Paying Attention to Our Depression

Depression isn’t just an illness.  It’s a messenger.

In his book, Unstuck, James Gordon, M.D., writes:

“Depression is not a disease, the end point of a pathological process.  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, a journey that can change and transform our lives.  Healing depression and overcoming unhappiness mean dealing more effectively with stress; recovering physical and psychological balance; reclaiming parts of ourselves that we’ve ignored or suppressed: and appreciating the wholeness that has somehow slipped away from us, or that we have never really known”.

If we would but listen, we might find that our depression is trying to tell us something; important insights about our lives and the ways we live it that might be keeping us mired in a soupy gloom.

We often don’t heed our inner wisdom, but keep going full-speed ahead in the wrong direction anyway. Richard O’Connor, Ph.D. observed, “Depression is a vicious circle and we keep doing these destructive patterns because “we don’t how to do anything else.”

When we think of depression only as an illness, we oversimplify its causes and remedies.  No doubt, it has profound effects on our brains and bodies.  Surely, it runs in families and likely has a genetic component. But if it were only that, a blue pill would solve the problem.  And it doesn’t.

The pain of depression may be an impetus for sufferers to live a more authentic life.  Often people who suffer from depression are living from a wounded place within themselves.  Along the way, they learned that they weren’t “good” enough or were “bad people”.  As a consequence, they learned to hide their true needs and wants and live an inauthentic life; a life that may not work, but they don’t know how to change.

In this vein, folks can come to think of depression as some sort of punishment:  a recompense of some unknown sins from an undefined past.  Or, maybe the very real wrongs they may have committed are magnified, as they are prone to be in the mind of a depressive, by the process of generalization: a known cognitive trick of depression where we take a negative incident (e.g. “I lost this case”) and turn it into “Why am I such a failure?”

Depression doesn’t just happen to anyone. Rather, it is the accumulation of a lifetime of varying degrees of psychic pain suffered during a lifetime, often starting in early childhood.  In our early years, many learned that it was dangerous to live from a space of our true selves because of a parent who was an alcoholic, abusive or in some way emotional abusive or absent.

Ellen McGrath, Ph.D., writes:

“Scientists know that traumatic experiences such as child abuse and neglect change the chemistry and even the structure of the brain.  They sensitize the stress response system so that those who are abused become overly responsive to environmental pressures.  They shape wiring patterns in the brain and reset the sensitivity level of the machinery.   Eventually, even small degrees of stress provoke an outpouring of stress hormones, and these hormones in turn act directly on multiple sites to produce the behavioral symptoms of depression. They push the brain’s fear center into overdrive, churning out negative emotions that steer the depression’s severity and add a twist of anxiety”.

Our parents, acting out of their own wounded souls, unconsciously played out their unresolved pain with us during our childhood.  They did so because of their distorted way of seeing the world; a place that they found threatening, its problems unsolvable and against them at every turn.  This hardened them and led them to fail in life’s most important vocation: the nurturance of their own children.

I recall my mom saying to me as a child, “Well, what are you going to do?”  While one could say this was the innocuous lament of a middle-aged mother of 5 kids, later in life I learned it was mom’s worldview that there weren’t really solutions to life’s fundamental problems, that we are, at our core, helpless in the face of life’s thorny challenges. 

My mom suffered from undiagnosed and untreated depression for most of her life.  I now see how this passive, victimized way of seeing the world took root in my psyche as a young man.  And how hard I had to work to overcome it over the years; how I had to struggle to listen less to the inner voice and critic of my parents and incline my ears toward my true self which was always there waiting to be heard.

In Listening to Depression, psychologist, Lara Honos-Webb writes that depression is trying to tell us something: that we are on the wrong track in life.  In this sense, depression can be a teacher if we would only listen to it.

How can we come to see depression as a teacher?  Honos-Webb writes:

“Depression can be seen as a break-down in the service of offering the person an opportunity for a break-through.  In this way, depression can be a corrective feedback to a life with little reflection.  We only reflect on those things that break down in life.  For example, if life is going along smoothly you won’t spend time thinking about the meaning of life.  We tend to think deeply about life when something is not working.  When we identify a problem, we begin to reflect on what caused the problem and how to fix the problem.  If you are disconnected from your deepest feelings and impulses you may still manage to get through life without realizing it.”

I admit that it’s hard to see depression’s value when in the thick of it, the swamp through which we slog with little relief.  But there’s much to be said for seeing depression not just as a disease, but as a messenger that our lives need to change for us to heal.

 

 

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.

Getting Unstuck From Depression

Two people look out the same prison doors: one sees mud and the other stars. – Frederick Langbridge.

Some of our best efforts to escape the deep mud of depression are misguided – – we step hard on the gas pedal only to find our wheels spinning deeper and deeper into the gooey, brown earth.

We keep using depressive thinking to get ourselves out of, well, depressive thinking.  We are asking the wrong questions:  “What’s wrong with me, why can’t I fix this, I suck at being a lawyer, my life is a mess.”  Surely, this is not the tow truck we need to pull us out of the swampland of depression.

Depression makes us feel like we are stuck in our lives; we can’t seem to move forward beyond our melancholic sighs.  According to psychologist Rollo May: “Depression is the inability to construct a future.”  Maybe this is so because the muck of depression is so painful and deadening that it freezes us like a deer caught in a steel trap.

Depression also handcuffs us to our past.  We mercilessly ruminate about all the ways our lives have gone wrong.  We marshal the evidence against ourselves and “guilty” is the verdict every god damn time.  What are we really “guilty” of?  Of being a human being who makes mistakes.  As newspaper columnist Jan Glidewell once wrote: “You can clutch the past so tightly to your chest that it leaves your arms too full to embrace the present.”

Our real and true self is sandwiched between our negative views of the past and our inability to move forward – hence, our bogged down blues.  We have to let go of the past and lean into a vision of a more optimistic future to begin living our lives again.

We largely ignore the truth that we are not perfect – like every other person on the planet  because we likely didn’t learn it in childhood. Perhaps, as much of the research as suggested, we were the victims of parents or other caretakers who caused us as children to see ourselves  as “bad” or “the problem” instead of the out of control parent(s) who dumped their toxic thoughts and/or unhealty thoughts and emotions on our precious heads. 

Our child’s mind, which lived in a world of magical thinking, was simply unable to process these painful interactions with our parental giants who held all the power.  We could not reason that it was the caregiver(s) that was the “bad” one –  and not ourselves. This dramatically changes how we view ourselves as people and we leave childhood with a high risk of adult onset clinical depression. 

I was one of these children with a raging alcoholic father and a depressive mother.  And I developed adult onset depression.

According to psychologist Richard O’Connor, author of the book and website Undoing Depression:

“Considerable research has shown that people with depression differ from others in how we perceive the world and ourselves, how we interpret and express feelings, and how we communicate with other people, particularly loved ones and people in authority.  We think of ourselves as unable to live up to our own standards, we see the world as hostile and withholding, and we are pessimistic about things every changing.  In our relationships with others we have unrealistic expectations, are unable to communicate our needs; misinterpret disagreement as rejection, and are self-defeating in our presentation.  Finally, we are in the dark about human emotions.  We don’t know what it’s like to feel normal.  We fear the honest feelings will tear us apart or cause others to reject us.  We need to learn to live with real feelings”.

Optimism researcher, Martin Seligman, Ph.D., wrote an article, “Why are lawyers so Unhappy?” which was reprinted on Lawyerwithdepression.com.  The essence of the piece is that lawyers have a pessimistic cognitive thinking style which is groomed in law school.  I think this theory is half-right:  we are groomed to “think like a lawyer” in school, but many people who come into law school are already vulnerable to depression based on genetics and their childhood experiences.  For these people, the stress of being a law student and the combat of practicing can law can tip them over into as state of depression.

In his book Unstuck, psychiatrist James Gordon, in a subchapter entitled, “From the Swamp of Stuckness to the River of Change,” writes:

“‘This is the way things have to be,” you may tell yourself. Or you plead, ‘I’m doing the best I can.’ Pride and stubbornness and, of course, fear fix you in a circle of pointless argument and hurt.  But it’s familiar and seems so justified.  Even as the pain of stuckness becomes intolerable, or life begins to pry your fingers loose, you still hold on”.

“You’re afraid that without your familiar mooring you will lose hope and, perhaps, life.  You will not let go, will not move into the current of your life, will not trust that this current will take you where you need to go.  And go you continue to live less than fully, in denial of the change that is possible and necessary.  And, as time goes on, as you persist in resisting or blocking your own movement, your depression may deepen”.

Dr. Gordon lays out his holistic approach to recovering from depression in a question and answer session on his website.

Depression gets to be a habit – a bad one.  The more we depress, the more likely we are to become depressed in the future, the more likely are to become . . . stuck.

Please understand that your depressive thoughts are just broken records that keep repeating crummy tunes about yourselves.  We become stuck because we refuse to change or we just don’t know how to do our life any other way.  We need to let go and see that we can lead  a very different and empowered life — a life without depression.

My Mom’s Passing Last Night

I was with my mom last night as she lay dying of brain cancer.  I stroked her brow and kissed her many times.  We were alone together in the room around 9 p.m. Only a crack of light from the hallway shined in from the partially closed door.  Holding her hand, I told her that it was okay to let go. That God would take care of everything.  I read to her from the book of Psalms. 

She slipped away at 10 p.m. 

Driving home late last night, memories of our journey together flooded me: her teaching me to whistle on kitchen steps one summer when I was 5, showing me how “big boys” tie their sneakers by themselves and lying in bed with her and my younger brother when we were small children and her teaching us our nighttime prayer:

“Now I lay me down to sleep, I pray the Lord my soul to keep.  If I should die, before I wake, I pray the Lord my soul to take.”

I prayed that prayer with her last night, over 40 years later from when  she had first taught it to me.

My mom’s life was marked by extraordinary kindness.

Psalm 85 reads, in part:

I will hear what God proclaims;

The Lord – for he proclaims peace.

Near indeed is his salvation to those who trust in Him;

glory dwelling in our land.

Kindness and truth shall meet

Justice and peace shall kiss.

Truth shall spring out of the earth,

and justice look down from heaven.

My mom wasn’t a particularly religious person, but it didn’t matter one damn bit.  Her Mass was one was sweetness, her host one of gentleness.

God rest this lady of kindness . . . .

As my Mother Lay Dying

The best conversations with mothers always take place in silence when only the heart speaks  – Carrie Latet

My mother is dying of cancer in a nearby hospital.  She just turned 82 years old last month.  She’s been in decline for the past year.  Her five children thought the thrust of her diminution was early dementia.  Sadly, we were wrong.  Mom fell and broke her leg two days ago.  Upon further examination, doctors found cancer throughout her body including her brain. 

I went to visit her in the hospital last night.  The place was new, more like a subdued resort than a place where sick people go.  I stepped off the elevator and could sense the quietude, so at odds with the standard beeping machinations of modern medicine.

Only one hour remained in visiting hours.  There was no one around except for the nurses at their station, their mood so at odds with my lugubrious gait.

I walked in mom’s room where she lay sleeping.  She could have been a child but for the deep furrows that ran across her face like newly plowed fields in the spring. I felt a sense of displacement, a breaking off of a piece of my Self.

I sat down and studied her face.  How complicated our journey through this life with are parents is.  We can gather pieces of it in our hands from time to time.  We try to make sense of it, but most of its meaning is shrouded in mystery.  While we can’t explain it, we know it at another level.  It is at moments like this that we are provided an illumination, a momentary aperture, where light transcends much of what we thought we knew about this life and our mothers.

All that my mom is and ever was and everything that I am were alive in that room last night.  I began stroking her head, her thinning grey hair providing no resistance.  She awoke briefly to look into my eyes and we met in that moment. 

“You know I love you Mom”.

She gestured that she did and said, “I’m just so tired.” 

After she drifted back off, I told her that it was okay to leave, that she didn’t have to struggle anymore.