ARTICLES

The Face of Sadness
by Carol P. Waldhauser
Mary Doe, Esquire sought treatment for her high blood pressure immediately.  John Doe, Esquire sought treatment for his diabetes.  Jane Doe, Esquire, suffers from a mental health illness known as clinical depression and although the human brain needs health care, just as any other part of the body needs care, Jane failed to seek treatment.  Eventually, the illness took her life.

Clinical depression is an illness.  Many people use the term depression loosely, referring to temporary sadness caused by almost any kind of personal setback or life-event.  Conversely, clinical depression is a medical illness that affects a person’s body, mood and thoughts.  It may appear suddenly, as an acute (short-term) episode or develop slowly, as a chronic (long-term) episode. 

Clinical depression occurs in all age, racial and socioeconomic groups. Women are twice as likely to be diagnosed and treated for major depression.  On the other hand, men are less willing to acknowledge a problem.  Studies suggest that some men may mask their symptoms with alcohol or drug use.  Moreover, people usually don’t seek treatment for depression because they mistakenly think:

• Depression is a weakness, not an illness;
• Depression is a normal part of aging; and/or
• Depression is best dealt with by non-health professionals.

Although family, friends and other support networks can be helpful, evaluation and treatment is best handled by licensed health-care professionals.  In diagnosing clinical depression, the first step is a thorough physical exam to rule out other illness.  Primary care physicians – who are often trained in recognizing depression - can help determine the best approach to treatment and refer patients to other appropriate health professions, counselors, etc.
SIGNS AND SYMPTOMS:
The difference between someone who is just blue and someone with clinical depression is the DURATION and SEVERITY of the symptoms.   See your doctor if you experience five or more of these symptoms for more than two (2) weeks:

• Feel sad, anxious, irritable, nervous or empty
• Sleep too little or too much, trouble falling asleep or waking up
• Appetite and/or weight gain or loss
• Loss of interest in activities once enjoyed
• Restless or slowed behavior
• Persistent physical symptoms  - such as headaches, chronic pain or digestive disorders  - that don’t respond to treatment
• Difficulty concentrating, remembering or making decisions
• Fatigue, loss of energy
• Feeling guilty, worthless or hopeless
• Thoughts of suicide or death (seek professional help immediately)
• Change in work style – work slower than usual, missing deadlines, inability to complete tasks, call in sick often, decreased involvement with work or interaction with co-workers.

The above information has been compiled by the Wellness Councils of America and its affiliated wellness councils.  The information contained in the above check-lists has been carefully reviewed for accuracy.  It is not intended to replace the advice of your physician or health care provider.

In addition to the above, lawyers often exhibit the following:
Inability to meet professional or personal obligations – procrastination, file stagnation and neglect, lowered productivity; missing deadlines (statutes, filing responsive pleadings or motions), excuse making and misrepresentation to clients.

• Emotional paralysis  - unable to open mail or answer phones
• Persistent sadness or apathy, crying, anxiety, “empty” feeling
• Loss of interest or pleasure
• Trouble concentrating or remember things
• Changes in sexual energy or desire
• Feelings of bafflement, confusion, loneliness, isolation, desolation, being overwhelmed, unavailable to what is going on around you
• Thoughts of Suicide, Planning Suicide, Suicide Attempts.

Clinical depression is finally recognized as a medical illness and effective treatment is available.  It is counterproductive to ignore, deny or downplay the fact that someone may be suffering from clinical depression.

Furthermore, clinical depression is believed to be caused by a chemical imbalance in the brain - specifically, a disturbance of neurotransmitters that regulate mood, sleep and appetite.  A depressed person often displays the “face of sadness”.

With early recognition, intervention and support, most people can overcome depression and get on with their lives.  Colleagues, family members and friends play important roles in recognition of depressive symptoms and helping that in need get treatment.  If you are experiencing symptoms of clinical depression or know a judge, lawyer, law student or staff person who is in need of help or want more information on clinical depression, health-care referrals, etc.  Call the MSBA’S Lawyers Assistance Program at (410) 685-7878 x3041. 
References:

• National Mental Health Association
• Downtime:  A worksite Guide to Understanding Clinical Depression.  Wellness Councils of America, Omaha, NE, 1993, developed with a grant from Eli Lily and Company.