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I am the same person you are.  A life long resident of the state, an honors graduate of my law school here in Mississippi, a good life with three wonderful children, brilliant and witty friends, active in the Bar and in the community, managing attorney of a medium sized law office, all of the things one imagines oneself achieving after graduation from law school.  Yet none of these things protected me from depression.

In retrospect, my illness began rather slowly, six months before I became dangerously ill in December. I had begun to have nightmares and suffer from rampant anxiety around the middle of July.  I also had begun to wish on some level that everything would just cease to be. The majority of these (to me, seemingly normal) symptoms were connected to a case I was handling.  Nothing at the time seemed unusual, and to this day, that absurd sense of “normality” is one of the memories that haunts me the most.

In the brief period immediately preceding the severe phase of my illness, one or two friends had suggested to me that I see a therapist. I made every excuse in the book why I could not possibly do this:  I didn’t want to spend the money, I didn’t have the time, I could control whatever was happening. On a subconscious level, I knew that if I looked below the surface of what was taking place, huge, possibly unwelcome changes would occur in my life.  Even today, over seven years later, I can instantly recall the intensity of the dread that accompanied this breakdown period.

In the hours after the trial of the matter of which I wrote above, I dropped off my client’s file at the office and went home. For the remainder of that afternoon, I walked around my house looking at and touching things that were dear to me, mostly pictures of my children and my books. By nighttime, I was in critical condition. I cried for hours, not knowing what was wrong, but pleading with God over and over to help me. The next morning, I awoke seemingly in a much better mood.  I got up that Thursday and thought to myself, “Today I will either kill myself, go to the hospital or find a psychologist.” Finally, even I realized something was seriously awry.  By two o’clock that afternoon, I was in a psychologist’s office.  I continued to go to that office at least twice a week for five years, a period during which I was totally unable to work.

I spent untold hours, days and months trying not to commit suicide when I was intensely suicidal.  Everything in my life had ground to a halt. I became what I can only describe as a “corpse with a pulse.”  I could no longer do things with my children, cook, read, go to the post office, to church, or to a store.  I had no sense of taste, zero libido, and I literally saw things in black and white. Sleep was either non-attainable or all consuming. An overwhelming sense of horror suffused my every waking moment and many of my dreams. My life was held together only by Monday and Thursday visits to my psychologist because that office was the one place I felt safe. This descent into paralyzing terror and severe depression came hard and fast, and was perhaps particularly shocking to a lawyer accustomed to controlling almost everything.

My survival of this illness I attribute to a combination of grace, good treatment on the medical front, and strong support from friends, children and therapists.  I now have a tremendous respect for people who fight and prevail over life’s challenges.  I still take antidepressant medication everyday and will probably continue to take it for the rest of my life. I am very cautious about not exceeding my limits.  (Funny thing about limits – you never know what they are until you exceed them.) I go to a psychologist whenever the need arises, which is seldom these days.  I look at my children everyday and thank God I am still alive.  I recently opened my own law office, which has been a dream of mine for years.

Below is a short list of what I feel are important touchstones for surviving depression.

1. If you think you are suffering from depression, you most likely are.  Ask questions, find a book on the subject, go on the Internet and research depression. You will find that depression is a medical illness, and major depression is a medical emergency. (Yes, just like a heart attack.) Don’t ignore the symptoms because major depression, left untreated, can quickly escalate to become a life threatening illness. It doesn’t need to be.

2. Find yourself a good doctor.  This can be your family physician if you don’t know anyone else.  Ask friends for references.  I have found through reading, conversations with fellow sufferers and medical professionals, and long personal experience that a combination of a good psychologist and a good psychiatrist (or psychopharmacologist) is the gold standard here. Family physicians may not be sophisticated enough to fine tune your medication needs in the long run.

3. Force yourself to ask a responsible adult to help you.  If you are unable to work for any length of time, you will need assistance with your financial affairs, disability filings, etc. You know hundreds of excellent lawyers – put one of them to work for you. The ideal time to discuss this with someone is early in your illness.  In moderate or severe depression, higher cognitive functioning may be one of the first things to go.  My current law practice is a testament to the fact that it can and does return.

4. If you’ve put all your eggs in one basket and don’t have interests other than practicing law, you should consider placing this issue at the head of your list of topics to discuss with your therapist.

5. Be honest with your family. You will need them, and they need you. They will not understand a lot of what is happening to you, but a competent therapist, in my opinion, should sit down with everyone in the family and discuss what is going on and what to expect.

6. Don’t become agitated if someone doesn’t understand the things you are going through. The more reasonable expectation is that other people will not understand. Depression is a serious illness, and unless the people around you have experienced it firsthand, they simply will not comprehend what you are feeling because the feelings and emotions that depression engenders are so far removed from the range of “normal” human experience.

7. Sometimes you have to surrender to the illness and not fight it.  If you can’t function, go to bed. I guarantee you this fact will not be reported on the six o’clock news.  (One of my biggest fears – “everyone will know.”)  Can’t sleep?  My solution was to rent four movies a night and watch them from 8:00 P.M. until 4:00 A.M. If you choose this solution, you might run out of good movies in a few weeks, but there is a bright side.  You will make friends with the people at the video store and possibly get a free movie every few nights. Flexibility is the key here.

8. Do not waste precious emotional energy by being embarrassed or shamed by your illness.  Forget about suppose stigma; your only job is to get well.  I found through trial and error that letting as many caring people as possible know about my illness was a safety net for me. Your friends can be the most supportive people on earth.

9. Try to do something everyday, no matter how small the task. You need to maintain some connection with the normal rhythms of everyday life. Start small with one or two things a day.  Do not, under any circumstances, put more than three things a day on a “to-do” list. You may not be able to complete them, and you have no business setting yourself up for failure.  (This was one of the wisest things my very wise therapist ever told me.)

10. Locate that one critical thing that triggers your self-preservation instinct. For me, it was my three children.  More than my actually committing suicide, I could not abide the thought that any one of them would ever be known as the child “whose parent committed suicide.” In all honesty, I was not always happy to oblige, but in the end, I could not let them down.

These are necessarily general guidelines.  Each person who suffers will experience depression in a way that is unique to him or her.  The above suggestions are the things that helped me through a lengthy illness.  I strongly believe that each person can find something that will serve as a beacon guiding him or her through depression.  For instance, I kept a dog eared copy of William Styron’s Darkness Visible on my bedside table long after it had been read, and would look at it every night and think, “Styron is someone who was at least as sick as I am, if not more so, but lived to write about it.” The mere fact that someone had survived a severe case of depression made me know it was survivable. This may seem idiotically simple to a person who has not suffered with depression, but anyone who has been a sufferer will tell you that it is the little things that count.

All of us are vulnerable.  I have known too many lawyers in the last few years who have suffered from depression and more than a handful who have committed suicide. Every one of those suicides was an irreparable loss, to friends, to families, to communities and to our profession. We owe it to ourselves to become educated about all facets of mental illness so that we cannot only help ourselves, but also help other lawyers when they need us. Do not be afraid to take action or become involved.  Your life or a colleague’s life may depend upon it.

Symptoms of Depression
There is a growing acceptance in the medical community that long hours and stressful work can contribute to professional burnout and clinical depression. The legal profession often provides ample opportunities for just such conditions. If you see yourself in this list, you may need help.  

• Persistent feelings of sadness or irritability
• Loss of interest in activities once enjoyed
• Changes in weight or appetite
• Changes in sleep patterns (e.g., insomnia, excessive sleeping, oversleeping in the morning)
• Feelings of guilt or hopelessness
• Inability to concentrate or make decisions
• Fatigue
• Restlessness or lethargy that is noticed by others
• Thoughts about suicide or death
• Isolating or avoiding friends and family

Any individual experiencing four or more of these symptoms for a period of two weeks or more should be evaluated by a psychiatrist.

(This article was originally published in The Mississippi Lawyer, Volume XLIX, Number 4, March-April-May, 2003)

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