Andrew Benjamin Archives - Lawyers With Depression

In the Beginning – Depression in Law School

The term clinical depression finds its way into too many conversations these days. One has a sense that something catastropic has occurred in the psychic landscape – Leonard Cohen

Everything has its beginning: the Cosmic Bang, the French Revolution and depression in the legal profession.

There is little doubt that for many, depression begins in law school. One study of law students found they suffered from depression at the same rate as the general population before entering law school. Just two months into the school year, however, their negative symptom levels had increased dramatically. By the spring of their first year, 32% of the same law students were depressed. By the spring of their third year, the number had risen to 40%. Two years after graduation, 17% of the students – about twice the rate of depression experienced by the general population – were still depressed. Such elevated levels of depression have been corroborated by later studies.

Plug in these stats and an estimated 30,000 to 60,000 of this country’s 150,000 law students struggle with depression at some point during their law school experience

Andy Benjamin, J.D., Ph.D., the lead researcher in the above study and others that have looked at law student and lawyer depression, wrote me last summer:

“Since the publication of our research about law student and lawyer depression, depression still runs rife for law students and practicing attorneys – nearly a third of all law students and lawyers suffer from depression. The data to support this statement have been published since the early eighties when the studies were first conducted. Several subsequent empirical studies have corroborated the grim findings up until 2010. As the stress, competition, and adversarial nature of the profession have continued to take their toll, not surprisingly, the rates of depression have not changed. Law students and lawyers remain at the greatest risk for succumbing to depression, more so for any other profession. After nearly forty years of compelling evidence about the prevalence of the severity of depression for the legal profession of law, more meaningful systematic changes must be implemented throughout the professional acculturation process of law students and lawyers.”

It’s difficult for the legal establishment to face all of this. William M. Treanor, immediate past dean of Fordham Law School, told The New York Law Journal last year: “Depression is a very important issue that often gets swept to the side. It’s a real concern and a problem in the legal profession. Studies indicate that it is common among law students and common among lawyers. Given that, it’s important to try to figure out ways to combat it and to let people know if they are suffering, they are not alone.”

As author Kathleen Norris wrote, “The religion of America is optimism and denial.” We’re a nation of suck-it-uppers; a people who drive their inner pain deeper and deeper into themselves until they break. The denial of depression in the law is both institutional and individual.

In Institutional Denial About the Dark Side of Law School, Florida State University Law Professor Lawrence Krieger wrote:

“There is a wealth of which should be alarming information about the collective distress and unhappiness of our [law] students and the lawyers they become. We appear to be practicing a sort of organizational denial because, given this information, it is remarkable that we are not openly addressing these problems among ourselves at faculty meetings, and in committees and without students in the context of courses and extracurricular programs. The negative phenomena we ignore are visible to most of us and are confirmed by essentially unrebutted empirical evidence.”

Attorney Andrew Sparkler, a friend of then fellow Fordham law student David Nee who suffered from depression (unbeknownst to his friends) and committed suicide in his third year of law school, observed, “To admit that you are depressed [in law school], to yourself or to others . . . , is a weakness and if you’re in a shark tank of hyper-aggressive folks around you, you’d be hesitant to expose it because why would you fess up to anyone that you have a problem?” Sparkler, his friends and the Nee family started the Dave Nee Foundation to address law student depression and suicide.

It doesn’t get much better when one graduates and enters the job market. A John Hopkins study looked at 104 occupations to determine which ones had the highest incidence of depression. Lawyers topped the list and were found to suffer from depression at a rate of 3.6 times that of other profession studies. Other studies have found that about 20 percent of all lawyers struggle with depression.

Plug in these stats and an estimated 200,000 of this country’s 1 million lawyers are hurting.

Obviously, something is really rotten in Denmark.

There have been several theories bantered about as to why law students suffer from such high rates of depression: pessimistic thinking styles taught in law school (“learning to think like a lawyer”), personality types that go to law school, a breakdown in inner values and the current nasty economy and stress to find and maintain a good job. The New York Times recently ran an article, No Longer Their Golden Ticket, – I was interviewed for this one – which spoke about the stress and uncertainty that law school students’ face:

“[The] days of [high pay and full employment] are over. As the profession lurches through the worst economic slump in decades, with jobs and bonuses cut and the internal pressures to perform rising, associates do not just feel as if they are diving into the deep end, but rather, drowning.”

However, there has been pushback against the theory that law school even causes much psychic damage.

In an article by University at Michigan Law Professor James Justesen White, Maiming the Cubs, he takes issue with Professor Krieger theory and argues that the law school experience does not “. . . cause permanent and irreversible change and that the ills of lawyers cannot be traced in any meaningful way to the stresses of the three years in law school.” He concludes:

“I wonder, too, whether the anxiety and depression that we observe in some of our law students is the unavoidable consequence of the challenge of hard learning and of confronting the looming need to prepare to behave like a lawyer. Soon after they come to law school, students must sense that however hard Contracts and Torts is, learning to be a successful practicing lawyer is harder, and that the road to success in the profession is even less clearly marked than the road to law school success.”

Sorry, I just don’t agree.

My take on law school depression

I think we must look at what makes people more vulnerable to depression before they enter law school – those 10% who already have depression or are at risk for developing it before they register for their first 1L class. For most, there is a genetic or family history of depression. Likewise, there is a history of family dysfunction: for example, alcoholism, physical and emotional abuse and/or neglect. These folks bring those major risk factors into law school. It is my view that law school doesn’t cause depression; rather, it may be the straw that breaks the camel’s back for those who already have some risk for it.

Pessimistic thinking and persistent stress , both powerful dynamics in law school, are known triggers for depression. When these influences are mixed in with other pre-law school risk factors, law school creates a “perfect storm” for depression to happen.

We tend to mix up law student unhappiness and dissatisfaction with depression.

They’re not the same thing; not even close. Unhappiness and discontent are relatively transitory; other emotions aren’t pushed to the margins or extinguished. We are adaptable in response to our environment. We might feel stressed or exasperated by the law school grind, but everyone bumps up and down throughout their days. We deal with our stress and balance ourselves out either with exercise, socializing or just by having stress resilient genes. Not so with depression. Richard O’Connor, Ph.D., in his best-selling book, Undoing Depression, writes:

“We confuse depression, sadness, and grief. But the opposite of depression is not happiness, but vitality—the ability to experience a full range of emotion, including happiness, excitement, sadness, and grief. Depression is not an emotion itself. It’s not sadness or grief, it’s an illness. When we feel our worst, sad, self-absorbed, and helpless, we are experiencing what people with depression experience, but they don’t recover from those moods without help.”

There is also a biochemical poverty about depression; the scarcity of neurochemicals like serotonin and dopamine that wreck havoc in our brains and set the stage for depression. As I wrote in Trial magazine about the connection between stress, anxiety and depression, the grind isn’t just about long hours in the office or law library cubicle, but the grinding up of our nervous systems.

We have a sense that such a lifestyle can be problematic to our happiness, but we’re willing to keep marching to that beat in the hope of later rewards (e.g. money, security, partnership). Yet, I can’t help but think that we’re dimly aware, if at all, of the risk we put ourselves in for major depression.

Besides the psychological-physiological links to depression, we live in a culture that breeds melancholy. How could this not eek its way into the law school experience?

Maybe it’s the moral and spiritual bankruptcy of our times; the torpor of the imagination which fails to inspire our young people to live an engaged and spirited life in the law, or the cynicism to think that such a life is even possible that worries me. Or, by the time young people get to law school, they’re so jaded by our consumer driven culture they just want the diploma to start making the big bucks. All of this contributes to depression, to a lonely society that undermines what it means to live a decent, healthy and happy life.

In 2008 the American Bar Association launched a Mental Health Initiative to address mental health problems on law school campuses. See the Mental Health Toolkit for Student Bar Organizations and Administrators distributed as part of this effort. Such initiatives’ involve mental health days (e.g. check out Marquette Law School) where they had out a document from Professor Krieger called The Hidden Sources of Law School Stress , “wellness” web pages on law school websites (e.g. check out the one at Harvard Law School) and referrals to a school’s counseling center (e.g. check out Cornell Law School).

While laudable, they’re an arm’s length effort to confronting such a deeply personal and painful human experience. Moreover, it seems like any presentation on the issue of depression in law schools is limited to first year orientation. What about the second and third year students? Studies conclude that depression rates continue to rise into the second and third year. If that’s true, what is being done to help these students? Another query: Just how many of the people who speak at these programs are law students or lawyers who actually had or are currently suffering from depression and disclose it? My hunch is few, if any.

Why should that matter? Because the students need to hear it straight-up. They need to listen to someone in the trenches of a profession they’ll soon be entering. Without such depression experiences, a speaker is like someone trying to enlighten someone about the dangers of smoking and cancer, but has never smoked. Wouldn’t it be a more powerful, credible and informative experience for students to listen to a law student and/or a practicing lawyer, who has depression and is willing to talk about it?

Instead, students are served up programs, usually offered up by well-meaning Dean or Vice-Deans of Student Affairs and therapists from a University’s Counseling Center. There’s a lump-it-all-together approach to it all. I was asked a few years back, when I was just beginning my advocacy work, to give a brief, 15 minute talk on depression. The school trotted out a variety of people in fifteen minute increments to talk about stress, drinking, drugging and, eventually, depression. Speaking in that big first year classroom, I was reminded of the ancient Greek amphitheaters. Many of the Greek dramas were tragedies. And make no doubt about it, depression is a tragedy.

I was saddened by the whole charade, the paucity of imagination and effort that went into addressing such a critical problem; the let’s pool this list of mental ills together into a small program on “mental health.” I sensed that the students failed to see how any of this was connected to them. The sliver of time allocated to depression couldn’t help but leave the students with the impression that the school really didn’t take the problem that seriously.

Over 130 million people suffer from depression worldwide on a planet where it is the leading cause of disability. In our country, it’s also the leading cause of disability and some 20 million people are afflicted. It’s been characterized as an “epidemic.” If that’s true, what does that say about the higher rates of law student and lawyer depression? Just what adjective could one use to describe the scope of the problem?

Addressing Depression In Law School – Really

Here’s what can be done right now:

1. Law Schools – show the thirty minute documentary, “A Terrible Melancholy: Depression in the Legal Profession.” Copies of the film on DVD are available form the Erie County Bar Associaiton. Here’s a trailer clip of this recently finished film:

2. Have someone come in to speak to the students that are in the legal profession who has suffered from depression to reach these students. Give it more than 15 minutes of your time and have programs for second and third year student on this critical topic.

3. Law Students – show up, watch the film and think long and hard about it.

Finally, I want to urge all of you reading this blog to write in and express your views about your law school experience, whether you’re in school now or it’s been thirty years. There’s much to be gained by such sharing. Please write.

Stressed and Depressed Guys in Blue Suits

Beneath the body armor of their pin-striped suits, male lawyers carry a terrible burden. Corrosive levels of stress bombard them and they’re expected to pony up and take it by fellow lawyers and judges — and themselves. There is a serious disconnect between the conversations going on inside their heads about how they really feel about their inner turmoil and the ways they present themselves to their busy world as competent, confident and glacial under pressure.

Studies show that lawyers suffer from elevated rates of stress and depression — more than double the rates found in the general population. There are some physiological and psychological clues as to why this is so for men in the legal profession.

A new study finds that stressed men have diminished activity in brain regions responsible for understanding other’s feelings. The study concludes that under stress, men tend to withdraw socially while women seek emotional support. Recently, I was preparing for a trial scheduled to go on a Monday. I had worked hard the whole weekend and was cranky and exhausted. Sunday afternoon, my wife asked if I felt okay and whether I was stressed. I shrugged off her question and said that I really didn’t want to talk about it.

Yet in times when my wife is stressed, she turns to me for support and encouragement – and she’s a lawyer too. As a man in the legal profession, I expect myself to just bear it and soldier on through the mud of litigation. If you can’t take it, you can’t cut it goes the mindset in the legal culture. As if there were no middle ground, no way to express this sense of free-floating anxiety. As if it was all that simple.

There was an interesting article in yesterday’s ABA Journal, “Lawyers under Stress are Critical, Cautious and Distant, Personality Test Shows.” The tests, administered to 1800 lawyers at big firms, were conducted in collaboration with Hogan Assessment Systems, found that, on average, the lawyers:

• Generally do not seem to have a strong need for public recognition, although there is a subset of lawyers who seem to crave recognition and notoriety.

• Tend to deal with others in a direct and matter-of-fact way, but may come across as cold, critical and argumentative.

• Tend to be self-critical and temperamental but are also self-aware, open to feedback, and emotionally expressive.

• Are most attracted to environments that emphasize quality and are less commercially focused than professionals in other industries.

• Tend to value education and educational activities.

While these stress-related problems don’t necessarily cause male depression, they are additional risk factors for those are predisposed to it.

Terrence Real, author of the book “I Don’t Want to Talk about It,” makes an important point about how men deal with their melancholy: for every male who discloses his depression and gets treatment, there are four others who are able to hide it and won’t get help. He writes:

“Covert male depression has three main domains: self-medication, isolation and lashing out. Self-medication may be drinking, drugging, womanizing and even watching excessive amounts of television. Some forms of self-medication are tolerated by our culture so it is hard to get across that what these men are doing is stabilizing depression.

A covertly depressed man will isolate himself and withdraw from intimacy with his partner, his kids, his friends. He can’t afford to be intimate with others because he is desperately trying not to be intimate with himself.

Lashing out can mean violence and domestic abuse. Untreated depression may be an integral part of many male batterers.”

Men drive their pain deeper into the well of their being to avoid dealing with it, to avoid facing the fact that they feel overburdened and, perhaps, afraid. Alone at the bottom, there is darkness with no ladder out. Many of them will need an escape rope dropped into them by other caring people, if they are lucky to have such people in their lives. They feel odd and alone; like they are the only man alive with this problem.

In fact, depression is a secret pain at the core of many men’s lives, and one that goes largely undiagnosed and untreated. Watch the trailer of the recent documentary “Men Get Depression” which aired on PBS:

What Men Can Do About Stress

Check out this stress blog by therapist, Elizabeth Scott.

We all know exercise is important to controlling our stress levels. The problem isn’t that we don’t know that. The problem is that we don’t do it. Hook up with a trainer at your local gym. It’s is a relatively cheap way to motivate you to exercise. It also makes you accountable to someone and it’s painful to the pocketbook if you blow it off – must trainers charge you for no-shows! Here’s a great blog about managing stress with exercise and a good diet from a personal trainer. Also check out the book Spark: The Revolutionary New Science of Exercise and the Brain which has three great sections about stress, anxiety and depression and what happens to the human body when we work out. I do use a trainer and it has had a dramatic impact on stress loads I carry.

For a quick fix, check this web article “Eight Immediate Stress-Busters.”

Read an article I wrote for lawyers in December, 2008 edition of Trial Magazine, “The Connection between Stress, Anxiety and Depression.” It is a companion to Dr. Andrew Benjamn’s wise advice, “Reclaim Your Life, Reclaim Your Practice.”

What Men Can Do About Depression

Read Terrence Real’s book because it’s important for all of us to learn about depression from a male perspective. Also check out the website Mid-Life Men which offers stories from guys about their depression experiences.

Have your wife read Is He Depressed or What? Many women ask themselves this question every day wondering whether their husband or boyfriend’s short temper, tendency to withdraw, and mysterious physical complaints might be indications of some deeper psychological issue. The book offers an overview of the ways men typically express signs of depression. It provides strategies they can use for improving communication, dealing with relationship complications, and coping with men’s physical symptoms related to depression, such as insomnia and sexual dysfunction.

Above all, the book helps your spouse avoid becoming lost in your depression. By paying attention to their own needs, they can best preserve their well-being and peace of mind—and so are able to offer the most support to you. I often suggest that men buy this book for their wives rather than ask their wives to go out and buy it. This demonstrates that you are in this together, that you care about her feelings and that you want her to understand.

Get help. Therapy is not scary and you don’t have to go it alone. Therapy will help you to feel better by having someone to talk with. Check out this article where a therapist answers seven questions about how therapy works and what to expect. It is something productive you can do about your stress, anxiety and depression and it can help you to develop some better coping skills. If you are concerned about being seen, many therapists have early morning or late evening hours. You also tell them that you have a concern about being seen by fellow attorneys or judges and request that he or she not schedule you at a time when that therapist may be treating someone you don’t want to see.

Men, you can’t handle exorbitant levels of stress and depression on your own. It’s not shameful to get help.

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.

Tag: Andrew Benjamin

In the Beginning – Depression in Law School

Stressed and Depressed Guys in Blue Suits

A Lawyer’s Heart

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