will suggest specific actions you can begin to practice to loosen the grip of depression.

Thursday, October 1, 2009

Coping Mechanisms for Managing or Relieving Stress in the Wake, or in Fear, of Job Loss (4-Part Series) -- Part IV: Accepting Help, Giving Help

Too often we turn away opportunities and offers of assistance when most needed because of some misguided, though completely understandable, sense of pride, shame, and/or embarrassment. If there is one positive thing that has come out of the nation’s economic crisis –if you can call any of this “positive” –it is the fact that because so many are experiencing layoffs at the same time, employers rarely dwell on the reasons for an applicant’s laid off status during the interview process.

Here are a few things to keep in mind, lest you turn away your next great opportunity:

· DON’T BLOCK THE BLESSING! Helen Keller once said, “When one door of happiness closes, another one opens; but often we look so long at the closed door that we do not see the one which has been opened for us. . . . " Too often we get so bogged down in our circumstances that we proceed through life with blinders on and miss potential opportunities that come across our path. Be conscious of when you feel yourself pulling in that direction and do an about-face. Don’t become so mired in the negative that you don’t hear when opportunity knocks. Maintain positive expectations and be open to possibilities.

· ACCEPT “THE GOOD” There is nothing to be embarrassed or ashamed about being laid off, especially in the current economic climate. Don’t let pride or shame lead you to turn away offers of assistance and opportunities. Identify and utilize all available resources to advance your goals. Similarly, now is not the time to decide to stop participating in your profession-related extracurricular activities, such as boards, task forces, committees, bar association groups and sections, etc. Now, more than ever, you want to cultivate and maintain those connections, which may prove useful in the end. This also ensures that you won’t give in to the urge to isolate yourself, or become disconnected from others. It can be quite beneficial to have fellow committee members see you “in action.” They would be able to comment on such things as your ability to lead, how well you work with others, whether you are a “team player,” your work ethic, and how well you get along with others. After all, you never know from where your next opportunity will come.

· SET UP YOUR OWN PERSONAL “DREAM TEAM” Your “dream team” is a person, or group of people, whom you trust to be there for you in a supportive role as you embark on this journey towards the next chapter in your work life. Some turn to people they’ve identified as mentors or role models, while others choose close, positive-thinking friends or confidants who they know will help to keep them moving forward. Ultimately, they should be people who know what your goals are and who are going to help you to achieve them by checking in with you on a regular basis to ensure that you are moving towards your goal and accomplishing tasks you identified for them during the prior call.

· PAY IT FORWARD. Helping others is not only good for the person you help, but also for your own soul. Remember also that good attracts good. Take the time to volunteer your services through pro bono work and public service. This has added benefits, including helping you to continue to practice and feel connected to the profession, advancing and honing your legal skills, networking and opening yourself up to other opportunities, as well as potentially exposing you to other practice areas. Additionally, if you were contemplating going into a particular practice area, but weren’t sure about whether you would like it, this is one way of making that determination prior to committing yourself via a long-term contractual arrangement. Contact your state and local bar associations, as well as your state’s legal aid office(s), to find out what pro bono and public service opportunities are out there. You can also simply pick up the phone and call solo, small, and/or mid-sized firms which specialize in the contemplated practice area and ask whether they could use some volunteer help in exchange for their willingness to allow you to be, in essence, an apprentice and shadow them. In today’s economy, with many firms being forced to significantly downsize in order to remain open, you are certain to find lawyers who will gladly take you up on that offer.

Even with these coping mechanisms, you may still need professional help with getting through your stressful situation, which may seem overwhelming and all encompassing. THERE IS NO SHAME IN GETTING OR SEEKING HELP, SO PLEASE DO SEEK PROFESSIONAL ASSISTANCE WHEN SUCH STRESS, OR ISSUES SUCH AS ANXIETY, DEPRESSION, SUBSTANCE ABUSE, OR OTHER TROUBLING BEHAVIORS PERSIST. For assistance, please contact us at Lawyers Concerned for Lawyers, Inc. (31 Milk Street, Suite 810, Boston, MA , (617) 482-9600, email@lclma.org, or visit our website at http://www.lclma.org/). Help can also be accessed through your: healthcare provider; local hospital; psychologist, psychiatrist, social worker, clinician or other mental health professional; or community healthcare center.See our web site Resource Page for a list of relevant stress resources.

Ms. Walcott presented this and other material in a program entitled, “Staying Positive in a Down Economy: Beyond The Group Hug” (June 30, 2009), which was part of the ABA’s Recession Recovery Teleconference Series. A download and course materials for this program are available online at http://www.abanet.org/cle/programs/nosearch/tspdmo.html.