My father used to offer this analogy about human nature in the context of finding their way through a serious crisis:
Imagine you’ve crawled into a whisky barrel. Someone comes along and seals the barrel with you still inside. Then, the barrel is tipped over and you feel yourself begin to roll down a hill. The hill grows steeper, and the rolling accelerates. You hit a progressively spikier series of rocks along that slope. Somehow, during this tumble, you feel what must be dozens of steel baseball bats start to slam into the sides of the barrel. Eventually, the barrel’s roll begins to slow, but now you smell and begin to choke on smoke.
Before too much longer, you will ask for help.
What’s your point?
Attorneys who have sought treatment for depression can probably relate to this journey in the whiskey barrel. Speaking from personal experience, asking for help is frightening. This becomes more pronounced as:
- Anxiety starts to overwhelm you
- Sleeping and eating patterns go crazy
- Motivation fades and idle agitation percolates
- Sadness, numbness, and hopelessness sets in
- Not-so-advisable coping devices creep into the equation
- Consequences of this figurative shutdown start to manifest themselves in law practice as well as health
- Perhaps even marital trouble or driving violations or related criminal charges arise
How does depression affect the larger community of attorneys?
Depression as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a significant, and in recent years, persistent issue among attorney populations, especially for those in high-pressure practice areas like mass tort.
The Journal of Addiction Medicine released a survey report back in 2016 revealing that among a survey population of more than 11,000 responding attorneys, 46 percent responded that they had experienced depression symptoms at some point in their careers and that 11.5 percent had suffered through suicidal thoughts.
Additionally, triggers built into the study’s methodology showed that 36 percent of respondents had consumed alcohol at levels associated with abuse or dependence. Nearly 22 percent reported opioid use. The percentages proved to be higher among female respondents and younger ones.
That is alarming enough. Here is where the JAM story becomes truly meaningful for attorneys: Comparative studies conducted by the journal discovered that depression and addiction rates for attorneys were significantly higher than in populations of other educated professionals.
There is also evidence of widespread co-morbidity, as well the significance of aging in lessening the burden. To quote the study findings: “Mental health concerns often co-occur with alcohol use disorders… and our study reveals significantly higher levels of depression, anxiety, and stress among those screening positive for problematic alcohol use. Furthermore, these mental health concerns manifested on a similar trajectory to alcohol use disorders, in that they generally decreased as both age and years in the field increased. At the same time, those with depression, anxiety, and stress scores within the normal range endorsed significantly fewer behaviors associated with problematic alcohol use.”
Finally, there’s devastating punctuation: For the sub-populations that had sought treatment for addiction and had not sought treatment, 51 percent, and 27 percent, respectively, cited “not wanting others to find out they needed help” as a major barrier. The authors of the study are clear in their conviction that depression and anxiety lay down tracks that lead attorneys toward chemical dependency.
That was 2016. What about now?
In the five years since the JAM study was released, it appears that not much has changed within the legal profession. ALM research released this past May shows 37 percent of 3,200 responding attorneys report they are depressed and roughly 14 percent are struggling with multiple mental health issues.
Increases in these numbers are linked to the COVID-19 pandemic explicitly by ALM, but that seems overstated. The overall numbers are only up marginally from rates reported by ALM in 2019. Then, 31 percent reported depression and 12 percent reported multiple mental health issues.
So how can I actually ask for help in a way that sidesteps “others finding out?” Is there a path to wellness for me?
Resources available to attorneys to address growing depression as they experience the stress, never-ending volume, and loneliness of their practices have grown. They’ve done so in step with the growing cultural awareness and acceptance of mental health treatment (think of the recent coverage of tennis star Naomi Osaka).
Many of these resources value anonymity and confidentiality. Here are some good ones to consider:
- State-based Lawyer Assistance Programs (LAPs): The American Bar Association promotes and propagates these all over the country. LAPs universally promise “confidential services” specifically for legal professionals and law students struggling specifically with mental health and substance abuse issues. There is a LAP phone number and email address available in all 50 states. The programs are offered through a combination of bar associations and private entities. The ABA organizes a committee to review and monitor the effectiveness of these program.
- The Lawyer Depression Project: This is a peer-to-peer community offering, by lawyers for lawyers. Resources are available only through a free membership to promote and protect confidentiality and anonymity (be aware that users need to opt-in via a checkbox to remain anonymous). Members attain access to meetings, confidential forums on specific topics and group chats that permit “24/7 access.”
- The Institute for Well-Being in Law: The Institute states as part of its mission statement that it “is driven to lead a culture shift in law to establish health and well-being as core centerpieces of professional success.” The institute’s resources focus acutely on healing, or starting the healing process, and is built on public-facing content rather than on one-on-one counseling. The specific resources include a comprehensive 2017 report that examined the legal profession and made recommendations within specific categories of well-being. They also include a sample job posting a law firm “wellness coordinator” position, and soon there will be a podcast.
- Depression and Bipolar Support Alliance (DBSA): DBSA offers support groups all across the country, and also has options for online support groups. The alliance’s website also offers a “wellness toolbox” to provide a wide array of resources to help sufferers of depressive disorders better understand their needs. These include a daily wellness tracker, a “wellness wheel” to self-evaluate strengths and weaknesses, and courses on living with mood disorders and goal-setting.
- National Suicide Prevention Lifeline: This is a sensitive but necessary resource for attorneys who find themselves in an emergency level of despair. The Lifeline describes itself as a “national network of local crisis centers that provides [sic] free and confidential emotional support to people in suicidal crisis or emotional distress.” The service is available 24 hours a day. Attorneys should consider programming the phone number, (800)-273-8255, into their phones.
I don’t struggle with depression, but what if I believe a colleague is suffering from depression and may need help? What should I do?
The simple answer is: Ask them. Do it discreetly, but the simple offer of friendship or concern might prove to be more meaningful than you realize. This may or may not work; the barrel might not be on fire yet. If your colleague does open up, however, be ready to listen and offer support. If you know of the resources we have just discussed or know of other resources, consider sharing them.
A Final Thought on Depression Among Attorneys
Asking for help is not fun. Often, it’s brutal. Ignoring a problem or bottling it up, though, can only exacerbate the feelings experienced during an active, untreated onset of clinical depression.
In this instance, adopt the mindset of a frantic client who needs a lawyer right now, unable to organize themselves around the moment. They need the attorney’s help. The attorney struggling with depression similarly needs help from other professionals.
Follow suit. Your wellness may depend on it.
Be sure to take advantage of our FREE Well-being in Law Mini-Course for more resources and tools for positive mental health. Access it at https://themasstortinstitute.ac-page.com/wellbeing-in-law-mini-course.
Written by Christopher O’Connor
About the Author
Christopher O’Connor, Esq., is a licensed attorney (N.Y.) and a longtime journalist. His areas of focus include mass tort practice, employment law, enterprise technology, mental and spiritual health, and law practice management. He also possesses CIPP/US certification as a privacy professional.
O’Connor lives just outside of Houston, TX, and enjoys hiking, podcasting, and cooking for his wife.