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Depression & Suicide

Are you or someone you know thinking about suicide? Suicide Prevention

The Clinically Depressed Lawyer

Symptoms of Depression

  • Firmly resolves every morning to get to those cases and projects having deadline, but doesn’t.
  • Has little or no energy; getting out of bed and making it to the office is exhausting.
  • Knows phone calls have to be returned but feels too enervated to do so.
  • Sometimes spends hours at the office behind a closed door staring out the window or playing mindless computer games.
  • Becomes angry or irritated easily and can’t seem to let it go – i.e. sweats all the small stuff.
  • Experience a pervasive sense of sadness; feels overwhelmed and immobilized by indecisiveness.
  • Has diminished ability to concentrate, analyze and synthesize information.
  • Isolates socially and professionally, pulls away from close relationships. May experience apathy and pessimism.
  • Is confused by inability to “snap out of it,” feels “weak” and berates self.
  • Feels extremely or inappropriately guilty about not meeting occupational or personal responsibilities.
  • Tries to feel better by using alcohol, sedatives, stimulants or other substances, including food.
  • Fantasizes about some kind of escape, has fleeting thoughts of suicide.
  • Thinks about ways to end the pain, may begin a plan for suicide; sometimes acts on this plan.

The Two Faces of Depression

The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) recognizes two main types of depression.

Common to both forms of depression are the following:

  • Depressed mood or irritability
  • Loss of pleasure in things that were once pleasurable
  • Insomnia or sleeping too much
  • Feeling sluggish or chronically fatigued
  • Changes in weight or appetite
  • Difficulties with memory, concentration and decision making
  • Feelings of worthlessness, inappropriate guilt or hopelessness
  • Thinking of death, suicide or making a suicide attempt

Although Major Depressive Disorder is the more severe in terms of debilitating symptoms, a disorder called Dysthymia, characterized by similar but less severe symptoms, can cause significant distress or impairment in functioning because of its chronicity.

The episodes of Major Depressive Disorder result in symptoms felt most of the day, nearly everyday that can last anywhere from two weeks to many months. With Dysthymia, the symptoms occur most of the day, more days than not, for a period of at least two years.

Fortunately, both forms of depression are treatable. The two most common forms of treatment are antidepressant medications and psychological therapy. Numerous studies have shown that the most effective treatment for depression both in terms of relief from symptoms and in terms of long-term recovery is a combination of both forms of treatment.

Mania--Bipolar Disorder

True mania is rare. Just as with depression, symptoms of mania can range from fairly mild (hypomania) to quite severe and even psychotic. A manic episode is characterized by a distinct period (noticeable to others) of at least one week of abnormally and persistently elevated, expansive or irritable mood. (DMS-IV, 1994) During a manic episode, a person often seems unusually cheerful, enthusiastic, and euphoric. There may also be rapid alterations of mood between euphoria and irritability.

In addition to the above signs of depression, the individual experiences several of the following to a significant degree:

  • Inflated self-esteem or grandiosity, sometimes rising to the level of delusions (firmly held false beliefs)
  • 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; speech may become so disorganized as to render the person incoherent
  • High level of distractibility as evidenced by the inability to screen out irrelevant stimuli
  • Marked increase in productivity and goal-directed activity
  • Use of poor judgment and excessive involvement in activities that have a high potential for painful consequences (buying sprees, sexual indiscretions, drastic business decisions)

Bipolar Disorder, the current name for the illness that used to be called Manic-Depressive Disorder, is diagnosed when an individual experiences at least one episode of mania. Often these episodes are followed by a return to normal functioning but sometimes by a depressive episode. Bipolar Disorder is recognized as a type of disorder involving chemical deficiencies in the brain.  Bipolar Disorder Self-Assessment

Because individuals in the midst of a serious manic episode often lack insight into their behavior, friends and family often have to assist the person in getting poorly assessed and treated, which may include hospitalization. The great majority of people with bipolar disorder can stabilize their mood swings by taking lithium or one of the mood stabilizing anticonvulsants. These medications, along with other supportive therapies, allow the person to return to their families, communities and jobs as fully functional members of society.

All of us have difficult days and, sometimes, difficult weeks. Coping with life’s challenges is an unavoidable aspect of the human condition. However, if you find yourself experiencing several of the above symptoms for a more prolonged period of time and find you don’t return to your previous level of functioning, don’t just hope things will get better.  

Suicide Warning Signs

Suicide is the third-leading cause of death among lawyers. Reasons include a number of unique characteristics and circumstances experienced by lawyers: a persistent high level of stress, a pessimistic outlook developed through law school and practice, long hours and isolation of daily work, perfectionism and low tolerance for failure or “losing face,” the high stakes nature of our work, and a reluctance to ask for help. 

Research shows that the great majority of those who attempt suicide give some warning signs, verbal or behavior, of their intent to kill themselves in the final weeks leading up to the act.  The more warning signs, the greater the risk.

Talk

If a person talks about:

  • Killing themselves.
  • Having no reason to live.
  • Being a burden to others.
  • Feeling trapped.
  • Unbearable pain.

Behavior

A person’s suicide risk is greater if a behavior is new or has increased, especially if it’s related to a painful event, loss, or change.

  • Increased use of alcohol or drugs.
  • Looking for a way to kill themselves, such as searching online for materials or means.
  • Acting recklessly.
  • Withdrawing from activities.
  • Isolating from family and friends.
  • Sleeping too much or too little.
  • Visiting or calling people to say goodbye.
  • Giving away prized possessions.
  • Aggression.

Mood

People who are considering suicide often display one or more of the following moods.

  • Depression.
  • Loss of interest.
  • Rage.
  • Irritability.
  • Humiliation.
  • Anxiety.

If someone is considering suicide, it’s crucial to get help right away. The National Suicide Prevention Lifeline is a service available to anyone 24 hours a day, seven days a week.

Suicide Prevention Lifeline

1-800-273-TALK (8255), National, Toll-Free, 24 Hours

If someone is in immediate danger, call 911.

If you need to talk to a TLAP representative outside of business hours, please call 615-741-3238 and press "1."  Leave a detailed message and someone will return your call as soon as possible.  All of the TLAP staff are certified in suicide prevention and are trained crisis counselors.

 

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