In 1995, a Portland lawyer wrote a suicide note to his =
family and=20
then drove to his favorite fishing spot in central Oregon. While =
sitting in=20
his vehicle, he shot himself. A year later, another lawyer practicing =
in the=20
Willamette Valley of Oregon left a suicide note to the members of his =
law=20
firm, and then walked to a park near his office and shot himself. Both =
lawyers=20
were experiencing depression. With it came the distorted thinking that =
a=20
permanent solution to a temporary problem was the answer.
I am shocked and saddened to lose a fellow lawyer due to suicide =
caused by=20
depression. Lawyers suffer a high rate of depression. That is why it =
is=20
important for lawyers and other bar leaders to understand the scope, =
nature=20
and extent of this disorder. How extensive is the problem?
In 1991, Johns Hopkins University in Baltimore interviewed 12,000 =
workers=20
about depression. Lawyers ranked No. 1 on the list of occupations that =
were=20
most depressed.=20
While 3 percent to 9 percent of the population at any given time =
may=20
experience depression, a quality-of-life survey conducted by the North =
Carolina Bar Association in 1991 reported that almost 26 percent of =
the bar's=20
members exhibited symptoms of clinical depression. Almost 12 percent =
of them=20
said they contemplated suicide at least once each month.
It is difficult to measure the economic and social consequences of =
lawyer=20
depression (such as malpractice or neglect of cases), but it is =
estimated that=20
depression in the United States population totals about $44 billion in =
both=20
direct cost (i.e., patient care and medication) and indirect cost =
(e.g.,=20
absenteeism and lost productivity), according to the National =
Institute on=20
Mental Health.
Symptoms of depression
If a lawyer has a "blue" mood =
that lasts=20
for more than two weeks and experiences any of the following symptoms, =
it is=20
likely that person is having an episode of depression. The symptoms =
include:=20
- A change in appetite (eating too much or too little).=20
- Problems with sleep (either insomnia or sleeping longer than =
usual).=20
- A loss of interest or pleasures. (It may take a form of =
withdrawing from=20
family or neglecting formerly enjoyed hobbies.)=20
- The inability to sit still, pacing or hand-wringing =
("agitation"). Or=20
slowed speech, increased pauses before answering a question, =
monotonous=20
speech, slow body movements or an overall decrease in energy level=20
("retardation").=20
- A sense of worthlessness or feelings of inadequacy, and other =
forms of=20
negative thinking, including inappropriate guilt.=20
- Recurring thoughts of death and/or suicide.=20
- Difficulty concentrating, slow thinking, indecisiveness (the =
smallest=20
task may seem difficult or impossible to accomplish).=20
- Memory difficulty and easy distraction.=20
- Fatigue.
Episodes of clinical depression may last from =
six=20
months to two years if left untreated. Most health care professionals =
believe=20
that stress and genetics play an important role in the onset of =
depression=20
even though they have been unable to pinpoint the cause of it.=20
Professional influences
Let's look at the law-related =
stressors.=20
A few years ago, Standish McCleary, a lawyer-turned psychologist (with =
a=20
Ph.D.), and I presented a program on stress management and burnout, =
and=20
identified some of the reasons why lawyers are above the norm for =
depression.=20
The stressors identified are:=20
- Time constraints and deadlines..=20
- The high stakes involved, including a loss of property, freedom =
and even=20
life.=20
- The high expectations of expertise.=20
- The constant scrutiny and critical judgment of our work from =
opposing=20
counsel or the courts.=20
- The legal process in general, which is inherently =
conflict-driven. An=20
opposing counsel is always determined to prove us wrong.=20
- The threat of malpractice, Murphy's Law, and CYB (cover your =
backside)=20
from other lawyers and even our own clients.=20
- A tendency to assume the clients' burdens.=20
- The demise of professional cordiality and camaraderie.=20
- The contrast between effective advocacy and personal =
relationships.=20
While lawyers are trained to be aggressive, judgmental, =
intellectual,=20
emotionally defended or withdrawn, and while that style may have =
practical=20
value, it may not be popular outside the arena of the legal case.=20
- The professional training that requires us to notice and =
anticipate the=20
negative and the downside in all situations.=20
- The group norms or culture in the law firm, which carries =
certain=20
expectations, including high billable hours. On top of work =
obligations come=20
CLE requirements, bar activities and community service work--all =
expected=20
from the "good" lawyers.=20
- The depletion of energy that comes from high demands, strong =
focus and=20
the need to stay on task.=20
- Frequent use of defense mechanisms--such as rigidity, =
compulsiveness,=20
and perfectionism. (See "The depressing nature of the law: Is law =
hazardous=20
to your health?", page 14.)
Burnout
Continued =
high levels=20
of stress over a long period of time, without adequate coping =
strategies, can=20
lead to burnout. Burnout is nothing more than a form of depression. It =
has=20
been defined as a type of depression characterized by apathy, negative =
feelings about the job, declining productivity, increased illness, and =
difficulty in personal relationships. Sometimes it includes an =
increase in=20
substance abuse.
Everyone occasionally feels frustrated, depressed and dissatisfied. =
But=20
when someone experiences depression or burnout, these negative =
emotions become=20
chronic and last for weeks or months. There is only so much =
psychological=20
energy to get us through the day, and our work may completely deplete =
us of=20
this energy. When this happens, our work performance is further =
reduced in=20
terms of quality and quantity. The lack of emotional energy makes it =
harder to=20
deal with our personal relationships and we may become frustrated and =
easily=20
angered with family and friends. Lawyers experiencing burnout may find =
themselves wondering "why bother?" about work that previously =
invigorated=20
them. Even the word, burnout, implies that at one time they were on =
fire, but=20
the flame has now flickered.=20
Burnout has been called a "romantic disorder" because it is =
characteristic=20
of a work ethic admired in our culture. Long hours and a selfless =
dedication=20
to work--to the exclusion of self-care--can lead to burnout. In the =
North=20
Carolina bar survey, it is noteworthy that 36 percent of lawyers =
surveyed in=20
North Carolina had not taken even a one-week vacation in the year =
prior to the=20
survey. Learning how to manage stress and take care of ourselves is =
critical=20
to preventing burnout. This, in turn, can help minimize the effects of =
depression.=20
Alcohol abuse
There is a definite relationship between =
alcohol=20
and depression. Alcohol is a drug that operates as a central nervous =
system=20
depressant, and approximately 30 percent of all depression cases are =
alcohol=20
induced. When the lawyer stops drinking and remains sober for an =
extended=20
period, depression disappears. When depression is the presenting =
problem, it=20
is important that a trained professional evaluate the lawyer for =
alcohol or=20
chemical dependency.
Studies in both Washington and Arizona show that lawyers suffer =
from a=20
higher rate of alcoholism than the general population. While =
approximately 10=20
percent of the population suffers from alcoholism, the number jumps to =
almost=20
20 percent in the legal profession, or one in five lawyers. This =
higher rate=20
of alcoholism in lawyers also explains the higher rate of clinical =
depression.
What can bar leaders do?
While it may seem daunting and =
even=20
depressing to hear the statistics regarding addictions and mental =
health=20
illnesses in our profession, the problem does not go away by ignoring =
it. In=20
the last decade many state and local bar associations have created =
Lawyer=20
Assistance Programs (LAPs) to assist lawyers suffering from =
impairments. Most=20
programs initially dealt with alcoholism and drug addiction, but as =
programs=20
develop and budgets increase, some LAPs have expanded to address other =
impairments such as gambling, career issues and burnout, as well as=20
depression. Budget and staffing limitations prevent other LAPs from =
doing the=20
same. Having a director and/or a well-trained staff to make a correct=20
assessment and referral to appropriate medical professionals is =
important.=20
LAPs market their services to lawyers and educate the legal =
community about=20
addiction. Once a person knows enough about the disease or illness to=20
recognize symptoms, the person can call the LAP for further assistance =
or=20
information. LAPs exist because of support of bar leaders, Supreme =
Courts, and=20
the general bar membership. This is a testimonial to LAPs and their=20
effectiveness.=20
A few years ago I was contacted about a young lawyer who suffered =
from=20
depression. I was able to match the lawyer with a peer volunteer who =
had spent=20
years battling depression and had successfully overcome the illness. =
One day=20
the depressed lawyer took an overdose of pills. Shortly after, he =
called the=20
peer lawyer. The depressed lawyer was taken to the emergency room and =
his life=20
was saved.=20
While the Oregon Attorney Assistance Program has helped thousands =
of=20
lawyers through the years, I often think of this one lawyer because I =
believe=20
he is alive today because bar leaders in Oregon had the foresight to =
create=20
and support a LAP. The author is a program attorney with the Oregon =
Attorney=20
Assistance Program in Portland. He provides confidential assistance to =
lawyers=20
on problems including depression, relationships, stress, burnout and =
career=20
issues. He developed a specific program tailored for solo and =
small-firm=20
practitioners, which has more than 600 members and holds monthly =
meetings in=20
six cities throughout Oregon.=20
Sweeney is a Certified Employee Assistance Professional, chair of =
the=20
Governor's Council on Alcohol and Drug Programs and co-founder of the =
Oregon=20
Partnership, a non-profit prevention, education and treatment referral =
service=20
for alcoholism and drug abuse. He is also the past president of the =
Oregon=20
Council on Alcoholism and Drug Addictions; past president of the =
Columbia=20
River chapter of EAPA; and past member of the Oregon State Bar =
Committee on=20
Combining Family and Career. He has written and lectured on impairment =
issues=20
to national, state and local bar associations.
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