TCL - = Depression Among Lawyers - January 2004 - Colorado Lawyers Helping = Lawyers

TCL > January=20 2004 Issue > Depression Among Lawyers

The Colorado Lawyer
January=20 2004
Vol. 33, No. 1=20 [Page 35]

=C2=A9 2004 = The Colorado=20 Lawyer and Colorado Bar Association. All = Rights=20 Reserved.=20
All material from = The=20 Colorado Lawyer provided via this World Wide = Web=20 server is copyrighted by the Colorado Bar = Association.=20 Before accessing any specific article, click here for disclaimer = information.=20

Departments
Colorado Lawyers = Helping=20 Lawyers
Depression Among Lawyers
by = Joan E.=20 Mounteer

Articles in this quarterly department are = presented by=20 Colorado Lawyers Helping Lawyers (formerly known as = the=20 Colorado Lawyers Health Program). Colorado Lawyers = Helping=20 Lawyers is a program approved by the Colorado Supreme = Court.=20 It is a volunteer-based, independent, non-profit = lawyers=E2=80=99=20 assistance program providing statewide confidential = peer=20 support and resource/referral information to all = Colorado=20 attorneys, judges, and family members who are dealing = with=20 substance and alcohol abuse, mental health issues, and = other=20 destructive behaviors or impairments. For questions or = comments, please call: (303) 832-2233 or (800) = 432-0977. Those=20 interested in contributing an article on lawyers and = mental=20 health/substance abuse problems should contact Frances = Smylie=20 Brown at (303) 620-4888 or = frances.brown@state.co.us.

Joan Mounteer, Denver, is Deputy State Public = Defender,=20 Colorado State Public Defender=E2=80=99s = Office=E2=80=94(303) 620-4888;=20 joan.mounteer@state.co.us.

Everyone experiences the occasional "blue day" or a = period=20 of feeling "down." It also is normal to feel sadness = or grief=20 after a loss. Sadness is a part of life. But chronic = feelings=20 of sadness are not a normal part of life. Depression, = a=20 serious medical disorder, differs vastly from the = transitory=20 state of feeling "down in the dumps."

Depression produces a profound low mood and = influences a=20 person=E2=80=99s thoughts, feelings, health, and = behavior. It is an=20 illness, just like heart disease and cancer are = illnesses. At=20 one time or another, depression will afflict more than = 25=20 percent of the population. It strikes all ages, all = races, all=20 economic groups, and both sexes. However, women are = the=20 victims of depression twice as often as men. It is a = major=20 cause of alcohol and drug abuse and other addictions.=20 Fortunately, depression can be successfully treated in = approximately 80 percent of cases.

Depression is not something to be ashamed = of. It is=20 not a character flaw or a sign of personality = weakness.=20 Moreover, it is not a "mood" that a person can "snap = out of,"=20 any more than a person can "snap out of" = diabetes.1 Depression=20 strikes the legal profession more often than any other = profession. This article explores the issue of = depression, its=20 signs and symptoms, the reasons for its prevalence in = the=20 profession, some specific problems depression poses, = its=20 impact on professionalism, and how to get help.=20

Symptoms of Depression and
Contributing=20 Factors

According to Dr. Amiram Elwork, a clinical = psychologist and=20 director of the Law & Psychology Training Program = at=20 Widener University in Minnesota, the symptoms of = depression=20 come in clusters and include the following:

=E2=80=A2 Persistent sad, anxious, "empty" = mood
=E2=80=A2 Feelings of=20 hopelessness, pessimism
=E2=80=A2 Feelings of = guilt,=20 worthlessness, helplessness
=E2=80=A2 Loss of = interest or=20 pleasure in ordinary activities, including = sex
=E2=80=A2=20 Withdrawal from family and friends
=E2=80=A2 = Sleep disturbances=20 (insomnia, early morning waking, or oversleeping) =
=E2=80=A2=20 Eating disturbances (either loss or gain of appetite = and=20 weight)
=E2=80=A2 Decreased energy, fatigue, = being "slowed down"=20
=E2=80=A2 Thoughts of death or suicide, suicide = attempts
=E2=80=A2=20 Restlessness or irritability
=E2=80=A2 Increased = alcohol=20 consumption (self-medication)
=E2=80=A2 = Difficulty=20 concentrating, remembering, making = decisions
=E2=80=A2 Physical=20 symptoms (such as headaches, digestive disorders, = and=20 chronic pain) that do not respond to = treatment.2

Many factors can contribute to depression. For some = people,=20 a number of components seem to be involved; for = others, a=20 single factor can trigger the illness. Depression also = strikes=20 for no apparent reason. According to the National = Mental=20 Health Association, however, common factors = contributing to=20 depression are as follows:

1. Biological: People with depression = typically have an imbalance of certain brain chemicals = called=20 "neurotransmitters," which help brain cells = communicate with=20 each other. Any imbalance can disrupt the = brain=E2=80=99s=20 mood-regulating system.

2. Cognitive: People with negative thinking = patterns=20 and low self-esteem are more likely to develop = depression.=20 Optimism in adulthood seems to have its roots in the = nurturing=20 and care of parents during childhood.3

3. Gender: Women experience = depression at=20 nearly twice the rate of men. While the reasons for = this are=20 still unclear, they may include female lifespan = hormonal=20 changes. Another reason may be women=E2=80=99s = multiple=20 responsibilities and consequent stress.

4. Co-occurrence: Depression is more = likely=20 to occur with certain illnesses, such as heart = disease,=20 cancer, Parkinson=E2=80=99s disease, diabetes, = Alzheimer=E2=80=99s disease,=20 and hormonal disorders.

5. Medications: The side effects of = some=20 medications can bring about depression.

6. Genetic: A family history of = depression=20 increases the risk of developing the illness. Studies = of twins=20 and adopted children seem to suggest that the risk has = a=20 genetic component.

7. Situational: Difficult life = events, such=20 as divorce, financial problems, or the death of a = loved one=20 can contribute to depression. It also is more likely = to arise=20 among those who have suffered stress over a long = period of=20 time.

Depression in the
Legal = Profession

In a study of more than 100 occupations, lawyers = had the=20 highest rate of depression.4 In fact, = lawyers are=20 almost four times more likely to experience depression = than=20 the general population.5 Aside = from depression,=20 one in four lawyers also experience feelings of = inadequacy and=20 inferiority in personal relationships, as well as = anxiety or=20 social alienation, at much higher rates than the = population at=20 large.6

Especially among lawyers, depression can be=20 life-threatening. Surveys of lawyers in Washington and = Arizona=20 reveal that most lawyers suffering from depression = also have=20 suicidal fantasies.7 A = disproportionate=20 number of lawyers commit suicide, unfortunately during = middle=20 age, when they would be most productive.8 Some=20 attribute this to the depressed lawyer=E2=80=99s = typical retreat into=20 isolation, which greatly enhances the risk of acting = on=20 suicidal thoughts.9 As a result, one study = concluded that=20 lawyers are at a much greater risk of acting on their = suicidal=20 thoughts and succeeding in doing so.10

Why is depression such a problem in the profession? = First,=20 the increase in the number of lawyers likely has led = to=20 increased competition and diminishing personal = relationships=20 with other lawyers.11 Second, = new=20 technology creates an unrelenting and faster work=20 pace.12 Also, the law is overwhelmingly complex = today.=20 Changing legal standards make it difficult to know how = to=20 advise clients, and courts render so many decisions = that it is=20 not easy to understand what the law actually is. The = only=20 certainty is that whatever the causes, lawyers suffer=20 increased rates of burnout, disillusionment, and=20 dissatisfaction, which can lead to attorney neglect of = files,=20 anxiety, depression, substance abuse, or = suicide.13

Because depression impacts productivity in the = workplace,=20 lawyers toiling under its burdens can cause = irreparable damage=20 to clients, law firms or offices, and the legal = profession, as=20 well as to their own health.14 A major = hurdle for=20 depressed lawyers is to realize they are, in fact, = depressed.=20 Depression is insidious. Often, those who suffer from=20 depression do not recognize it as such. This may be = because=20 those who have lived with suffering for so long are = used to=20 feeling depressed or are out of touch with their=20 feelings=E2=80=94being depressed can have a numbing = effect.=20

Distinctive Lawyer Personality=20 Traits

Empirical research suggests that lawyers have = personality=20 characteristics that distinguish them from the general = population.15 Some aspects of the lawyer = personality can=20 exacerbate depression and hinder acknowledgment that = there may=20 be a problem. For example, research on personality = traits of=20 lawyers reveals they have a low interest in emotional = concerns=20 and interpersonal matters; a disproportionate = preference for=20 "thinking" as opposed to "feeling";16 a = greater than normal=20 incidence of psychological distress, including = depression; and=20 substance abuse problems.

Lawyers are trained to be rational and objective. = This=20 training, combined with the devaluation of emotional = concerns=20 and feelings, can become obstacles to seeking help. = Due to=20 their unique personality traits, lawyers may not = recognize=20 their own problem until the disciplinary committee = comes=20 knocking on the door. Lawyers also have more = "masculine"=20 traits, including being argumentative, competitive,=20 aggressive, and dominant, any one of which can = contribute to=20 social isolation.17 Socially isolated lawyers may = not have the=20 peer or family support to help them become aware that = they may=20 be suffering from depression. Moreover, due to these = masculine=20 traits, lawyers may perceive their need for help as a=20 character weakness, deny the problem, and sink deeper = into=20 depression=E2=80=99s depths.

Impacts on Professionalism

Ethics violations resulting from depression are = likely to=20 stem from incompetence, lack of diligence, and = communication=20 lapses. For instance, Colorado Rule of Professional = Conduct=20 ("Colo. RPC") 1.1 requires lawyers to provide = "competent=20 representation" to their clients. That rule defines = "competent=20 representation" as the requisite "legal knowledge, = skill=20 thoroughness and preparation reasonably necessary for = the=20 representation." Likewise, Colo.RPC 1.3 mandates = lawyers to=20 "act with reasonable diligence and promptness" and to = "not=20 neglect a legal matter entrusted to" them. Similarly, = Colo.RPC=20 1.4 dictates that lawyers keep clients "reasonably = informed=20 about the status of a matter." It further provides = that=20 lawyers "promptly comply with reasonable requests for=20 information."

Obviously, lawyers suffering from the crushing = burden of=20 depression are likely to violate these basic tenets of = professional conduct because the depression overwhelms = every=20 aspect of life. Hence, Colo.RPC 1.16(a)(2) = specifically=20 prohibits lawyers from accepting or continuing = representation=20 if their mental condition materially impairs the = ability to=20 represent the client. Additionally, if partners or = direct=20 supervisors are aware of that mental impairment, they = must=20 take steps reasonably to ensure that it will not lead = to=20 professional conduct violations.18

How to Help=E2=80=94Or to Get = Help

Because lawyers are so susceptible to depression, = which can=20 create problems of professionalism in the law firm and = the=20 courts, it is critical for colleagues to be watchful = for=20 warning signs. It also is important for lawyers who = have=20 symptoms of depression to seek help before their law = practices=20 and family life suffer.

Recognizing a Colleague=E2=80=99s = Problem

Lawyers who work in a law firm or organization have = an=20 advantage. Depressed lawyers are not hard to recognize = if=20 other lawyers pay more attention to "interpersonal = concerns."=20 Even in the absence of such sensitivity, certain = behaviors can=20 signal depression. These include decreased = productivity,=20 absenteeism, morale problems, uncharacteristic lack of = cooperation, complaints about always being tired, = disruptive=20 behavior, and substance abuse.19 = Additionally, talk of=20 suicide should be taken
seriously.20 = Depression can kill=20 and, tragically, suicide is its = instrumentality.21

Early treatment equates with less time lost at work = and=20 increased productivity. It also is a way to circumvent = poor=20 judgment decisions that can lead to professional=20 misconduct.22
Encourage the colleague to = get help. A=20 family physician can adequately diagnose and treat the = condition or refer a specialist, if=20 needed.

Getting Help for Yourself

Today=E2=80=99s anti-depressant drugs are truly a = godsend. There=20 are a wide variety of such medications, the best known = of=20 which is probably Prozac. A family physician is well = versed in=20 the pros and cons of these medications. All can be = effective=20 at restoring the chemical balance in the brain. One = drawback,=20 however, is that these drugs take a long time to start = working; in some cases, up to a month. This lag may = discourage=20 some from continuing the treatment. However, even if = the=20 particular drug first prescribed is ineffective, = another may=20 be prescribed with success. These drugs are very=20 powerful and should be taken only by prescription = and=20 under the supervision of a medical doctor.

Psychotherapy also is helpful. A person will = progress more=20 quickly in therapy once the antidepressants sweep away = depression=E2=80=99s low mood and negative thinking. = Additionally,=20 psychotherapy is vital in addressing the underlying = problems=20 that triggered the depression. It also can be the = forum for=20 discovering adequate coping strategies for stressors = that can=20 lead to depression.

Conclusion

Depression is all too pervasive in the legal = profession.=20 Although the individual attorney may be prone to = developing=20 depression, empirical research reveals that attorneys = as a=20 group have personality characteristics that = distinguish them=20 from the general population and make them more = vulnerable.=20 Depression among lawyers can have serious professional = consequences and can impact not only the lawyer = suffering from=20 depression, but the firm or organization as well. = Therefore,=20 it is important to identify the suffering as = depression and to=20 get help quickly when its symptoms = arise.

NOTES

1. See Bakke, "My = Experience=20 with Depression: Brainstorm," 73 Wisconsin = Lawyer (Dec.=20 2000), which is a first-hand account of one = lawyer=E2=80=99s struggle=20 with depression, at http://www.wisbar.org/wislaw=20 mag/2000/12/qol.html.

2. See Gehan, = "President=E2=80=99s Page:=20 Depression Among Lawyers," Bench & Bar of = Minnesota=20 (July 1998) at=20 = http://www2.mnbar.org/
benchandbar/1998/jul98/prezpage_7-98.htm.

3. The Dennis Prager Show, = Interview with Dr. Stephen Marmer, M.D., = Psychotherapist=20 and Assistant Professor Psychiatry, UCLA School of = Medicine=20 (KRLA radio broadcast, June 6, 2003).

4. Sells, The Soul of the = Law:=20 Understanding Lawyers and the Law (1994) at 99,=20 citing, Eaton, Mandel, and Garrison, = "Occupations and=20 the Prevalence of Major Depressive Disorder," 32 J. = Occupational Med. 1083-1132 (1990).

5. Id.

6. Sells, supra, note 4, = citing=20 "Are Lawyers Distressed? . . . And How!" Wash. = State Bar=20 News (WSBA Lawyers=E2=80=99 Assist. Program Staff) = (Feb. 1988) at=20 13.

7. Sells, supra, note 4, = citing=20 Benjamin, Darling, and Sales, "The Prevalence of = Depression,=20 Alcohol Abuse and Cocaine Abuse Among United States=20 Lawyers," Int=E2=80=99l J.L. & Psychiatry = 13 (1990).=20

8. Sells, supra, note 4 at = 99-100,=20 quoting Blachly, Osterud, and Josslin, "Suicide = in=20 Professional Groups," New England J. Med. 268 = (1963).=20

9. Blachly et al., supra, = note 8 at=20 241.

10. Id.

11. See "Alternative = Careers," a=20 download available on the LawCare: Health Support and = Advice=20 for Lawyers website: http://www.lawcare. org.uk. While = the=20 general population increased 15 percent from 1970 to = 1985, the=20 population of lawyers nearly doubled. See also=20 Daicoff, "Lawyer, Know Thyself: A Review of = Empirical=20 Research on Attorney Attributes Bearing on = Professionalism,"=20 46 Am. U. L.Rev. 1337 (1997).

12. "Alternative Careers," = supra, note=20 11.

13. Id.

14. See National Institute of = Mental=20 Health, Pub. No. 97-3919, What to Do When an = Employee is=20 Depressed: A Guide for Supervisors: Depression Affects = the=20 Workplace (1996).

15. Daicoff, supra, note = 11.

16. Id. Based on the = Myers-Briggs Type=20 Indicator, a popular test administered by business and = career=20 counselors to classify and describe people=E2=80=99s = personalities.=20 See Myers, Exploring Psychology, 4th ed. = (New=20 York: Worth Pubs., 1999) at 401.

17. Daicoff, supra, note = 11.

18. ABA Comm. on Ethics and = Professional=20 Responsibility, Formal Op. 03-429 (2003), "Obligations = with=20 Respect to Mentally Impaired Lawyer in the = Firm."

19. Id.

20 National Institute of Mental = Health,=20 supra, note 14.

21. Id.

22. See the LawCare: Health = Support and=20 Advice for Lawyers website at "Depression":=20 http://www.lawcare.org.uk/depression.htm.

Helpful=20 Resources

Online:=20

=E2=80=A2=20 National Mental Health Association: http://www.nmha.org/infoctr/factsheets/index.cfm

=E2=80=A2=20 National Institute of Mental Health: = http://www.nimh.nih.gov/publicat/index.cfm#disinfo

=E2=80=A2=20 American Psychological Association: http://www.apa.org/psychnet/depression.html

=E2=80=A2 All=20 About Depression: http://www.allaboutdepression.com

=E2=80=A2=20 Depression and Bipolar Support Alliance: = http://www.dbsalliance.org

=E2=80=A2=20 LawCare (resource for U.K. lawyers, but = pertinent=20 information and downloads for lawyers anywhere): = http://www.lawcare.org.uk

=E2=80=A2=20 Despair Inc.: http://www.despair.com

=E2=80=A2=20 Prozac: http://www.prozac.com

=E2=80=A2=20 Zoloft: http://www.zoloft.com

Books:

=E2=80=A2=20 Styron, Darkness Visible: A Memoir of Madness = (New York,=20 NY: Random House, 1990)

=E2=80=A2 Kramer, Listening=20 to Prozac (New York, NY: Penguin Group,=20 = 1997)

=C2=A9 2004 The Colorado Lawyer and = Colorado Bar=20 Association. All Rights Reserved. Material from = The=20 Colorado Lawyer provided via this World Wide = Web=20 server is protected by the copyright laws of the = United=20 States and may not be reproduced in any way or = medium=20 without permission. This material also is = subject to the=20 disclaimers at http://www.c= obar.org/tcl/disclaimer.cfm?year=3D2004.=20

Back=20

Search

Most Viewed