The legal profession has a problem. Lawyers are suffering and, far too often, they are taking their own lives.
Lawyers, as a group, are 3.6 times more likely to suffer from depression than the average person. A John Hopkins study found that of 104 occupations, lawyers were the most likely to suffer depression.
Further, according to a two-year study completed in 1997, suicide accounted for 10.8% of all deaths among lawyers in the United States and Canada, and was the third leading cause of death. Of more importance was the suicide rate among lawyers, which was 69.3 suicide deaths per 100,000 individuals, as compared to 10-14 suicide deaths per 100,000 individuals in the general population. In short, the rate of death by suicide for lawyers was nearly six times the suicide rate of the general population.
A quality of life survey by the North Carolina Bar Association in the early 1990s revealed that almost 26% of respondents exhibited symptoms of clinical depression, and almost 12% said they contemplated suicide at least once a month. Studies in other states have found similar results. In recent years, several states have been averaging one lawyer suicide a month.
Before I tell my story, I want to spend a little time talking about why these diseases are so prevalent among lawyers.
One of the more eloquent “whys” for the high incidence of depression among lawyers was contained in an opinion piece by Patrick Krill (a lawyer, clinician, and board-certified counselor) that accompanied a CNN article on lawyer suicides. As Patrick put it, “lawyers are both the guardians of your most precious liberties, and the butts of your harshest jokes; inhabiting the unique role of both hero and villain in our cultural imagination…” Patrick explained that the high incidence of depression (and substance abuse, which is another huge problem) was due to a number of factors, but that “the rampant, multidimensional stress of the profession is certainly a factor.” Further, “there are also some personality traits common among lawyers—self-reliance, ambition, perfectionism, and competitiveness—that aren’t always consistent with healthy coping skills and the type of emotional elasticity necessary to endure the unrelenting pressures and unexpected disappointments that a career in the law can bring.”
Patrick’s discussion of this issue really struck a chord with me. Practicing law is hard. The law part is not that hard (that was the fun part for me), but the business side of law is a bear. Finding clients, billing time, and collecting money are just a few aspects of the business of law of which I was not a big fan. Keeping tasks and deadlines in dozens (or hundreds) of cases straight, and getting everything done well and on time, is a constant challenge. The fear of letting one of those balls drop can be terrifying, especially for the Type A perfectionist who is always terrified of making a mistake or doing a less than perfect job. Forget work-life balance. Forget vacations. Every day out of the office is another day you are behind.
Plus, as a lawyer (and especially as a litigator), no matter how good a job you do, sometimes you lose. That inevitable loss is made worse by the emotion that the lawyer often takes on from his or her client. Almost no client is excited to call her lawyer. Clients only call, of course, when they have problems. Those problems can range from the mild (for example, a traffic ticket) to the profound (like a capital murder charge). But whatever the problem, the client is counting on the lawyer to fix it. Every lawyer I know takes that expectation and responsibility very seriously. As much as you try not to get emotionally invested in your client’s case or problem, you often do.
When that happens, losing hurts. Letting your client down hurts. This pain leads to reliving the case and thinking about all of the things you could have done better. This then leads to increased vigilance in the next case. While this is not necessarily a bad thing, for some lawyers this leads to a constant fear of making mistakes, then a constant spike of stress hormones that, eventually, wear the lawyer down. This constant bombardment of stress hormones can trigger a change in brain chemistry that, over time, leads to major depression.
Depression is a subtle and insidious disease. By the time you are sick enough to recognize that you have a problem, your ability to engage in accurate self-evaluation is significantly impaired. It is a strange thing to know, deep down, that something is wrong with you, but to not be able to recognize the massive changes in yourself. Helping yourself at that point is often impossible. Unfortunately, those suffering from depression become expert actors, extremely adept at hiding their problems and building a façade of normalcy. Eventually it takes all of your energy to maintain this façade. The façade becomes the only thing there is.
Depression is not a character flaw. It is not a weakness. It is not a moral failing. You cannot “just get over it.” No amount of will-power, determination, or intestinal fortitude will cure it. Depression is a disease caused (in very basic and general terms) by an imbalance and/or insufficiency of two neurotransmitters in the brain: serotonin and norepinephrine. In this way, it is biologically similar to diabetes, which is caused by the insufficiency of insulin in the body. As a disease, depression can be treated, and treated very effectively. But it takes time and it takes help—personal help and professional help.
And now we get to the personal part. Don’t say I didn’t warn you.
Though I likely had been depressed for a long while, I was diagnosed with severe clinical depression in late 2005. As another lawyer who helped me put it, suffering from depression is like being in the bottom of a dark hole with—as you perceive it from the bottom—no way out. The joy is sucked from everything. Quite often, you just want to end the suffering—not so much your own, but the perceived suffering of those around you.
You have frequent thoughts that everyone would be better off if you were not around anymore because, being in such misery yourself, you clearly bring only misery to those around you. When you are in the hole, suicide seems like the kindest think you can do for your family and friends, as ending your life would end their pain and misery.
While I do not remember all of the details of my descent into the hole, it was certainly rooted in trying to do it all—perfectly. After my second child was born, I was trying to be all things to all people at all times. Superstar lawyer. Superstar citizen. Superstar husband. Superstar father. Of course, this was impossible. The feeling that began to dominate my life was guilt. A constant, crushing guilt. Guilt that I was not in the office enough because I was spending too much time with my family. Guilt that I was letting my family down because I was spending too much time at work. Guilt that I was letting my bosses down because I was not being the perfect lawyer to which they had become accustomed. Guilt. Guilt. Guilt.
The deeper I sunk into the hole, the more energy I put into maintaining my façade of super-ness, and the less energy was left for either my family or my clients. And the guiltier I felt. It was a brutal downward spiral. Eventually it took every ounce of energy I had to maintain the façade and go through the motions of the day. The façade was all there was. Suicide seemed rational.
There were danger signs, of course, but neither I nor anyone around me recognized them for what they were. I burst into tears during a meeting with my bosses. I started taking the long way to work in the morning and home in the evenings—often taking an hour or more to make the five mile trip. Eventually—after months of this—my wife asked me what was wrong and I responded, “I just don’t know if I can do this anymore.” She asked what “this” was. I said, “You know…life,” and started bawling. The façade crumbled and I was utterly adrift. (I don’t actually remember this conversation with my wife, but she does.)
After getting over the initial shock of my emotional collapse, my wife forced me to go to the doctor and get help. She took the initiative to find a doctor, make me an appointment, and took me (which is good, because I was utterly incapable of doing any of those things). She called my firm and told them I needed FMLA leave. One of my colleagues put me in touch with the NC State Bar’s Lawyer Assistance Program (LAP), which connected me with a LAP volunteer who had suffered from severe depression and recovered. I found the peer support of LAP to be a critical tool in my road to recovery. With his help, treatment from my doctor, and the support and love of my family, I got better and better. I started taking medication and clawed my way to the top of the hole.
But, for more than a year I was sort of clinging to the edge of the hole about to plummet back down. So I changed doctors and medications and did a lot of talk therapy. Eventually, more than 18 months later, I was finally back to some semblance of my “old self.” I was happy again (mostly). I was a good father again (mostly). I was a good husband again (mostly). I enjoyed being a lawyer again (mostly). I enjoyed life again.
There have been a couple of relapses, where the hole tried to reclaim me. However, I never fell all the way back down. I will happily take medication for the rest of my life. And I will regularly see a therapist for the rest of my life. I will be forever vigilant regarding my mental state. Small prices to pay.
Had I not gotten help, I would not be writing this article because I would likely not be alive today. No amount of will power or determination could have helped me climb out of that hole. Only by treating my disease with medication and therapy was I able to recover, control my illness, and get my life back.
Now, I don’t write any of this to solicit sympathy or pity. I am doing fine. I have five wonderful (if occasionally maddening) children and an amazing wife. I have a job that I love and am truly good at. I have the job that I was put on this earth to perform, which makes me incredibly lucky. I have wonderful students who will be outstanding lawyers. I have no complaints.
I write this because I know that when you are depressed you feel incredibly, profoundly alone. You feel that you are the only person on earth who has felt the way you do. You feel like no one out there in the world understands what you are dealing with. You feel like you will never feel “normal” again.
But you are not alone. You are not the only person to feel this way. There are lots of people who understand. I understand. I have been there. I got better. So can you.
So please, if you are suffering from depression or anxiety (or both) get help. Tell your spouse. Tell your partner. Tell a colleague. Ask for help. Asking for help does not make you weak. It takes profound strength to ask for help. You can get better. You can get your life back.
Trust me when I say that life is so much better once you get out of—and away from—that dark hole. It is well worth the effort.
– By Brian Clarke
Brian Clarke is an assistant professor of law at Charlotte School of Law.
The North Carolina Lawyer Assistance Program is a confidential program of assistance for all North Carolina lawyers, judges, and law students, which helps address problems of stress, depression, alcoholism, addiction, or other problems that may lead to impairing a lawyer’s ability to practice. If you would like more information, go to nclap.org or call: Cathy Killian (for Charlotte and areas west) at 704-910-2310, Towanda Garner (in the Piedmont area) at 919-719-9290, or Robynn Moraites (for Raleigh and down east) at 704-892-5699.Tags: depression, LAP, mental health, perfectionism, stress, suicide, workaholic, workaholism Posted by