Rumination in the Legal Profession

There’s always a lot going on in my head.

But then again, there’s a lot of racket coming from yours too.

Lawyers think for a living, after all.  There’s always the mental hum of marshaling the evidence, resolving conflicting LexisNexis opinions or assessing the climatic shifts in office politics and how it affects the pecking order.  As advocates, we give a lot of deliberation to turning our analysis into persuasive locution. Lincoln, reflecting on his life as a trial lawyer, wrote, “When I get ready to talk to people, I spend two thirds of the time thinking what they want to hear and one third thinking about what I want to say.”

For lawyers with depression, there’s another kind of inner buzz.  It’s called rumination.

We might be tempted to think of rumination as a form of worry, a rehashing of all the shit that can go wrong. But, it’s actually not.  Worry focuses on potential bad events in the future.

Rumination, a cousin of fretful forecasting, is similar to worry except it focuses on bad feelings and experiences from the past. 

According to book The Mindful Way through Depression,

“When we ruminate, we become fruitlessly preoccupied with the fact that we are unhappy and with the causes, meanings, and consequences of our unhappiness.  Research has repeatedly shown that if we have tended to react to our sadness or depressed moods in these ways in the past, then we are likely to find the same strategy volunteering to ‘help’ again and again when our moods start to slide.  And it will have the same effect: we’ll get stuck in the very mood from which we are trying to escape.  As a consequence, we are at even higher risk of experiencing repeated bouts of unhappiness.”

In the First Person

I need a lot of time to get going in the morning – slurps of java, (the Starbucks “bold blend” varnish remover if I need a “stiff drink”) time to read the morning news, a sliver of time to plan my day  — and sometimes, ruminate. When ruminating, it’s as if pieces of my past are painted on those little squares of a Rubik’s cube that I’m endlessly manipulating  to solve.

Even though this style of thinking ends up making me feels crummy, in varying degrees, I like to ruminate. It some odd way, it seems to temporarily relieve me of any free-floating anxiety I might be experiencing.

Melissa Kirk writes,

“It feels good to ruminate.  Why is this? Two things happen to me when I’m dwelling on a problem.  The dwelling seems to stop the immediate pain or distress, the way rubbing a sore muscle can relieve the soreness temporarily, until you stop rubbing.  Also, I feel like, when I’m ruminating, that I’m acting on the problem of trying to solve it.  Rumination, then gives us the sense of taking action towards a situation that is distressing us, which relieves the distress in the short-term.”

This type of “mind rub” also skews the facts: I ignore the positive side of those past events and accentuate the negative.  Indeed it is rumination’s focus on the negative that gives it its solution-less quality.

We usually don’t ruminate when we’re happy.  When life is good, we savor everyday plentitudes of grace that have fallen on us whether earned or not.  This type of looking back is really reflection, not rumination.  When we reflect, we appreciate and learn from our past; no need to chomp on the bitter morsels of yesterday.   Interesting aside: the origins of the word “ruminate” come from the Latin word to describe the process in which cows chew and regurgitate their food, or “cud,” over and over again – yummy! 

We chew on our thoughts when we’re upset or in some kind of emotional pain or funk.  Rumination is a way of responding to life that involves repetitively and passively focusing on the symptoms of distress, and on its possible causes and consequences.   This plugs into depression because depression is passive.  We feel scant energy and incapable of taking action when in a melancholic ditch.

According to The Mindful Way through Depression,

“We ruminate because we believe it will help us overcome the unhappiness of depression.  We believe that not doing it will make our condition worse and worse.  We ruminate when we feel low because we believe that it will reveal a way to solve our problems.  But research shows that it does exactly the opposite: our ability to solve problems actually deteriorates markedly during rumination.  All of the evidence seems to point to the stark truth that rumination is part of the problem, not part of the solution.”

According to research done by Susan Nolen- Hoeksema, Ph.D., many ruminators negative outlook hurts their problem-solving ability. According to her research, they often struggle to find good solutions to hypothetical problems.  For example, if a friend is avoiding them, they might say, “Well, I guess I’ll just avoid them too.” Even when a person is prone to rumination comes up with a potential solution to a significant problem the rumination itself may induce a level of uncertainty and immobilization that makes it hard for them to move forward. Such depressive rumination most often occurs in women as a reaction to sadness.  Men, by comparison, more often focus on their emotions when they’re angry, rather than sad.

Percolations in the Brain

According to a recent Stanford study by Sian Beilock, Ph.D., changes were discovered in the brains of depression sufferers when ruminating.   MRI’s were taken of two separate groups: those with and those without depression.  Each group was separately prompted with various techniques to promote ruminative thinking. The MRI’s of people’s heads disclosed that a lot is going on in our brains when we are ruminating. 

According to an article in Montior magazine commenting upon Beilock’s work:

“People with major depression had greater activation than controls during the rumination task in a part of the brain called the anterior cingulate cortex. Thought to be involved in mood regulation, the anterior cingulate cortex may be infusing more emotion into the depressed individual’s ruminations than controls.  Depressed individuals also had greater activation in the amygdala, that almond shaped region deep in the brain that is a major player in negative emotional reactions.  Finally, and perhaps most interestingly, people with depression showed greater activation in the prefrontal cortex, where our working memory (a.k.a. cognitive horsepower) is housed.  If depressed individuals spend a lot more of this neural real estate trying to regulate their thinking, they may have less brain power left over to do other important thinking and reasoning tasks.  This may explain the cognitive deficits depressed folks sometimes show.” 

Unplugging From Rumination

Here are some thoughts about how to deal with rumination.

First, need to learn that rumination doesn’t solve our problems – it insidiously perpetuates them.  “We can’t,” wrote Albert Einstein, “solve problems by using the same kind of thinking we used when we created them.”  We can’t solve our depression by using the same ruminative thinking habits that may have caused it to begin with.

Second, we need to see why, if it doesn’t work, we keep doing it.  We do so because it tricks us into thinking we are actually being productive and briefly reduces our anxiety.

Third, once we have seen that it doesn’t work and why we keep doing it, we need to make small behavioral steps and resolutions to change it.  Yet, as Dr. O’Connor says, “We aren’t to blame for our depression.   But, we are responsible for getting better.”  Responsibility implies action, not just good intentions.

Depressives often hit a wall in their recovery when asked to change their thinking and/or behavior: they’re either too tired, frozen or can’t get out of their own way.  Often, they are fatalistic:  “The way I see the world is just the way the world is and my life is – screwed up.” They feel that life has dealt them a bad hand and try to solve unsolvable problems:  “What did I do to deserve depression?  Why can’t I ever get things done?”  These thoughts just produce paralysis, not productive solutions.

Of course, there’s an element of truth to many of our ruminations.  If there weren’t so, we wouldn’t endlessly cudgel ourselves over the head because we would quickly see just how silly ruminating really is.  For example, would any of us ruminate about why we didn’t  become a circus clown?  We don’t because there’s not a scintilla of evidence in our past that we ever wanted to be a clown or had the opportunity to do so. 

Rumination is more clever and seductive than that.   The ruminative habit compels us to churn away at half-truths or things that actually did happen.   For example, “why were my parents so screwed up?” Or “why did they leave me a legacy of depression or anxiety?”  There’s truth in these questions.  My parents were screwed up.  My parents did leave me a legacy of depression.

It’s been written that the truth will set us free.  The problem here isn’t with the truth, it’s what we do with it.  Ruminators run with it in a destructive way when they cycle through these issues over and over again with no resolution in sight.  With regard to our parents painful legacy for many of us, is there any answer that would ever satisfy us?

There is tragedy in this world, bad things do happen to good people and life is often unfair.  Yet, as Helen Keller once wrote, “The world is full of suffering.  But, it’s also full of the overcoming of it.” THAT is reality too.  So, when we sit down to eat our daily fare of our thoughts and meanderings that make up our days, we might want to pick from the upbeat side of the menu. 

And not chew on our food too much.

Judges and Depression

Loneliness is the most terrible poverty — Mother Teresa

I’ve written a lot on stress, anxiety and depression in the legal profession, but not about the judiciary. There has been much commentary, research and Law Journal articles about what ails law students and attorneys — but not about judges.

I guess that’s not surprising.  In my work over the past four years, I have spoken with scores of judges from all over the country.  It’s a noble, important calling in life.  But it’s also very stressful, demanding and . . . lonely.

Here’s a clip from the new documentary A Terrible Melancholy: Depression in the Legal Profession. My good friend Judge Michael Miller talks about the loneliness of being a judge:

Isolation, Loneliness & the Judiciary

In an article for Judicature magazine, psychiatrist Isaiah Zimmerman culled through twenty years of notes he accumulated from treating state and federal judges.  Here are the voices of the judges in their own words: 

“Before becoming a judge, I had no idea or warning, of how isolating it would be.”

“Except for those very close, old friends, you cannot relax socially.”

“Judging is the most isolating and lonely of callings.”

“The isolation is gradual.  Most of your friends are lawyers, and you can’t carry on with    them as before.”

“When you become a judge, you lose your first name!”

“It was the isolation that I was not prepared for.”

“After all these years on the bench, the isolation is my major disappointment.”

“The Chief Judge warned me: ‘You’re entering a monastery when you join this circuit.’”

“I live and work in a space capsule – alone with stacks of paper.”

“Your circle of friends certainly becomes smaller.”

“Once you get on the appellate bench, you become anonymous.”

These weren’t isolated comments or small pockets of pedestrian sadness.  Dr. Zimmerman notes that about 70% of the judges he interviewed came up with these observations on their own.

There are several things that contribute to a sense of judicial loneliness.  The Code of Judicial Conduct imposes restrictions on judicial behavior both in and out of the courtroom.  Judges must avoid the appearance of impropriety and thus must be cautious and keep an appropriate distance and bearing at social and bar events. There are good reasons to have these restrictions, but if a judge isn’t careful to live a balanced life, they can help trigger a profound sense of lonesomeness.

Loneliness isn’t just emotionally painful; it’s also dangerous to your health on multiple levels.  According to an article by psychologist, Hara Estroff Marano, writes:

“Evidence has been growing that when our need for social relationships are not met, we fall apart mentally and even physically. There are effects on the brain and on the body. Some effects work subtly, through the exposure of multiple body systems to excess amounts of stress hormones. Yet the effects are distinct enough to be measured over time, so that unmet social needs take a serious toll on health, eroding our arteries, creating high blood pressure, and even undermining learning and memory.”

Given the pressures and isolation of the job, judges need to recognize the dangers associated with loneliness: unhappiness, discontent, health problems and perhaps . . . depression.

Judges and Depression

Judges are supposed to be problem solvers in black robes; not human beings with psychological problems of their own.

Given the position that judges occupy in our society, the stigma around disclosure to others –and perhaps getting treatment for clinical depression — is much, much greater. 

One psychiatrist I know who treats judges told me that judges request very early or very late weekday or weekend appointments.  Moreover, they ask not to be scheduled before or after another lawyer or judge and pay in cash so as not to attract attention or leave a paper trail.

For the first ten years of my career, much of my practice was spent litigating cases in state and federal courts in New York City.  One of my best friends from those days is now a judge.  When I decided to go public with my depression four years ago by writing an article for Trial magazine, my friend called me for dinner to catch up on things.  He wanted to know how I was feeling and expressed concern about my plans to go public about my depression. 

“Dan, why can’t you write the article anonymously,” the judge said.  “But that’s the problem, isn’t it?” I replied. “Why should I have to write such an article anonymously? What do I have to be ashamed of?  Depression is an illness no different than diabetes or heart disease.  Would I write an article about those illnesses . . . anonymously?”

We kept in contact with dinners and phone calls over the next four years, but over time our conversations centered less on my depression and well-being and more on his.  You see, my friend the judge disclosed to me that he was suffering from depression and had tried to commit suicide some years before. 

I think he felt he could trust me.  Moreover, I think my disclosure gave him implicit permission to talk about his pain and struggles; a hurt only his therapist and wife knew of.  He spoke of the loneliness of his job and how he missed the collegiality of his old large firm.  But, he said that on the balance,  he’d rather be a judge and didn’t regret his change in vocation; a move from the courtroom to the chamber.  He liked his job, enjoyed the intellectual challenge and the chance to do justice.

The statistics on lawyer depression are deeply troubling.  They suffer from depression at a rate twice that (20%) of the general population.  As such, about 200,000 of this nation’s 1 million lawyers are struggling with depression right now.  No studies have been done on judicial depression.

There are 1,774 federal level judges in the U.S. Were you to plug in the 20% depression rate we see with attorneys to the number of judges, approximately 350 judges across America are suffering from depression. Even though there haven’t been any studies of judicial depression, why would we expect the 20% rate to be any different than that found with attorneys?

I couldn’t find any statistics on how many state judges there are in the U.S.  New York State has 1,250.  Were you to plug in the 20% depression rate we see with attorneys to the number of these judges, approximately 250 of the Empire State’s judiciary are suffering from depression.

This isn’t sadness or burnout, but true clinical depression.  Sometimes, we confuse being down in the dumps with depression. They’re really not the same thing – not even close. Here’s how psychologist Richard O’Connor, best-selling author of the book Undoing Depression, distinguishes it:

“Everyone knows what depression feels like.  Everyone feels the blues at times.  Sadness, disappointment, fatigue are normal parts of life.  There is a connection between the blues and clinical depression, but the difference is like the difference between the sniffles and pneumonia.”

Nobody’s Perfect

Perfection is also an indicator for depression.  In his article Even Judges Get the Blues, Judge Robert L. Childers writes:

“Because of the weight of public expectation, judges generally feel that they should be perfect.  Not only do they feel that they should be fair, impartial, and make the right decision 100 percent of the time, but the public expects this of judges as well, as do the lawyers who practice before them.  This can create undo pressure for judges and, consciously or unconsciously, keep judges from admitting or recognizing the signs of debilitating disease.”

In an article from the ABA Journal,  Perfectionism, Psychic Batterning’ Among Reasons for Lawyer Depression, the piece states: “Lawyers [and judges] are taught to aim for perfection, to be aggressive and to be emotionally detached. They ‘intellectualize, rationalize and displace problems on others’ . . . . They don’t take direction particularly well. They tend to have to have fairly elaborate denial mechanisms. And they tend to challenge anything they’re told.”  In another article from the ABA Journal, it notes that when combined with depression, perfectionism makes it harder for a person to seek help.  And in the worst case scenario, leads to suicide.

Loneliness & Depression

Depression is a multifaceted illness that has several different causes – some genetic, some physical and some emotional.  In the depths of my depression, I felt very alone – like I was trapped at the bottom of a dark well. 

Many with depression isolate themselves because it’s painful to be around others.  I would hang out at Starbucks and do my work.  I didn’t want others I knew to engage me; I didn’t want others to see the pain I was desperately struggling with.

I’ve found that loneliness and depression often travel the same road.  This creates a lot of problems because the two can feed off one another.

According to psychologist Dr. Reena Sommer:

“Depression is a problem that often accompanies loneliness. In many cases, depressive symptoms such as withdrawal, anxiety, lack of motivation and sadness mimic and mask the symptoms of loneliness. In these cases, people are often treated for depression without considering the possibility that loneliness may be a contributing and sustaining factor in their condition.”

Generally, the debilitating symptoms of depression can usually be managed with antidepressant medication. But when the underlying loneliness is ignored or overlooked, the depressive-like symptoms will probably continue. Unless the reasons for loneliness and depression are separated out, it can easily turn into a ‘chicken and egg’ situation where depression leads to loneliness, and loneliness leads to depression.”

Turning It Around

While depression might not be our fault, it is our responsibility to get better.  We need to start behaving and thinking in constructive ways.  Here’s some food for thought:

1. Get help.  You can’t handle this by yourself.  It is a problem bigger than any individual person.  The A. B.A. ‘s Commision on Lawyer Assistance Programs recently created a Judicial Assistance Initiative.  Reach out to them and they can get you pointed in the right direction.
2. You may have to take antidepressant medication to help you.  That’s okay.  You may have a chemical imbalance that you need to address.  For many, psychotherapy alone won’t help until they quieted down their somatic complaints — e.g. fatigue from sleep problems — so that they can have the energy and insight to work on their problems.
3. Whether you need medication or not, you will need to confront your negative thinking with a therapist.  A lot of research suggests that cognitive behavioral therapy is a particularly effective form of treatment for depression.  Interview a couple therapists before you settle on one.
4. Exercise. The value of exercise is widely known: It’s simply good for everybody. For a person with depression, it becomes not just about a healthy habit, but a critical behavior and habit – they absolutely need to work out.  In his book Spark: The Revolutionary New Science of Exercise and the Brain, Harvard psychiatrist John Ratey devotes a chapter to the importance of exercise in alleviating depression.  Please check this book out.
5. If you have a spiritual practice, do it.  If you don’t, think about starting one.  This could be anything from a formal meditation practice, going to Mass, or walking the woods.  A lot of research suggests that people who have a spiritual practice do better with depression recovery.  If you believe in God or a higher power (I am Catholic), you can avail yourself of help and support from Someone who is bigger than your depression.  If you do not believe in God, maybe you believe in some other form of spirituality you can tap into.  Spiritual growth and development, in my opinion, are very important pillars of recovery. Two books from my tradition include Seeing beyond Depression by Father Jean Vanier and Surviving Depression: A Catholic Approach by Sister Kathryn James Hermes.  Also see the wonderful guest article she wrote for my website.
6. Get educated. Read some good books on the topic. As part of your education, learn about the powerful connection between stress, anxiety and depression.  On this subject, I recommend Dr. Richard O’Connor’s Undong Perpetual Stress: The Missing Connection between Depression, Anxiety and 21st Century Illness. Dr. O’Connor suggests that depression is really about stress that has gone on too long. The constant hammering away of stress hormones on the brain changes its neurochemistry.  This can and often does result in anxiety disorders and/or depression.  Also see the article I wrote for Trial Magazine about the connection between stress, anxiety and depression. It is a companion piece to an excellent article written by Andrew Benjamin called “Reclaiming Your Practice.”
7. Build pleasure into your schedule.  Judges, like all those in the legal profession, are busy and have the “I will get to it later” mentally – especially when it comes to things that are healthy pleasures.  We have to jettison this approach to how we live our days.  We must begin to take time – now – to enjoy pleasurable things and people.  A hallmark of depression is the inability to feel happiness or joy.  We need to create the space where we can experience and savor good experiences and feelings.
8. Practice mindfulness. In mindfulness meditation, we sit quietly, pay attention to our breath, and watch our thoughts float by in a stream of consciousness. Normally, we immediately react to our thoughts (e.g. “I am losing my mind with all of these deadlines”).  With mindfulness practice, we can begin – slowly – to let the thoughts and feelings float by without reacting to them.  If such an approach to depression seems far-fetched, read the best-selling book The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness, for an excellent primer on how you can incorporate mindfulness into your day.
9. Remember to be kind to yourself. It sounds so simple. I tell this to depressed lawyers and judges all the time and they usually look puzzled.  They often admit that they have rarely, if ever, thought about it and don’t know how to be kind to themselves.  I believe that it first begins with a conscious intention – “I am not going to treat myself poorly anymore.” Such a simple refrain can help us.  Depression is often built on poor mental, emotional and physical habits. We must learn to acknowledge that we are worthy of love from ourselves and others and that part of such love involves taking better care of ourselves.
10. Spend time outside and in nature.  We humans forget that we are part of nature and the animal kingdom.  We need fresh air and sunshine.  Even more so when the darkness of winter strikes.  If you live in a part of the country with long winters, load up on vitamin D and consider using a light box to help you.

If you or a judge you know might be suffering from loneliness and/or depression, please forward this article to them.  Here’s a list of depression’s symptoms and a self-test from the Mayo Clinic.