The unhappiness paradox is one lawyers share, as much or more, than any other group in our culture. The richer we have grown as a society, the more dissatisfied we have become. The 1950’s were the happiest decade of the century. Since then the divorce rate has doubled, the teen suicide rate has tripled, recorded violent crime has quadrupled, the prison population has quintupled and the percentage of babies born to unmarried parents has sextupled. Whether or not you are a part of these percentages you are a part of a society where depression and anxiety disorders have reached epic proportions and are often largely untreated. Indeed, much of the resistance among lawyers to treatment these days stems from an unwillingness of individuals to want to identify with a social trend that seems despairing.
But like it or not we are part of this culture. The social stew we swim in, just like the microbes we breathe, plays a major role in determining whether we are healthy or sick. When the Titanic is going down, it is no time to be talking about the increase in icebergs in shipping lanes. But it is important to talk about icebergs, if your feelings about them are preventing you from going to board a lifeboat. It is important to realize that the social conditioning of omnipresent ads, tawdry sex and graphic violence tends to isolate us into individualistic self-centered consumers and pleasure seekers; just as often does the lawyer philosophy of I work hard and I play hard. The fact that most people in our culture live outside of poverty is a major stress reliever. Poverty offers no inherent benefits to promote happiness. However, when people are poor and must share goods in order to survive they create a social milieu which has been in the past almost a complete antidote to depression and anxiety.
The point is not that we should be poor, but that we should build into our lives the social structures of family, friends, professional relations and organizations, religious and civic activities that support our common humanity. People are our worst problem and our greatest solution. Dysfunctional families can create lives that only years of therapy can help stabilize. Civic, professional and religious organizations can be individualistic and competitive and not places where effort is routinely spent to serve a greater good.
Absent life enhancing social support, our normal cultural milieu creates conditions where prolonged hours of work or the death of a loved one may well push many into a medically defined illness called depression. Depression is a disabling and treatable disorder. However, we tend to view it differently from other diseases. Lawyers don’t talk about “toughing it out” with their asthma. No, they get medication that is going to allow them to function so the disease state does not overwhelm them. This is equally important to do with depression. Pharmacological treatments for depression give patients the chance to function at a more normal level so that they can address issues that might have triggered the condition, such as the opportunity to fully grieve the loss of a loved one.
One of the peculiar aspects of depression is its subtlety. Like most chronic conditions it does not announce its arrival with any sort of acute pain or recognizable sign of illness. More often what happens is a sort of gradual slide into a state of despondency and low energy that appears clear only in retrospect to suggest the onset of a disease. Depression is an illness where the sooner and more effectively it is treated the less are the chances of it reoccurring and the more effectively it can be managed if it does reoccur. Unfortunately we lawyers don’t want to even consider that we might have a depression problem, much less try to head it off at the pass with the early intervention of treatment.
Depression is a disease of isolation. Lawyers with depression tend to become defined in narrower and narrower routines until they can’t return phone calls or even get out of bed in the morning and go to work. Unfortunately the isolation the disease brings is exactly what needs to be broken down for health to be restored. It is social support and the exercise of those neuronal structures in the brain that deal with positive relationships that are the key to restoring a healthy brain chemistry balance. Not only is stabilization through pharmacological treatment important, so is the assistance of a good therapist who can help the patient understand the walls and barriers that have been built as survival mechanisms around the patient, but now keep recovery and health out.
In 1901 Sir William Osler, a renowned physician of his time, said: “The way to live the longest is to acquire a chronic disease and take good care of it . . . ” To add just a shade of gloss to his comment: the way to live the happiest is to acquire a chronic disease and take good care of it. We live in a culture that promotes the illusion of happiness and we work in a profession with attributes of power, prestige and material well being that are often seen as synonymous with happiness. These attributes and much of our society’s mores are at best neutral. If you have your ladder up against the wall of just these values, when you get to the top you won’t find much on the other side. For many lawyers getting to the top will not even be an option if depression sets in and is allowed to persist untreated.
Metaphorically, the idea of being pushed down by sadness or non-clinical depression is a way the psyche tells us to examine more closely what is going on in our lives, to look within: are we meeting our physical, mental, emotional and spiritual needs on a regular basis in a life sustaining way? We all must find our own unique way to do this. What is pretty clear is the ways that don’t work. While the pain of a chronic disease is a sure way to force a look at these issues, it is not the only way. One need not acquire a chronic disease, just the same realistic way of looking at one’s own life and happiness that serious illness brings. For us in the legal profession a starting point is to actively seek out the sort of relationships that foster well being in our personal and professional lives and, at the first sign of trouble, reaching out for help.
-by Don Carroll and Ed Ward
Bar Journal article – FRIENDS column
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