Stress, Depression and Our Bodies

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Working as a lawyer and struggling with clinical depression is tough.  I know, because I deal with both every day.  In a peculiar sense, it’s really like having two full-time jobs that absorb all of our time.  As we know, the daily demands and stress of our jobs as lawyers are often unremitting:  Deadlines to meet, phone calls to return, and that motion to argue in Court the next morning.  We often feel that others who aren’t lawyers really don’t understand us and our work because they haven’t walked in our shoes.

The “job” of being depressed seems to parallel my experience as a lawyer.  A common experience of feeling depressed is feeling alone and isolated.  When people who care about us reach out to help, there are times we push them away out of a sense of bitterness, thinking:  “You really don’t know what it’s like to be a lawyer”.

Yet, there may come a time when we might want to begin seeing depression and our vocation as lawyers a little differently.  Not as two jobs, but really one.  The one job is to find a way to take care of ourselves.  Mother Teresa once said that what God expects of humanity is that we be “a loving presence to one another.”  Taking that further, I would suggest what God equally expects is for us to be a loving presence to ourselves.

In any law firm, the barometric pressure of stress rises and falls frequently. Consequently, we often find it difficult to be a “loving presence” to ourselves:  to eat well, exercise, get enough sleep, and nurture a support structure of good friends.  The gale-force winds of stress, burnout and depression can begin blowing and disconnect us even from this basic agenda.  Yet, if we are to regain our health in the midst of chronic stress, burnout and depression, we must return to these basic concerns because these maladies afflict our minds and our bodies.  Our physical state -our precious bodies- gets hammered by the unremitting punishment which they dish out.  I have often described my depression to friends as “wet cement running through my veins.” 

The biochemical imbalance that is so often a part of depression affects every part of our physical makeup: our eating, our weight, our energy level, and our ability to sleep.  How can we realistically hope to “feel better,” to regain the healthy ground that depression has knocked us off, if we don’t offer a loving presence to our tired and afflicted bodies left unbalanced, weakened and fatigued in depression’s wake?

Being a loving presence to our bodies is like being a loving parent.  We need to pause – and to have a support structure of people who remind us to pause – to ask ourselves what is good for our bodies.  My family doctor once told me that our bodies are like giant tape recorders that remember everything we have done to them.  Too little sleep, too much stress, not enough exercise tells our body that we simply don’t care and/or don’t have the time for it.  This pattern can have catastrophic consequences when depression hits because the body that we need to help us is not fully able to be our ally.  Because it has been ignored, it is of little help to fight depression and actually participates in it.  Anti-depressant medication can be a way, especially in the beginning, to begin to soothe our bodies, to calm our minds enough, so that we can begin thinking of how we are going to rebuild that loving relationship with our bodies.

One of my favorite parts of the Bible comes from the Old Testament, the Twenty Third Psalm.  To me, it speaks about the journey: “Yea, though I walk through the valley of the shadow of death, I will fear no evil; for You are with me; Your rod and Your staff, they comfort me.”  All humans must make this journey.  We must all “walk through the valley” of a life which is certain to have its victories and times of happiness, but also its stunning defeats and times of deep sorrow.  The shape of those victories and defeats take a particular form for lawyers.  Even more so for lawyers who struggle with depression.  The valley can feel more like a deep trench with no way out.  Our bodies can feel buried in this trench with no light or air able to penetrate depression’s paralyzing weight.  Yet, there are steps each of us can take to begin our climb out of this hole.  In my experience, our bodies are like the ladders propped against the trench of depression.  The great Psalm tenderly says to us that we are not alone; God is there with us in the deepest darkness.  Yet, I would also suggest that our bodies are there for us also, waiting to assist us in our journey towards wholeness.

A Lawyer’s Heart

I’ve felt plenty of anger over my twenty years as a litigator.  Sometimes, and thank God they were few and far between, I would blow up at opposing counsel or a client.  More often, my anger would sometimes simmer just below the surface.  This is an all too common reality for today’s lawyer.  “By definition, the adversarial system is conflict-ridden, and conflict creates certain types of emotions like anger, guilt and fear, which causes stress, says Amiram Elwork, Ph.D. author of the book, Stress Management for Lawyers

According to Chicago litigator, Shawn Wood, the “nature of civil litigation involves two lawyers (often Type A personalities) squaring off against one another under circumstances where there will be a winner and a loser, and part of each lawyers job will be to capitalize on any possible error in judgment that the other side makes.”  I really don’t buy into this completely.  Many lawyers that I know aren’t “Type A” personalities.  They are usually hard working and successful.  But, it can take a tremendous toll on their mental and physical health.  They struggle with the simmering variety of anger.

Anger turned outward is hostility.  Such hostility can express itself in a number of ways for lawyers.  Andy Benjamin, Ph.D., both a lawyer and psychologist who treats lawyers with stress, anxiety and depression, describes hostility as an “array” of the following thoughts and behaviors: 

  • Holding persistent negative, hostile, or cynical thoughts during relationship interactions;
  • Chronic impatience;
  • Frequent irritability
  • Disconnecting from others due to an empathetic deficit (for example, being rigid in relationship interactions);
  • Suffering continual fatigue.

You could say most people have these problems in our hectic, stressful world.  “But lawyers are particularly susceptible to stress-related illnesses because of the unique interplay of the legal profession and lawyer personality” says the ABA Journal.  A study that followed University of North Carolina law students as lawyers for 30 years suggested that those with significantly elevated levels of hostility were more likely to have died prematurely from cardiovascular disease.

According to Jesse Stewart, assistant professor of psychology at Purdue University, depression and hostility commonly occur together.  When a person is both depressed and hostile, the traits interact in a complex way to elevate inflammatory proteins in the body.  The combination of hostility plus depression appears to be as dangerous a risk factor for heart disease as high blood pressure or even smoking.

Edward C. Suarez, Ph.D., of Duke University, says a recent study, “. . . suggests the possibility that men who are . . . hostile and exhibit depressive symptoms, even in the mild to moderate range, are at heightened risk for cardiac events.”  This is so because of the release of adrenaline during times of stress.  According to Dr. Cleaves M. Bennet, clinical professor of medicine at UCLA Medical Center,  “Adrenaline is the growth hormone for the heart muscle.  On the one hand, its good to have a big, strong heart, but at the same time that the heart is getting bigger and stronger, the arteries are narrowing to protect the tissue.”

Given the clear connection between lawyer hostility, depression and the heightened risk for a cardiac event, what can lawyers do about it?

First and foremost, they need to educate themselves about the connection between depression, hostility and heart disease. Most people don’t see the correlation. But, there’s no denying the science which makes the links. 

Second, because hostility creates stress in the body (i.e. the release of adrenaline and cortisol when the body goes into the fight or flight mode), it’s critical to discharge the stress through some form of exercise.  When I go through a good workout after a confrontational day, it’s as if I am wiping the slate clean.  I am discharging the stress that is causing so much trouble in my body and bringing it back into some kind of balance.  Exercise is really just a formalized form of the flight response to stress.  Our bodies want to step on the gas.  Listen to your body and let it run.

Third, you need to find out where your hostility is coming from.  Is it from problems in your personal life that you bring into your daily life as a lawyer?  If so, these need to be met and addressed.  Or, is it the other way around?  Is it the daily grind and confrontation at the office that you bring home?  It’s important to figure this out.  If opposing counsel is a jerk and elicits a hostile reaction from you, it might be time to learn (and, yes, it is a skill you can learn) different ways of being assertive without harming your heart and increasing your risk for depression.  If it is problems at home, identify them and if need be, go for counseling.

Fourth, learn to tell the difference between being assertive and being aggressive. For further reading on this topic, check out this article “Are you Assertive – or Aggressive?” and the article “Assertive, Not Aggressive.”  To help evaluate your own levels of perceived stress and associated health risks, visit the University at Pittsburgh Center’s Healthy Lifestyle Program Web site.

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