Megan Grandinetti, Esq., a lawyer, yoga teacher, and coach, offers her suggestions on how to effectively cope with burnout. Read the News
A landmark study by the American Bar Association and the Hazelden Betty Ford Foundation depicts a profession troubled by problem drinking, depression, anxiety—and abiding fears about seeking help. In a pair of interviews, Joan Bibelhausen of LCL and study co-author Linda Albert discuss the findings and what the profession can do to address them. Read the News
Business West reports, “Lawyers say they entered the legal field to help people with their problems — often very difficult, serious problems. The danger is internalizing those problems and making client stress a permanent part of one’s psyche. That pitfall, and other stressors common to lawyers, from time pressures to sometimes-adversarial work relationships, contribute to unusually high levels of burnout, depression, substance abuse, and even suicide in the legal field. One challenge, experts say, is to recognize those dangers before they take root.” Read the News
Despite being in a remunerative and prestigious profession, lawyers often fall victim of depression. According to a 2014 pool, “52 percent of practicing lawyers describe themselves as dissatisfied. Read the Blog
The website, Law360 reports: “When Dallas County’s district attorney took a leave of absence to treat serious depression — a problem that affects attorneys in disproportionate numbers to the general population — she faced calls for resignation, but experts say getting treatment and ensuring that any clients are taken care of is the ethical thing to do.” Read the News
Since you are reading a website about lawyers and depression, you are probably wondering whether you are suffering from depression, or what to do about it. You’re in good company. It is estimated that 1 in 10 members of the public suffer from depression; among lawyers the rate is 3.6 times higher. That would make it likely that about 1 in 3 lawyers are suffering from depression.
I am one of those lawyers (so, two of you are off the hook—you’re welcome). There are many articles covering the symptoms of depression. (See, e.g., this NIMH list.) If you even think you are suffering from depression: GET PROFESSIONAL HELP. At first, I refused to admit to myself that I needed help. I told myself that I could muscle my way through. It was a trap: while my higher consciousness assured myself that I could handle it all, my depression kicked in when it was time to get things done. “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.”
My particular form of depression involved feeling as if I was in a daze, as if I was not in control of my actions, as if someone else were running my life. I did not respond to client calls, I did not get work done until the last minute (if at all), I missed court appearances, I forgot to pay bills, I failed to monitor my trust account. I am doing much better now thanks to the help of many including our host Mr. Lukasik.
The problem—well, one of the problems—for lawyers suffering depression is that they cannot let their mental condition interfere with their ethical and legal duty to their clients. A.B.A. Model Rules of Professional Conduct Rule 1.1 requires that a lawyer “provide competent representation to a client.” And Rule 1.16(a)(2) states:
(a) Except as stated in paragraph (c), a lawyer shall not represent a client or, where representation has commenced, shall withdraw from the representation of a client if: . . . .
(2) the lawyer’s physical or mental condition materially impairs the lawyer’s ability to represent the client.
I don’t think the A.B.A. expects one-third of the lawyers to immediately stop representing their clients. Depression does not mean that you cannot ably represent your clients; but depression is also no excuse for failing in your duties. What I address in this article are some actions you can immediately take that I hope will help you keep up with your responsibilities while you seek professional assistance.
The Matrix. The science-fiction metaphor of The Matrix (what is the Matrix?) helped me understand depression. The brain functions at a level that we are not always consciously aware of. Sometimes we can override our instincts; sometimes we cannot. Think of yawning, or sneezing. When you are depressed, the Matrix has you. To deal with the immediate impact of depression, you must get out of the control of the Matrix.
Make a list, work the list. Making a list of what you need to do puts your higher consciousness in charge. Rumination is controlled by the Matrix; the list is outside. Work the list. It should be as specific as you can make it: Not “write the brief” but “write section I of the brief.” Give yourself a time estimate, start a stopwatch, and do the work. This should be no big deal: you bill by the minute, you can plan by the minute too. Don’t just think, “I ought to do X.” Writing it down is important.
You won’t necessarily get the work done in the time allotted; that’s OK. Lawyers are aggressive perfectionist. Your inner mind likes specific achievable goals. When the time is up, look at the list and chose something to do next. It could be continuing to do what you are already doing. Write down a new time goal and get at it.
There were times when my focus waned. I tried to recognize what was happening and do something physical. Give yourself a defined short respite: Stand up, walk around, talk to someone, hide in the bathroom, whatever. When the time is up, get back to the list.
Existential problems. Sometimes the consequences of (in)actions are just too dire: failing to file an Answer, missing a court appearance. If the list idea is not working perfectly to save you from existential dangers, get someone else involved. Ask someone you trust outside your workplace to contact you every day, ask you whether your list and your calendar cover everything that needs to be done, and ask you whether you are doing what’s on the list.
You need to be brutally honest with your friend and yourself. If not have not done what needs to be done, you should articulate your next steps as specifically as possible. Not, “I’ll do this tomorrow,” but “I’ll do this at 8:00 a.m. tomorrow.” This takes a good friend.
Adjust your body. Changes in your diet, exercise and social climate may improve your mood. Depression is not a “mood.” But good mood will help address how to get through the days, weeks and months without screwing up your client’s and your lives.
My exercise regimen is simple: I take a 30-minute quick walk in the morning, enough to get my heart rate up. It is surprising what a positive effect this little bit of exertion has. My main dietary culprit is sugar. “People who suffer from depression are especially vulnerable to sugar’s evil power.” I find that exercise and diet go together: The more I exercised, the less craving I have for sugar.
As above, take the decision-making power out of the Matrix. Get an exercise buddy. Find a time for exercise (easier said than done, I know) and put in on your list / calendar. When I wake, I do not ask myself whether I should go for a walk; I say to myself, “time for my walk.” Put snack breaks into your schedule and have an apple or banana available.
Meditate. If you scoff at this, here is my challenge: close your eyes and think about nothing but your breathing for two straight minutes. Go ahead, I’ll wait. . . . . Not so easy, is it? Random thoughts kept jumping into your mind. You had an instinctual emotional reaction to these thoughts (anxiety, self-loathing, dread, etc.). The random thoughts and emotions are from your subconscious (the Matrix); where the depression lives. Do not battle the thoughts. When they happen, tell the thoughts that you will get back to them as soon as you are done meditating, and return to thinking about nothing but the breathing. (For you Matrix fans: the thoughts are spoons; you must realize that there is no spoon.)
When you meditate you are developing the skill to recognize your emotional reactions without succumbing to them. You can impress your therapist by referring to this as CBT: cognitive behavioral therapy. It takes practice, but just starting this routine will help immensely.
A day is 24 hours long—no more, no less. I cannot follow my own advice all of the time. I still eat cookies; I still get lost in my personal miasma. At the end of the day I tell myself, “that was today, I will follow the program tomorrow.” No recrimination; just observation. Try to avoid thinking on Tuesday that you have to “make up” for what you missed on Monday. Just do Tuesday.
These are stopgap measures. GETTING PROFESSIONAL HELP is the most important thing you can do. But in the meantime, I hope this helps you get you through the days ahead.
Mitchell Chyette graduated from the University at Michigan School of Law in 1979 and currently works in San Francisco, California.
In January 2014, CNN reported that lawyers are among the top five occupations associated with suicide. In the summer of 2014, just before the start of the law school academic year, a law professor from the University of Vermont died by suicide. Since then, in a period of eight months, the United States law school community has seen seven law student deaths from suicide. Approximately one suicide per month, and the actual number may be greater than what has been reported by the media and the law schools.
In the painful days, weeks, and months after a suicide, family members and loved ones often are left with unanswered questions. Many times one of those questions or comments is some version of “I don’t understand why (s)/he did not just ask for help.”
A study published in the American Journal of Psychiatry, it was found that of people aged 35 and younger who died by suicide, only 15% had received mental health treatment within one month of their death by suicide and just 24% had received mental health treatment within one year of their suicide. The study also found that 23% of those who died by suicide who were under 35 visited a primary care doctor within one month of their death and 62% visited a primary care doctor within one year of their death.
While interpretation of statistics should be done with caution, the data suggests that young people at risk for suicide present more often to primary care physicians than mental health professionals. And while this perhaps speaks to the need to better train primary care physicians to recognize warning signs of suicide, it also begs the question just posed: why don’t people who are feeling suicidal reach out for help?
Based on feedback from law students who attended one of the Dave Nee Foundation’s Uncommon Counsel programs at 35 different schools in the 2013-2014 academic year, 64% agree or strongly agree with the statement that law students do not seek help when needed for fear of the professional consequences. One of our 2L attendees suggested: “…lobby the ABA and character and fitness people to recognize treatment for depression is a good thing, and that legal professionals are people too.” Another 1L attendee noted, “I think it is worthwhile to discuss the stigma associated with seeking mental health services, i.e. perception that s/he ‘can’t hack it’ is weak, thin-skinned, that you’re ‘unstable’ or ‘crazy’. Professional consequences of people knowing this about you, etc.”
While it is easy to point to the ABA and to other systems that may contribute to stigma, it is harder to see systemic change. It is easier to begin with individual change. Here are some things that you can do beginning right now to help reduce the stigma associated with mental health treatment.
Talk non-judgmentally with anyone you are concerned about:
- It is OK to ask someone if they need help.
- It is OK to ask someone if they are thinking about suicide, it will NOT give them the idea.
- It is NOT OK to say “You are not thinking about suicide are you?” or “What do you have to be depressed about?”
- It is OK to say, “I have noticed some changes in your behavior, is everything OK?”
- It is OK to say “It sounds like you are experiencing depression, often times people with depression have suicidal thoughts, are you thinking about suicide?”
Be mindful of language:
- The term “died by suicide” is preferable to “committed suicide” as the term “commit” has negative connotations.
- Avoid talking about suicide attempts as “successful or unsuccessful”; there are more suicide attempts in a year than completed suicides.
- When describing individuals with a mental health diagnosis, try not to define them by that diagnosis. Put the person first, “s/he is a person with bipolar disorder” not “s/he’s bipolar.”
Promote mental health care services:
- We are encouraged regularly to get a physical exam annually; we are regularly tested for blood pressure, glucose, and BMI. Why not promote a mental health check up?
- Visit Screening for Mental Health to find out how to bring an online screening service to your place of employment.
For more tips on how to help someone or for ways you can be involved in reducing stigma please visit the Dave Nee Foundation’s website.
June of 2015 will be the 10th anniversary of Dave Nee’s suicide. Dave was a beloved and brilliant brother, friend, son, and student. The suicide of Dave Nee prompted his loved ones, friends, and family to honor Dave’s life and prevent deaths like his from happening again by establishing the Dave Nee Foundation. Ten years later, there is much that the Foundation has done to promote wellness, raises awareness about depression & anxiety, and to prevent suicide in the legal field via law school and state bar association presentations. We know that 97% of our Uncommon Counsel attendees agree or strongly agree that the information learned will help them to recognize the symptoms of depression. We know that 95% of our Uncommon Counsel attendees agree or strongly agree that as a result of the presentation they can identify three warning signs of suicide. Perhaps most importantly, we know that 97% of Uncommon Counsel attendees agree or strongly agree that they know what steps to take if they felt a law student was at risk for suicide. (All data based on 2013-2014 Uncommon Counsel program feedback.)
As much progress and impact we hope we have had, until there are NO news stories of lawyer and law student suicides, we will not be satisfied. We hope that our passion and commitment might inspire other stakeholders, perhaps more powerful ones, like the ABA, the NCBE, law school administrators, and Big Law firms, to take steps towards creating cultural change and help us to destigmatize getting help and treatment for mental health concerns in the legal profession.
By Katherine Bender
Upon graduating from Georgetown University as an English and Theology major, Katherine Bender began teaching at an independent Catholic secondary school for girls in Philadelphia. During this time, she became increasingly interested in the social concerns of young women and decided to pursue a degree in community counseling with a focus on women’s issues at the University of Scranton. After completing an internship providing individual counseling to undergraduate students at a residential college, as part of her Master’s degree in counseling, she began working as a full time mental health counselor for college students in Daytona Beach, Florida.
Recognizing that advocating for students with mental health issues in higher education would likely require a Ph.D., Kate began her doctoral work at Old Dominion University in January of 2011, focused her dissertation on research regarding college student suicide prevention, and in the summer of 2013, successfully completed her doctoral program. She now has a PhD in Counseling, Counselor Education & Supervision.
She joined the team at the Dave Nee Foundation as Programming Consultant in September of 2012 and became Programming Director in September 2013. In this role, she leads the Uncommon Counsel program and LawLifeline. She sees her role with the Dave Nee Foundation as an excellent way to continue to provide outreach services and to raise awareness about depression, anxiety, and suicide prevention for higher education students.
You can reach Kate by email at Kbender@daveneefoundation.org
From Student Lawyer magazine, a story about a critical topic: the high rate of law student depression. Read the News
Studies show that as many as forty percent of law students will suffer from depression by the spring semester of the second year of college. It’s critical for them to have a mental health screening. Here’s a piece about how to go about it. Read the Blog