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Depression

The Various Forms of Depression

Depression

Sadness or downswings in mood are normal reactions to life's disappointments and pressures which typically pass within a couple of days. When you have depression, these feelings linger, interfering with daily life and making it difficult to function and feel enjoyment. But no matter how severe your depression, you can get better with treatment. Medications, psychotherapies, and other methods can effectively treat people with depression. Understanding the signs, causes, and treatment options is the first step in overcoming the problem.

The World Health Organization projects that by 2020, depression will become the world’s second most devastating illness, after heart disease. Currently, one in five Americans will experience major depression in their lifetime, and one in ten suffers from recurring episodes of major depression.

Among lawyers and judges, the rate of depression is twice that of the general population. When adjusted for socioeconomic factors, the rate for legal professionals tops the list of 104 occupations for symptoms of major depressive disorders.

Most (80 percent) of persons who suffer from depression either do not seek treatment or drop out shortly after initiating treatment. This is particularly tragic given that 80% of those treated for depression show improvement within four to six weeks of beginning medication, psychotherapy, support group participation, or a combination of treatments. 

People with depressive illnesses don't all experience the same symptoms. The severity, frequency, and duration of symptoms vary depending on the individual and his/her particular illness. If you identify with several of the symptoms listed below and they have persisted for more than two weeks, you may be suffering from depression.

Signs and Symptoms

  • Feelings of hopelessness and helplessness
  • Loss of interest in friends, activities and hobbies you used to enjoy
  • Persistent sad, anxious or empty feelings
  • Fatigue and decreased energy
  • Irritability, restlessness or increased agitation
  • Difficulty concentrating, remembering details and making decisions
  • Insomnia, early-morning wakefulness or excessive sleeping
  • Significant changes in appetite and/or weight
  • Aches or pains, headaches or digestive problems that do not ease even with treatment
  • Greater consumption of alcohol than normal, or engaging in other reckless behavior

Bipolar Disorder

Bipolar disorder, formerly known as manic depression, is a mood disorder in which an individual fluctuates from feeling depressed to feeling super-charged or manic. These mood swings are much more severe than the normal ups and downs most people experience, and they do not follow a set pattern.  Individuals may go through the same mood (depressed or manic) several times before experiencing the opposite mood. These moods differ in severity from person to person and they can also change over time for the same individual, becoming more or less severe. The episodes are also variable – occurring over a period of weeks, months, and sometimes years.

During depressive periods, a person with bipolar disorder may display many of the symptoms described in the preceding section on depression.


Although the exact cause of bipolar disorder is unknown, research points to genes, brain changes, and stress as probable factors. Bipolar disorder typically surfaces in late adolescence or young adulthood and can run in families. It can be difficult to recognize initially, especially during the early manic phases. For individuals who experience only slight mania and are primarily depressed, misdiagnosis is common.  These individuals may be prescribed antidepressant medication which, without a mood stabilizer, can often push them into a severe manic episode.


Because individuals in the midst of a serious manic episode frequently lack insight into their behavior and those in a depressed state feel hopeless and lethargic, friends and family often must assist the person in getting assessed and treated, which may include hospitalization. The great majority of individuals with bipolar disorder can stabilize their mood swings by taking a mood stabilizer such as lithium, Depakote or Lamictal, and some individuals may benefit from adding an antidepressant or other medication. It can take time to find the right medication(s), thus it is important to work closely with one’s doctor to determine the right medication at the right dose.


In addition to drug therapy, psychotherapy and support groups are an important part of treatment for bipolar disorder. Behavioral therapy, cognitive therapy, and interpersonal therapy are all effective approaches that enable individuals with bipolar disorder to be fully functional.

Signs and Symptoms

  • Excessive happiness, hopefulness, and excitement
  • Inflated self-esteem or grandiosity
  • Restlessness, increased energy and decreased need for sleep
  • Increased sociability, talking more than usual or pressure to keep talking
  • Racing thoughts or abrupt changes from one topic to another
  • High level of distractibility as evidenced by the inability to screen out irrelevant stimuli
  • Marked increase in goal-directed activity (social, work/school, sexual)
  • Use of poor judgment and excessive involvement in activities with a high potential for painful consequences (buying sprees, sexual indiscretions, drastic business decisions…) 
     

Depression and Suicide Risk

A 2015 national study of legal professionals has found that almost a third of lawyers and judges suffer from depression, which is the number one cause of suicide. Lawyers and judges have the highest suicide rate of any profession - six times the rate of the general population.

If you have depression you may feel exhausted, helpless and hopeless. While this makes it difficult to take any action to help yourself, it is important to not wait too long. The disease of depression is treatable and starting treatment sooner will reduce the negative impact on your practice, your health and your relationships.

If you or another lawyer, judge, law student or family member is experiencing symptoms of depression, contact NMJLAP. All calls are confidential and you can call anonymously if you prefer.


What if I or Someone I Know Is in Crisis?

If you are thinking about harming yourself, or know someone who is, tell someone who can help immediately.

  • Do not leave the person alone, and do not isolate yourself
  • Call your doctor
  • Call 911 or go to a hospital ER to get immediate assistance, or ask a friend or family member to help you do these things
  • Call the 24-hour NM Crisis Line to speak with a supportive clinical professional at 1-855-662-7474; TTY: 1-855-227-5485
  • Call the 24-hour National Suicide Prevention Lifeline at 1-800-273-8255; TTY: 1-800-799-4889. to talk with a trained counselor.

Resources

Videos:  Depression, the Secret we Share by Andrew Solomon                 

Web Links
National Institute of Mental Health
Psych Central
Stop a Suicide

Articles
A Lawyer Breaks the Silence about Depression (from everydayhealth.com)
Reading this Article Just Might Save Your Life - Cindy Wyrick, former TBA President


 

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