here was no doubt that Meir was depressed. The question wasn’t really one of diagnostic clarification, rather it was one of causality. 

This was a great kid from a well-known family who had done well in high school, enjoyed a year at a prominent one-year yeshivah program in Jerusalem, and had graduated from Yeshiva University with honors by the age of 21. He had enrolled in the same prestigious law school that had educated his father and three older brothers and was doing well in his classes. On the outside, Meir seemed to have it all — and with his family connections and expectations, success was practically carved out for him.

But on the inside Meir was suffering. As he headed into his final semester, he began to have difficulty with sleep and lost much of his energy and focus. It was a challenge getting out of bed in the morning and breakfast became a chore, as food started to lose its taste. If not for his quick wit and good standing, he might not have reached the finish line.

After graduation, Meir headed back to his out-of-town community where he was received with open arms by the kehillah, and his first Shabbos back he was honored with maftir at the Young Israel that his zeidy had cofounded. Mothers in the women’s section turned their heads, thinking of the prospect for their own daughters on the market, but Meir slipped out of the kiddush early as he just didn’t have the energy to talk with the throngs of friends and family who were waiting to pat him on the back. Instead, the mazel tovs went to his father, who was as proud as could be to welcome his fourth son into the family law practice that had been the city’s litigation powerhouse for three generations. Back at home Meir had crawled into bed, dreading his first day in the office.

Less than 48 hours later, his father and brothers paraded him around the office, and even Zeidy came in to celebrate the new start. But before he could control what was happening, Meir was at the office with the rest of his family until 10 p.m. The only thing he had to look forward to was an end-of-the-summer trip to Israel his parents promised as a graduation present — but the way he was feeling, even that seemed like an elusive dream.

Meir’s mother discovered that he would cry every night, and she eventually became nervous enough to bring him to a psychiatrist for signs of depression. His symptoms seemed clear, but for some reason the first antidepressant didn’t work and neither did the second or third. Sleeping pills made Meir drowsy but didn’t alleviate his condition, and soon his father and brothers were furious at Meir for not pulling his weight. Meir’s older brother even gave him a dressing down at an office meeting in front of the entire litigation team. Meir walked out, headed home, and buried himself under the covers. He refused to come to work for the rest of the week and only left his room to catch his flight to Eretz Yisrael for his promised vacation.

Meir’s mother had been in touch before the flight to let me know she wanted to schedule a consultation. The story she had e-mailed me left me with a number of questions to ponder before I met with Meir. Why hadn’t the standard treatments helped a kid with classic depressive symptoms? Why was the town’s best catch completely uninterested in shidduchim? What else was going on that wasn’t written in the e-mail?

Meir entered my office looking like he had been run over by a truck and then hastily stuck together with a roll of duct tape. He answered questions in a voice that was alternatingly apathetic or irritated as he demonstrated just about every symptom of depression under the sun. No smiles, no appetite, no hope for the future, no good night’s rest. The poor kid was in bad shape.

But as I asked more and more questions, a picture emerged indicating that the onset of his symptoms and their subsequent worsening was tied to the tremendous expectations and eventual realities of joining the family practice. While his father and three older brothers were clearly alpha males with aggressive personalities built for litigation, Meir was softer and more introspective. While the rest of his family loved the spotlight as leaders in their community, Meir preferred listening to speaking. And while his brothers were proud to plant their own family trees in the same city in which Zeidy had built the shul and staked their claim in the business, Meir was dying to get away and the pressure was crushing him.

“I’m suffocating there. I’m not built for this kind of life, Dr. Freedman. The pressure to live up to my family’s expectations is so intense that just thinking about it brings on a wave of depression,” he said.

“I hear you loud and clear,” I said. “Of course all of the medications they’ve been giving you haven’t cured your depression — they’ve ignored the root cause.”

“So how do I get myself out of there? Maybe I should move to Toronto or something like that and start out on my own? It’s not like I don’t love my family, they’re great people. But it’s three generations and dozens of brothers, cousins, and uncles who are all doing the same thing. It’s too overwhelming — I need my own life. I don’t want to work 14 hours a day for corporations who are in trouble — I’d prefer to do something more meaningful, maybe represent struggling non-profit educational institutions. Look, I’m not sure about the future, but one thing’s for sure — I don’t want to stay stuck where I am.”

“It makes sense to me,” I answered. And of course it did. Here was a bright young man who clearly didn’t have the temperament for litigation and needed to develop into his own person. This was something no amount of antidepressants, stimulants, or tranquilizers could fix.

“So what do I do, Dr. Freedman? I just sit down with Mom and Dad and tell them I’m out?”

“Reb Meir, Chazal tell us that there are shivim panim l’Torah. Lots of ways to crack an egg. Being yourself isn’t an aveirah. You’re not going off the derech, you’re just finding your own way home.”

“You don’t know my father though. He’s intense.”

I could only imagine. But in the end, Meir alone would have to make the decision to blaze his personal trail.

“Meir, I’d love to help you on this journey. You’re a smart, lovely young man. The first step is for you to figure out where you want to be and once you’ve got that part down, you can lay it out for the family. You’re suffocating and it’s leading you down a path of tears, unnecessary medications, and your own inevitable personal deterioration. What worked for your brothers doesn’t necessarily have to work for you. Life isn’t one size fits all.”

“So you say I should quit?”

“I’ll make sure your dad fires you if you don’t.”

Originally featured in Mishpacha, Issue 723. Jacob L. Freedman is a psychiatrist and business consultant based in Israel. When he’s not busy with his patients, Dr. Freedman can be found learning Torah in The Old City or hiking the hills outside of Jerusalem.  Dr. Freedman can be reached most easily through his website www.drjacoblfreedman.com.