Depression takes a heavy toll on lawyers

Suvor

Daniel Suvor thinks he has the right idea. Early on, remove the stigma of mental health treatment for lawyers — who suffer the most depression of any profession — and they may be able to avoid the total breakdown or career nosedive that harms them and others.

As one of his priorities as chair of the ABA’s Law Student Division, Suvor, a third-year student at George Washington University Law School, had March 27 declared National Mental Health Day at law schools across the country to increase awareness of law student mental health issues. The division is providing a toolkit on the ABA Web site about signs and symptoms of depression and anxiety as well as ideas for stress reduction.

Carlton

Richard Carlton, deputy director of the State Bar of California’s Lawyer Assistance Program (LAP), the voluntary program that offers aid to attorneys with substance abuse or mental health problems, is all for tackling depression early. “I think it’s an excellent idea,” he says of the Mental Health Day. “The idea is not to wait until the harm is done, but to intervene on the front end,” adds Janis Thibault, director of LAP, who wants lawyers to avail themselves of LAP services at the first sign of distress.

Thibault

According to a Johns Hopkins University study, lawyers suffer the highest rate of depression among workers in 104 occupations. A University of Washington study found that 19 percent of lawyers suffered depression compared to 3 percent to 9 percent in the general population. And a University of Arizona study of law students found that they suffer eight to 15 times the anxiety, hostility and depression of the general population.

“There’s something about the practice of law that attracts a certain personality that is prone to experiencing these problems,” says Carlton. “They’re very intelligent, very driven to succeed — accomplished people.”

“There’s a bit of all or nothing,” adds Thibault. “If you don’t win, you lose. Most professions don’t experience that extreme . . . I’ve never seen such a lonely profession — the inability to connect with other people at a deep level because there’s so much of an adversarial relationship. The profession in a lot of ways makes it very difficult to build trust.”

At the same time, driven attorneys are the very people who are reluctant to seek treatment — if they get to the point of admitting they have a problem at all. “You’re the warrior when you go into the courtroom,” says Tim Willison, a licensed clinical therapist who is one of nine LAP group facilitators from throughout the state. “Emotional stuff is seen as a weakness.”

That emphasis on the thinking part of the brain does wonders in the courtroom and in parsing and analyzing legal issues. “There’s an absolute need to keep feelings in check, especially if they’re litigating,” Willison says. But it can take a toll elsewhere, and anger often becomes the dominant emotion. “For everybody, part of mental health is being able to process feelings. Everybody needs to be able to use their head and their heart.”

Willison, whose LAP territory covers San Francisco, Sacramento and Davis, says lawyers who come to him with depression are typically in their 40s and 50s because the pressures have built up to the boiling point by then. “It’s cumulative,” he says. When the lawyers walk in his door, he sees the telltale signs: fatigue, low energy, a sense of being overwhelmed. At home or in the office, “there’s creeping paralysis.”

Willison described some typical symptoms:

They may have come to the point where they can’t bear to open another envelope from the State Bar, and those unopened envelopes are piling up in a drawer somewhere. They don’t feel they can deal with one more demand from a client. They can’t answer the phone. If they’re at the beach on a beautiful, sunny day, it’s “So what?” They can’t experience pleasure. Nothing is fun. They may have trouble sleeping. There may have been a change in appetite.

And Willison says he doesn’t know how anybody could be happy working 80 to 90 pressure-filled hours a week. “It’s a set-up,” he says, and it’s particularly hard on solo practitioners, who besides working the long hours, do it in isolation and also take on every job in the office, from making copies to filing papers at the courthouse. “I think you have to work at finding a way at practicing law that is balanced.”

Treatment may include private therapy and medication and is increasingly including meditation. Carlton and Willison believe the biggest help is the group support even though, as Willison points out, the initial reaction from a lawyer to group support is often incredulous: “‘You want me to sit in a room full of attorneys and you tell me that’s going to help?’ I have to offer some reassurance.”

But once they join the groups, which usually have more men and typically meet once a week, participants realize that they are not alone. “There’s an enormous sense of relief when they find out they’re not the only one,” says Willison. “They’ll be out there pretending it’s OK and feel they’re the only broken soldier.”

According to a 2006 LAP report, 27 percent of program participants suffer from substance abuse, 37 percent have mental health issues and 36 percent have a dual diagnosis.

A 2002 study by Florida State University law professor Lawrence Krieger and Missouri-Columbia psychology professor Kennon Sheldon found that the most dissatisfied law students were also the ones who had lost sight of such intrinsic values and rewards as personal growth and contribution to the community. Krieger also wrote the advice handbook being promoted by the ABA Law Student division. “Scientific research for the past 15 years has consistently shown that a primary focus on external rewards and results, including affluence, fame and power, is unfulfilling,” Krieger wrote.

“These values are seductive — they create a nice picture of life but they are actually correlated with relative unhappiness. Instead, people who have a more ‘intrinsic’ personal/ interpersonal focus — on personal growth, close relationships, helping others or improving their community — turn out to be significantly happier and more satisfied with their lives . . . Research shows that there are only two motivations for choosing work (or other actions) that will promote your life satisfaction: you inherently enjoy the process of doing that work or the work supports a fundamental value or makes a higher goal possible.”

Susan Daicoff, professor at Florida Coastal School of Law and author of Lawyer, Know Thyself, believes that lawyers may be able to learn something from Krieger’s work. Studies have found a strong correlation between job dissatisfaction and psychological distress in lawyers, but from research she has conducted and read, she does not believe it can be concluded that these people were ill-suited to law in the first place. In fact, she says, their dissatisfaction may reflect dissatisfaction by clients and society as a whole in the way lawyers perform.

For example, says Daicoff, it may be in clients’ best interest to try to bring families together, but neither law school nor the legal profession consider that an important consideration. Lawyers stick to precedent and fairness — “If we had this situation last week, we should treat it the same way this week” — when both they and their client might be better off if they could take an “ethic of care” approach that looks at the whole situation and considers numerous options. In other words, lawyers could get back to the intrinsic values that Krieger talks of and make their work more satisfying to both themselves and their clients.

It’s possible that lawyers dissatisfied with their profession “are seeing some changes we need to make,” says Daicoff. “Maybe we need to respond to the criticisms.”