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Why lawyers suffer from twice the rate of depression

Depression develops because of a complex interplay of genes, neurochemistry, emotional history, and personality. About ten percent of this country’s population currently suffers from depression.  Unfortunately, lawyers have twice the rate of depression of the general population.  Why?
The culprit seems to be stress – chronic stress. Recently, scientists have been focusing on the connection between stress and anxiety and the role they play in producing and maintaining depression. This is something that should be of interest to all lawyers, who frequently report feeling stressed or burned out in their practices.

“Stress” is anything in our environment that knocks our bodies out of their homeostatic balance.  Stress responses are the physiological adaptations that ultimately establish balance.  Most of the time, our bodies do adapt, and a state of balance is restored.

However, “if stress is chronic, repeated challenges may demand repeated bursts of vigilance,” warns Dr. Robert Sapolsky, an expert on stress-related illness. “At some point, this vigilance becomes overgeneralized, leading us to conclude that we must always be on guard – even in the absence of stress. And thus the realm of anxiety entered.”

Sapolsky further writes, “If the chronic stress is insurmountable, it gives rise to helplessness. This response, like anxiety, can become generalized:  A person can feel . . . at a loss, even in circumstances that he or she can actually master.”

Helplessness is one pillar of a depressive disorder that becomes a major issue for lawyers because we think of ourselves as invulnerable superheroes who are helpers, not the ones in need of help.  Lawyers often don’t get help for their depression and feel ashamed if they do.

Many lawyers do not appreciate the connection between stress and anxiety and their risk for developing clinical depression.  But the occurrence of anxiety disorders with major depression is frequent: in fact, 60 percent of people with depression are also suffering from anxiety.

Depression “is stress that has gone on too long,” according to Richard O’Connor, Ph.D., a depression expert who treats people in New York City.  Many people with depression have problems dealing with stress because they aren’t “stress resilient,” writes Dr. O’Connor.  It’s not some central character flaw or weakness but a complex interplay between genetics and one’s experience over a lifetime.

How our bodies and brains deal with stress and anxiety hasn’t changed much in the last 10,000 years.  A wonderful defense mechanism, which is wired into our nervous system, is called the fight-or-flight response.  When confronted with a threat – whether real or perceived – this response kicks in and floods our bodies with the powerful hormones cortisol and adrenaline, which propel us into action. This was an essential survival device for our ancestors who lived in the jungle and would have to flee beasts or fight foes trying to kill them.

Lawyers don’t face these types or real life-or-death threats. But they perceive life-or-death threats in their battles with opposing counsel while sitting in a deposition or sparring in the courtroom.  Our bodies respond as if we were being chased by a hungry lion.  Accordingly, the stress response can be set in motion by mere anticipation, and when humans chronically believe that a homeostatic challenge is imminent, they develop anxiety.

Over time, this chronic anxiety causes the release of too many fight-or-flight hormones.  Research has shown that prolonged release of cortisol damages areas of the brain that have been implicated in depression: the hippocampus (involved in learning and memory) and the amygdala (involved in how we perceive fear).


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