The Lawyer Therapist: Can I help a colleague with depression?

In the course of our careers, co-worker relationships can become some of the closest connections we may have in life.

We get to know our co-workers, often on a quite personal level, when we work closely with them. In many cases, we may spend more time with them than we do with our own families.

And, sometimes, we may notice that things are off with a colleague. We sense that something may be going on, but we’re not sure if we’re misreading the situation or if it is our place to say or do anything. The onset of depression may be something we suspect but that we may not know if or how to approach.

Statistically, one in four women and one in 10 men can expect to develop depression at some point in their lives. These statistics are based on those who self-report. In actuality, men are likely just as susceptible as women are to depression, but men are often more loathe to name, accept, or admit their feelings, preferring instead to “act like a man” and “suck it up.” Four in 10 Canadians report that someone close to them has been formally diagnosed with depression.

Legal professionals have been observed to have measurably higher rates of depression than members of the general public, with some estimates being as high as four times the rate of depression in non-lawyers. Rates of suicide are also higher for lawyers. Lawyers have been described as having certain personality traits that serve as obstacles to reaching out for help.  They are often self-starters, perfectionists, and extremely self-judgmental. They generally assume that their colleagues are high functioning and impervious to depression (or other mental health conditions), leaving those individuals feeling ashamed of their own inability to function. They isolate. As such, as a colleague of such a person, it can be that much more difficult to help the person who avoids sharing or asking for support.

Depression is a very treatable illness. It is estimated that approximately 80 per cent of people with depression can recover and feel better, with a reduction in symptoms, if they receive appropriate treatment. As well, clinical depression can be identified by the presence of certain symptoms. Individuals with clinical depression exhibit significant distress or impairment in social, occupational, or other important areas of their lives.  Interestingly, symptoms of grief are similar to those found with depression, but grief is a healthy response to loss, albeit a painful one.

An individual who has had five or more of the following changes to her previous functioning for a period of two weeks or longer may be clinically depressed. Here are the symptoms to look for:
1. Depressed mood: The person feels sad and morose and can be tearful. The person feels empty and unfulfilled but does not know how to get meaning back into his life.

2. Diminished interest and pleasure: The person just does not seem to care about anything anymore — even topics or events that used to give them pleasure. Nothing at all excites the depressed person.

3. Weight gain or loss: Significant weight changes (more than 5% in a month) are evident when a person is not dieting or trying to gain weight. The person either cannot get enough to eat or is never hungry and does not eat at all.

4. Insomnia or hypersomnia: The person either sleeps very little or much more than is normal for that person.

5. Agitation or low energy: The person either cannot sit still or, on the flip side, cannot get the energy up to even want to move. Even with agitation, the person will usually feel tired with little energy.

6. Feelings of worthlessness or excessive or inappropriate guilt: The person is unduly self-critical even when work quality is perfectly acceptable. The person judges herself by an unrealistic set of unachievable standards.

7. Diminished ability to think or concentrate or indecisiveness: The person takes longer than usual to think things through. He seems out of sorts. He is often ambivalent or unable to make decisions.

8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, a suicide attempt, or a specific plan for suicide: The person will say things like “Everyone would be better off if I were dead” or “I can’t go on like this” or “It will all be over soon” or  “I wish I were dead.” The most telling sign is a suicide attempt.

These symptoms may seem quite daunting, and they can be, even to seasoned mental health professionals. Here are some suggestions for what to do or say to someone you think may be depressed:
1. Listen without judgment: Let the person talk without trying to push the conversation. Let there be gaps in the discussion, if necessary. Let the depressed person set the pace and be willing to go at her speed.
Simple, non-judgmental listening can have profound therapeutic effects.

2. Don’t say patronizing things such as: “You’ll feel better tomorrow” or “No big deal” or “Buck up.”

3. Do say things such as: “What can I do to help?” or “Is there anything I can do?”

4. If you’re able, help make his workload more appropriate to his condition by reducing or refocusing his energies to manageable or successful tasks.

5. If she is seeing a doctor, offer to take her to just be with her.

6. Try to talk about the things that used to excite them: Engage them on subjects you know are of interest or passion to them. Keep it light.

7. If the behaviour or comments are of a suicidal nature, directly ask the person if she is considering taking her own life. If the answer is yes, seek immediate medical attention for the person even if that means taking her to the emergency department of the hospital or calling 911.

As well, each province has a lawyer assistance program created specifically to help in these situations.
Here in Ontario, the Member Assistance Program (www.myassistplan.com) offers a 24/7 crisis line, free, confidential counselling, and peer support.  And in many cases, simply by offering your friendship and acceptance, you can serve as the key to helping someone get help. One-to-one non-judgmental presence is often even more effective than medical interventions. If you see something, say something.

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Doron Gold is a registered social worker who’s also a former practising lawyer. He works with lawyers and law students in his role as a staff clinician and presenter with the Member Assistance Program as well as with members of the general public in his private psychotherapy practice. He’s available at dorongold.com.