Ed. note: This post is written by Will Meyerhofer, a Biglaw attorney turned psychotherapist, whom we profiled. A former Sullivan & Cromwell associate, he holds degrees from Harvard, NYU Law, and The Hunter College School of Social Work. He blogs at The People’s Therapist.
A New York Times article from a few weeks ago holds enormous potential ramifications for lawyers bent over their desks at big law firms. The tentative conclusion of the piece was simple: if you are dealing with minor depression, or in fact, with anything other than massive, serious depression, popping anti-depressant pills is probably a waste of time. In fact, a placebo might do you more good.
How many lawyers are currently taking anti-depressants? According to the admittedly anecdotal evidence from the lawyers I’ve seen over the years in my private practice, quite a few.
It’s such a lawyerly thing to do. You figure out you’re depressed, so you do something about it — march over to your doctor, or maybe a high-powered shrink with a top reputation, get diagnosed, and get your pills. The whole thing takes a few minutes, and you’re back on the job. No wasting billable hours, no whining and complaining on a therapist’s couch — you take care of the problem and move on. Take a pill and knock it off with the martyr routine.
However, there are a few problems with anti-depressants…
First, like I said, they might not work. Don’t believe me? Here’s an excerpt from the article:
Some widely prescribed drugs for depression provide relief in extreme cases but are no more effective than placebo pills for most patients, according to a new analysis released Tuesday.
The findings could help settle a longstanding debate about antidepressants. While the study does not imply that the drugs are worthless for anyone with moderate to serious depression — many such people do seem to benefit — it does provide one likely explanation for the sharp disagreement among experts about the drugs’ overall effectiveness.
Second, the side-effects. This includes the “sexual side-effects” — which might mean, if you’re a guy, erectile dysfunction, and whichever gender you are, inability to reach orgasm. And there are “regular” side effects, too — like weight gain.
Third, anti-depressants only work while you’re on them. I’ve heard of people staying on anti-depressants for decades, but I have no idea what the long-term effects are because no one knows. If you’d like to experiment on yourself, I’m sure the pharmaceutical industry would be fascinated to find out.
Fourth, to the extent they do work, it’s by erasing feelings. Anti-depressants tend to narrow the bandwidth of what you feel, chopping off the top and the bottom — no more highs, no more lows. That can bring relief, but at a cost.
Fifth, other than the vague explanation that they “affect neurotransmitter levels,” no one really understands how they work. Anti-depressant medications, especially the new generation of drugs, are a relatively recent development, and the exact mechanism that produces the results isn’t fully understood.
Is there another option?
Read on at The People’s Therapist.
I also regularly read and quote from health articles in the NY Times. Can I be a therapist, too?
1/2 teaspoon, for fast, effective relief…
Why do the ATL servers suck so much?
When I was at Big Law years ago, my Economy Bottle of Prozac was the only thing that got me through the day. True, no highs and lows, but I just found myself not reacting to Partners and Senior Associates berating me while I paid off my student loans and planned my escape. I needed to be numb to get through the day.
This guy is an idiot. Unless he’s an MD he doesn’t have a basis for making the medical statements he’s making. Last I checked, psychotherapists are not MDs.
The mind boggles. What a wonderfully thorough, nuanced, and subtle plug for the physchotherapeutic profession…”Erasing feelings…” Is that what they taught you at Hunter College?
http://www.urbandictionary.com/define.php?term=klong
See Definition #2.
3 – Ditto.
The mind boggles. What a wonderfully thorough, nuanced, and subtle plug for the physchotherapeutic profession…”Erasing feelings…” Is that what they taught you at Hunter College?
http://www.urbandictionary.com/define.php?term=klong
See Definition #2.
This guy is an idiot. Unless he’s an MD he doesn’t have a basis for making the medical statements he’s making. Last I checked, psychotherapists are not MDs.
Are you a Scientologist, Meyerhofer? Or just a flat-earther when it comes to treating depression?
You dismiss antidepressants for most patients, yet offer an equally trite diagnosis for depression — it’s caused by bottled up anger. Wow, it’s really that simple? Genetics don’t play a role at all? How would you know, you’re not a scientist or medical doctor, are you?
Could it be that both antidepressants and therapy are helpful? Many patients need the medication to improve their mood sufficiently to engage in the kind of intensive therapy that you espouse. I know this from longtime personal experience.
4 is dead on. I prefer opiates though. You get the indifference plus some nice feelings. You do get nauseated every now and then though.
This guy is an idiot. Unless he’s an MD he doesn’t have a basis for making the medical statements he’s making. Last I checked, psychotherapists are not MDs.
The people’s therapist? Were you appointed by Commissar Obama? If so, please refer yourself to as the therapy czar. Did Commissar Obama confer you with immunity from criminal prosecution for practicing medicine without a license? How did you become an authority on anti-depressants?
In my opinion, depression is a condition of the mentally weak. Unfortunately, America is depressed and this has spawned the “mental therapy” industry. Sure there are days when I need a boost, which is why I drink Spike. And, when it comes to bedroom performance, the yomhimbine content with each drink ensures that I don’t need viagra or any other ED treatment.
A Soma a day keeps the doctos away.
I need my Soma
Wait, is this guy an idiot?
Please stop this nonsense with the post linking to another blog. No need to inflate the readership of his crap site.
Mystal, stop chewing on the server wires, you gigantic mutant Walrus-Rat!!
Ok..well now that I know my medication is worthless, I guess I will just go back to excessive drinking to calm my nerves and deal with the stress and occassional cocaine use to deal with the resulting depression. Yes, that will make me much more productive and a better, “well-adjusted” person.
Also, if depression is caused by “bottled-up anger”, I guess I will just scream at my wife when I come home and bitch about my day at the office and then I will not be depressed.
As an attorney with borderline personality disorder who would likely have to be institutionalized without proper medication, I’d like to politely invite you to please go jump off a bridge.
As an attorney with borderline personality disorder who would likely have to be institutionalized without proper medication, I’d like to politely invite you to please go jump off a bridge.
This quack really shouldn’t title his bio “the doctor is in”; I have nothing against therapists practicing with a MSW, but he’s only a “doctor” in the sense that anyone is who has a JD, which is to say not really.
The level of quality represented by “The People’s Therapist” reminds me of a lawyer who advertised himself as “The People’s Lawyer” in the Bay Area. He sat on a bad couch, had a lousy hairdo, and spoke in a soft and effeminate voice in late-night television ads for his low-end personal injury practice. I think his name was Jim Rogers.
“Listen. You give ‘em a Percocet, two Vicodin and a couple of beers, and the panties drop. It’s very nice.”
-Tweeter
Will,
I thought I told you to go die in a fire. Please do what you’re told and stop bothering the busy people.
Love,
Mom
Get this fucking loser out of here.
so a depressed person starts taking antidepressants, then gets fat and can’t get it up?
hmm. i think i know why antidepressants don’t work.
Get this fucking loser out of here.
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What an arrogant prick. Doctor my ass. A masters in social work does not a doctor make. Even if you were a trained psychologist, you’d be out of your league talking about clinical research on meds that require an MD to dispense.
And here’s the first clue – your points 4 and 5 are blatantly contradictory. Which is it – do the meds cut off the peaks & valleys, or do we have no idea how they work? Sounds to me like you’re describing lithium in #4, and SSRIs in #5, but if the NYT didn’t point that out, how could you really be expected to know the difference, really?
Regarding the side effects, don’t be frightened by this guy’s blanket tarring of psychiatry (including pharmacological treatment), which is clearly driven by his focus on ‘talk therapy’ which is all a social worker like him can provide. Those side effects can be easily handled and moderated by monitoring and adjusting specific meds and dosages. If you’re depressed, seek help. Therapy, medication, or both, but if you are not inclined to want to talk to someone, don’t limit your options.
Ditto #18. As an attorney who has been on anti-depressants since age 15 for depression, severe anxiety and an eating disorder that almost killed me, this post only serves to trivialize the very real problems of many people–not just attorneys. In fact, hundreds of studies (by people who have authority to comment on this type of thing) have some that some people do have a chemical imbalance in the brain that SSRI’s and other meds can help correct.
Please delete this post.
17 FTW.
And by the way, half my bottled up anger is due to this f’ing website taking 8 minutes to load a single damned page.
That giant sucking sound you hear is people getting back to work and leaving here in droves. (Or Elie…[insert fat joke here])
17 FTW.
And by the way, half my bottled up anger is due to this f’ing website taking 8 minutes to load a single damned page.
That giant sucking sound you hear is people getting back to work and leaving here in droves. (Or Elie…[insert fat joke here])
All the therapy in the world, even by therapists who “welcome authentic feelings,” often has zero impact on a severe, clinical depression. It is misleading and deeply upsetting of you to suggest that the “talking cure” really cures, or even makes you feel better after the first session. You basically wrote a white paper for your own practice.
If pills aren’t a panacea for severe depression (and I agree they are not), good luck convincing someone who has can’t-get-out-of-bed-need-a-medical-leave depression that just 50 minutes of talking will do the trick. Usually, it’s a little of column A and a little of column B that helps.
Did this guy even read the NYT article prompting his incredibly misinformed column? The article itself says that the study, which studied a grand total of 718 people, was poorly done and likely misinterpreted. It refers as well to a study of 16,000 persons and identified the real problem with mental health in America (and certainly among attorneys too), as being under-treated, not over-treated. (That includes therapy and medicine, admittedly.) Here are a few nuggets that the ‘Doctor’ should have paid more attention to:
“Antidepressants do work for very severely depressed people, as well as for those whose mild depression is chronic. However, the researchers found, the pills don’t work for people who aren’t really depressed — people with short-term, minor depression whose problems tend to get better on their own.”
“None of this comes as news to people who have been prescribing or studying antidepressants over the past 20 years. Neither is it all that likely to change the practice of treating depression — at least as it’s carried out by responsible doctors.”
“This is the big picture of mental health care in America: not perfectly healthy people popping pills for no reason, but people with real illnesses lacking access to care; facing barriers like ignorance, stigma and high prices; or finding care that is ineffective.”
“And, contrary to popular belief, there’s no evidence that most psychiatrists regularly prescribe pills straight off to people who can get better by reading about depression, exercising or doing nothing. What numbers do exist… indicate that relatively few people with minimal depression leave psychiatrists’ offices with a prescription.”
Meyerhofer may be in violation of NYS licensing laws for purporting to be a doctor based on his law degree: http://www.naswnyc.org/l1.html
Please stop posting this clown’s rantings on your blog. He is irresponsible, only interested in promoting his own interests, and can’t even do the simplest research (i.e. reading the entire NYT article). Most of the readers are savvy enough to figure this out but you are just encouraging him by continuing to give him a forum.
And by the way, since I as a JD have more right to hold myself as a doctor than he does, I hereby disagnose Mr. Meyerhofer with narcissistic personality disorder.
Anyone that pays this “therapist” for his “services” is an idiot.
no need for anti-depressants, just get a prescription for adderall.
This article is irresponsible.
I’ll take the rapists for $200.
@22 – Big difference between this ass hat and Jim Rogers. No matter how ridiculous his ads or what those of us who saw them thought of him, “The People’s Lawyer” was licensed by the state to practice his trade.
The “People’s Therapist” appears to be a sad young man who realized too late in life that what he really really wants to be when he grows up is a doctor, but forgot that there’s some school and licensing involved that he’d prefer just not to deal with. This guy has a degree in social work – not a doctor, not qualified to do more than counsel welfare moms about what they need to do to get their kids back.
At least he didn’t blatantly violate client confidentiality this time.
“Minor” depression or anxiety disorders may be treated effectively by getting a pet. If you have long hours, you should consider getting a cat.
The cost of taking pills and owning a pet is similiar. I recommend alternative therapies for patients before putting them on pills at the drop of a hat. No doubt, the pills work but they have side effects. For small problems, their risk outweigh their benefits.
Gentlemen, I sell services that will make you feel better, with no side effects, so long as you glove the love.
My ladies are ready to WORK!
“Antidepressants, shockingly, might not work for all people in all situations. You know how I know? I read it in the NYT.”
Headdesk
There is nothing wrong with popping pills, as long as they are percocet and you are snorting them.
Without pills, I wouldn’t be able to urinate.
Ever hear of the expression ‘Don’t kill the messenger?’ I for one think Dr. Meyerhofer’s advice is important and he should not be criticized. Anyone who’s ever dealt with Depression knows its a serious medical illness, and especially relevant for lawyers.
Ever hear of the expression ‘Don’t kill the messenger?’ I for one think Dr. Meyerhofer’s advice is important and he should not be criticized. Anyone who’s ever dealt with Depression knows its a serious medical illness, and especially relevant for lawyers.
I always kill the messenger. I have devoured 3 mail men this week.
-Mystical Walrus
The other NYT articles that 34 quotes from can actually be found here. Not disagreeing with him…the “Doctor” should know better.
http://www.nytimes.com/2010/01/12/health/12mind.html
http://www.nytimes.com/2010/01/09/opinion/09warner.html
It’s a shame. I want to like this guy, I truly do. Whether he’s an MSW, a bona fide shrink, or a medical doctors is immaterial to me. What matters is that he is an empathic person interested in helping others, and moreover, that coming from biglaw, he could understand more acutely the worlds we come from. I want to relate to his writings, and find an understanding. And I’m guessing that’s what he wants to provide. And yet…
every post of his is worse than the one before. And now this drivel is just the icing on the cake. He really should get a new day job. And then be sure not to quit it this time.
Listen Will – good intentions (and I’ll give the benefit of the doubt and ascribe you those) are not enough. Competence goes a long way, and you sir, clearly have none.
48 & 49 the fact you don’t see this article as a platform and advertisement for this idiot’s business model makes me question your analysis capabilities as a lawyer/law student.
51/52
This writer has got to go. Dangerously terrible advice.
48/49 – are you a complete moron? You say “Anyone who’s ever dealt with Depression knows its [sic] a serious medical illness, and especially relevant for lawyers.” No shit. It’s [see what I did there?] clear that everyone attacking this guy on this thread is doing so from a place of being all-too-familiar with depression, which is precisely how they know what a crock that posting was.
48/49=the author of this article. And even that comment is idiotic. “Important inforamtion should not be criticized?” Why not, if anything, it should fall under much stricter scrutiny. ”
Anyone whose ever dealt with depression knows it’s a serious medical illness, and especially relevant to lawyers.” No shit, which is why you shouldn’t spout your absolute bullshit to anyone because your advice is dangerous.
Even if 48/49 isn’t the author of this article, the fact you don’t realize this is a complete advertisement hidden under the guise of an article makes me question your analytical ability.
Ok, Kash, we get it. You have a thing for NYU Law grads. You have a double thing for disaffected NYU Law grads who left the practice of law. You have a triple thing for disaffected NYU Law grads who left the practice of law to do the only thing that adds less value to this world than being a lawyer. But really, just fuck him already and stop wasting ATL space playing internet footsies wit this loser.
42 – I don’t disagree with you about the differences between The People’s Lawyer and The People’s Therapist…Meyerhofer just served as a funny reminder of Rogers and those awful commercials
21 (not 22)
After reading this thread, I do hope Mr. Meyerhofer does not become overly depressed. He certainly has had his ass thoroughly handed to him.
59: this guy isn’t into chicks.
http://www.facebook.com/profile.php?id=100000710250008&ref=nf
Well, Mr. Doctor/Lawyer guy, ever since I started my first job and had health insurance, I have seen a shrink. and taken some form of anti-depressant. I am not sure either has really helped me…and it has been 8 years!
I had a really shitty life before I started practicing. I grew up extremely poor and it is a miracle I even graduated from high school considering the awful things that happened to me. Imagine being in law school in the town where you grew up and having the house you grew up in on the front page of the major local newspaper for a drug bust.
I thought the key to happiness was getting a good education and a good stable job. For the first few years, things were great. I had great bosses and great work. Then, my firm imploded and I was laid off. I took my next job at a questionable firm out of desperation and have paid for it ever since. The firm was sued and is a complete joke in the legal community.
A female partner at my last firm was so abusive that, through an attorney, I negotiated a severance agreement because she was so awful. After being at the firm for 5 months, the woman tried to have me fired. Then, I found out that people in my position rarely lasted 2 years because the woman would just beat them down until they left. I basically had a breakdown because my resume looked like shit and I had nowhere to go.
I barely had a legal leg to stand on, but the woman was so horrible that the firm just wanted to avoid the embarrassment. No, I am not sensitive, imagine a partner that wants you to research language in a contract but won’t give you the contract, requiring you and another partner (yes) had to dig through storage to find another copy. Then scream at you for taking so long on the project. You could not speak to this woman without her going on a tirade. She was COMPLETELY IRRATIONAL and you couldn’t do anything about it. If you stood up to her, she would try to get you fired. I mean, she would become fixated on having people fired and put all of her energy in to it. I have never had a human being single me out and be a complete asshole for absolutely no reason. The other partners I worked with loved me, but that horrible woman had a longstanding relationship with the largest client and she basically did whatever she wanted, even biting off her nose to spite her face. Recently, the same partner freaked out on her secretary and the secretary went on medical leave. When she returned, she was reassigned and a new secretary was hired to work for the crazy female partner. Oh, did I mention that another former secretary of this partner went in to labor about 2 months prematurely after a crazy partner tirade? She was reassigned after that as well. In fact, crazy partner has sit downs with the management where they seemingly instruct her to stay away from the pregnant women in the office! I shit you not.
Unfortunately, the really sick attorneys do not seek help. That woman clearly has a personality disorder and a chemical imbalance. She is a ticking time bomb and I look forward to the day that she falls off of the deep end and ruins her own career. I cannot believe the firm keeps covering for her, I would post her name, but I am legally obligated to keep it confidential. Hint: Chicago midsize firm.
Personally, I think my depression is based on my miserable life circumstances. I worked my ass off to have a better life and my career is ruined. I haven’t had a job for a year! Thanks for playing legal career. Thanks for playin.’
Bring back Dookapile
Everyone is overstating matters.
The study is important, in that it confirms some types of antidepressants are more effective for more severe depression, and less effective for less severe depression.
The study does NOT mean that, if you are moderately depressed, antidepressants can’t or won’t help.
The study examines two types of antidepressants, and does not address other types.
SSRIs are prescribed, properly, for conditions other than depression, which doesn’t seem to be addressed by the study.
There are promising theories as to how SSRIs work that go beyond a focus on increasing the amount of available neurotransmitters; but it is true that no one knows how they work.
The most effective approach to psychological problems like depression and anxiety is a combination of medication and some form of talk-therapy.
The author doesn’t need an MD to offer an informed opinion on this subject.
I think the somewhat harsh reaction of some commentators is due to an understandable perception that the author is offering advice in bad faith. It’s understandable to view his post in that way, given some of the exaggerations he makes. The author should be more careful to qualify his statements regarding psychopharmacological treatments in the future.
57, it is you who is the moron. Fixating on an anonymous poster’s grammer and apostrophe’s is exactly the type of behavior that makes lawyers like you depressed. But, I’m glad to know that I am the source of your depression.
Why not just smoke some crack?
the true nature of attorneys, which comes out anonymously on this board, makes me depressed
Every attorney I know is either taking some medication for depression/anxiety or has a drinking or substance abuse problem. Most I know fall into both categories.
Nature of the profession.
“Talking” with a therapist serves no useful purpose. A therapist cannot make the inordinate amount of stress, long hours, and constant beratement at work go away. A therapist cannot make you less of a perfectionist or overachiever. Yes, drugs take away the highs and lows—but that is exactly what every attorney needs….the ability to function in a high pressure environment with cool, cold, logical detachment, free from any form of extreme emotion.
[[[ First, like I said, they might not work. ]]]
So they work for clinical depression and dysthymia, although it may take a few trials to get the right medication, but not for temporary, non-clinical depression, grief, situational depression…. I can accept that. But the key point is that they work for clinical depression and dysthymia.
[[[ Second, the side-effects. ]]]
Yes, the side-effects can be bad. All the more reason not to give them to people who aren’t actually clinically depressed or dysthymic.
[[[ Third, anti-depressants only work while you’re on them. ]]]
So we’re on the same page – if you’re actually depressed or dysthymic, the correct medication works?
For some people, the boost they get from being on an antidepressant is what helps them get the CBT or make the life changes necessary to get their lives on a positive track. Frankly, if a GP is handing out antidepressant prescriptions year after year, without doing anything to encourage the patient to change his way of thinking, he’s doing his patient a disservice – but that doesn’t mean the patient would be better off unmedicated.
[[[ Fourth, to the extent they do work, it’s by erasing feelings. ]]]
Maybe that’s true for some medications or some individuals, but your generalization is otherwise false. In my experience it’s bunkum.
[[[ Fifth, ... no one really understands how they work... ]]]
So what?
Look, when I first tried antidepressants I was squarely in the skeptic’s box. Elavil (a tricyclic) was mood altering and even mind-altering, but it was more of a distraction from depression than an anti-depressant. (One of the reasons. Zoloft and Paxil offered significant side effects with no benefit. Some years later I tried Celexa and boom – wow – these things really work! And they help a lot during short-term therapy. A couple of years after that a dip back into depression, another few months of Celexa coupled with a series of deliberate lifestyle changes and I’ve never gone back. I’ve had plenty of “normal” lows, for which people who don’t know what depression is might complain, “I’m depressed” – but there’s a huge difference.
For a depressed lawyer, here’s the short version of how to help yourself: If you were a happy person before you became a lawyer, it’s probably your job that’s making you miserable. If you were a depressed or dysthymic person during the years leading up to your practice of law, you may need some medication and therapy to get out of your rut. But if you’re in either camp and hate your job, really, you can make your life a lot better by finding a different job.
I’m hoping that the post was really more of a “hey – we should think about whether there are other options” than a “stop-taking ADs, you idiots.”
Nonetheless, it’s hard to discern, which is a problem. The first time I read it, my immediate reaction was: “This is a person who has never struggled with serious non-situational depression, and certainly has no idea what it feels like to have that lifted from you.”
My second reaction was: God, did ATL give this guy cred because he used to work at a fancy law firm?”
ADs work for some people. For some they are lifesavers, for others they don’t do anything, or not enough to make them worthwhile. The key is to find a doc who gets that, and you, and figure it out.
And just because someone worked at Cravath/Skadden/Whatever Firm doesn’t mean they are expert at everything.
Yes, he gets law firm life, no he doesn’t really get depressed people, or how to communicate.
Mike Triforce here -
AAAAH HA HA HA HA! Buddy, do you have me pegged. Seriously, I am a 4th year associate at a large Philadelphia law firm and I waited out the last few rounds of layoffs AT HOME ON THE COUCH by taking short term (by that I mean six months) of PAID LEAVE on disability thanks to…my depression! Well, technically I had to say I was bipolar, but you know whatever. Doctors and pharmacists need to get paid. By the way, there are no side effects if you flush your meds or sell’em to college kids (in case pulling 150k for nothing doesn’t quite do it for you). Hey, I know it sounds like alot, but I had alot of free time to fill.
Now, here’s the two part genius to my plan. I will admit I didn’t think of this ahead of time, I was just a lazy con, but 1) I couldn’t have a stealth layoff because they can’t fault a performance IF ONE DIDN’T OCCUR and 2) shit, they’re scared of me now because if they drop me I simply sue for discrimination based on the Americans with Disabilities Act! I think being paid to not do or bill shit is a “reasonable accomodation” WOO WOO WOO! Suck it chumps! Obama I hope that curbing waste and abuse in the medical system thing works out for you…but not too well.
UHHHH!
I am seriously sick of this guy’s self promotion. Spend less time finding idiots to guest write on the blog and more time fixing your hosting issues.
ATL, please stop publishing this quack.
I used to refer to the law firm where I summered as Prozac Nation.
I know Mike Triforce. He works for Echert Seamen, in my opinion, one of the top Philly firms to work for.