Treating Lawyers with Depression: One Psychologist’s Top 10 Tips

 

Here is an interview I did with Dr. Tyger Latham, a clinical psychologist and psychoanalyst in Washington, D.C. and the Commonwealth of Virginia. He received his Ph.D. George Washington University.

What is depression?

Depression is a mental health disorder that affects roughly 10 to 15 percent of the general population. According to the DSM, the manual used by psychiatrists and psychologists to diagnose depression, a person is diagnosed with depression if she/he experiences depressed mood, along with several other related symptoms, for a minimum of 2 weeks. Some of these other symptoms include: disrupted sleep; diminished energy; changes in appetite or weight; difficulties with concentration; restlessness or lethargy; feelings of guilt, worthless, and helplessness; and, in extreme cases, thoughts of death or suicide. This is the medical definition of depression. However, this definition fails to capture the experience of what it’s like to be depressed. I think Paul Simon has described depression best when he wrote: “Hiding in my room, safe within my womb, I touch no one and no one touches me. I am a rock, I am an island. And a rock feels no pain; and an island never cries.”

Have you treated many law students, lawyers and judges for it?

At any one time, I would say about a third of my practice is comprised of lawyers or law students, of which a large majority suffer from depression or some related mood disorder such as persistent depressive disorder or bipolar disorder.

Can you tell us what kind of issues concerning depression lawyers come to you for? (E.g. problems on job, marital)

As with all of my clients, I find that lawyers come to therapy for a myriad of reasons, including depression. In the case of lawyers, however, the practice of law often serves as a backdrop for their presenting concerns. I have yet to work with an attorney whose work was not adversely affected by their depression. In fact, many lawyers who are diagnosed with depression only become aware of it after it begins to affect their productivity. These lawyers might complain of being unable to concentrate; feeling indifferent or apathetic about their work; withdrawing from colleagues; or, in some cases, they talk with me about feeling burned-out or they might share fantasies of leaving the practice of law altogether. All of these symptoms can be associated with depression and when taken together they build a strong case for clinical depression.

Attorneys will often employ a number of coping strategies – some adaptive, others not-so-adaptive – to deal with their depression. Most attorneys are accustom to working long hours, so I often see many attorneys with depression pour themselves into their work as a way to escape. I’ve also worked with a number of attorneys who have resorted to alcohol and drugs as a way of managing their symptoms. While I wouldn’t say all attorneys who are depressed abuse alcohol and drugs, the majority of attorneys who abuse alcohol and drugs almost always suffer from some form of a mood disorder like depression, bipolar, or anxiety.

The Twin Pillars of Depression

“Once you choose hope, anything is possible.” – Christopher Reeve

There are two pillars upon which depression rests.

Helplessness

When in the grip of depression, we feel helpless despite our efforts to pull out. The more we struggle, the more exhausted we become. In her book Eat, Pray, Love, Elizabeth Gilbert writes, “They flank me – Depression on my left, loneliness on my right. They don’t need to show their badges. I know these guys very well . . . then they frisk me. They empty my pockets of any joy I had been carrying there.”

Hopelessness

Helplessness often leads to profound hopelessness about the future. In her book Prozac Nation, Elizabeth Wurtzel writes, “That’s the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious and compounds daily that it’s impossible to ever see the end.”

What I have learned over the past twenty years of living with depression is we need to chisel away at these twin pillars. I began to discover helplessness and hopelessness are disempowering: I had no choice but to live my days under this rock of sadness. My healing involved learning that I did have options in how I related to life when depressed. And I found this power to choose empowering and life-affirming.

How did I leave helplessness and hopelessness behind?

The Dark Side of Success: A Psychiatrist’s Exploration of Depression in the Legal Profession

By Joann Mundin, M.D.

There are significant effects of depression in the legal profession that are pervasive. Lawyer depression can have terrible personal and professional ripple effects for attorneys but also impacts clients, business partners, employees, and staff.

The general population is significantly affected by depression, with 17.3 million persons, or 7.1% of all adults in the US, reporting having experienced a major depressive episode in 2017. But, the proportion of depression among attorneys is considerably higher: according to ALM’s Mental Health and Substance Abuse Survey from 2020, 31.2% of the more than 3,800 respondents report having a depressive disorder. This indicates that compared to the ordinary US adult, lawyers have an approximately three-fold higher risk of developing depression.

Nevertheless, the stigma associated with mental illness keeps lawyers from getting help immediately. This can cause excessive and prolonged distress, making the problem worse over time.

Wired: Anxiety Strikes at Harvard Law School

Freud was of the opinion that in fear a person is responding to a specific and immediate threat to physical safety while in anxiety a person is responding to a threat that is objectless, directionless, and located somewhere far off in the future—ruination, for example, or humiliation, or decay. Daniel Smith, Monkey Mind: A Memoir of Anxiety

I spoke at Harvard Law about the challenges of living with depression and the epidemic of poor mental health in the legal profession. It was a memorable event.

Days before I am scheduled to talk, my sleep goes cuckoo. I become incredibly anxious about my speech. What if I fall flat on my face? I graduated from some third-tier law school, after all. I don’t belong lecturing at Harvard.  My churning nighttime ruminations now seep into my days as the event gets closer.

Real Men Cry: Men & Depression

“A lazy part of us is like a tumbleweed. It doesn’t move on its own. Sometimes it takes a lot of depression to get tumbleweeds moving.”  – Robert Bly, Morning Poems

Growing up the son of a WWII vet, my dad’s parenting style could best be described as minimalist: punishment at his leisure as alcoholics are prone to do; hard, physical labor built character; and praise came from athletic accomplishments like football which prized hitting.

Crying? Only once as a young child. Dad’s reaction? “I’ll give you something to really cry about if you don’t knock it off. Only girls cry!” Looking at him through the eyes of a child, the message was clear: Crying (or any display of sadness) was never to be done again if I wanted his approval (In essence, his love which never came).  As I grew older, he added this maxim: Pain, physical or emotional, was to be endured, if not conquered.

Change Your Thinking, Change Your Anxiety and Depression

Catastrophizing is an irrational thought a lot of us have in believing that something is far worse than it actually is.

It can generally can take two different forms: making a catastrophe out of a current situation, and imagining making a catastrophe out of a future situation.

Decastrophizing means mentally bringing the problem back to its proper perspective.

We may end up recognizing that a situation rates only a “5” or “10” on our awfulness scale and not the “95” that we currently perceive.  Decastrophizing means more than purely acknowledging that our feared situation is unlikely to arise. It means considering the consequences if it should arise.  It means considering the consequences if it should arise, and recognizing that in any event, we would cope.

Bottoms Up: My Drunk Dad, My Depression

My dad was an alcoholic.

He died at age 56 from too much drinking. Almost 40 years ago.

I was 19 at the time, a sophomore at a local state college. I lived upstairs from my Polish grandma who, was a big woman with arms as strong as an elephant’s trunk.

One morning, my Aunt Clara, who, with her husband Eddie (who was genuinely cross-eyed), lived with grandma downstairs, came up to tell me, “Your father died today.”

I had never heard my dad called “father.” It sounded formal, like, “The President of the United States died today.”

My dad had been ill for months. The year he died, 1981, Hospice wasn’t around. Most people, as sick as my dad with cancer and cirrhosis of the liver, met their end in the hospital.

Too Much Depression, Too Little Sleep: 3 Things You Can Do to Get a Better Night’s Slumber

The worst thing in the world is to try to sleep and not to. – F. Scott Fitzgerald

When first diagnosed with depression, my sleep became fragmented in a way I had never experienced before.

Before this time, I, like most frenzied lawyers, had periods of restless sleep tinged by stress and anxiety. But my sleep would return to normal after a lengthy trial or round of contentious depositions.

But this was different.

Lots of Depression, Little Sleep

I was always tired, but couldn’t sleep through the night. I went to bed early, exhausted from trying to make it through another day with depression. Trouble sleeping is a symptom of major depression.  Kay Redfield Jamison, M.D., a psychiatrist, writes:

The body is bone-weary; there is no will; nothing is that is not an effort, and nothing at all seems worth it. Sleep is fragmented, elusive, or all-consuming. Like an unstable, gas, an irritable exhaustion seeps into every crevice of thought and action.”

The Suicide of a Law Student Hits Home

When people are suicidal, their thinking is paralyzed, their options appear spare or nonexistent, their mood is despairing, and hopelessness permeates their entire mental domain. The future cannot be separated from the present, and the present is painful beyond solace. ‘This is my last experiment,’ wrote a young chemist in his suicide note. ‘If there is any eternal torment worse than mine I’ll have to be shown.’ – Kay Redfield Jamison, M.D., “Night Falls Fast: Understanding Suicide”

A second-year law student at the University at Buffalo School of Law, Matthew Benedict, died by suicide earlier this week by leaping from the Liberty Building he had been clerking at according to the Buffalo News. Another account of Matt’s life and suicide was reported in The New York Law Journal.

Matt’s funeral is tomorrow. By all account’s he was a tremendous, loving, talented, bright young man.Matt was kind-hearted, passionate and driven.

Uplift: How Pushing Weights Lifts My Depression

“Human beings are designed for regular physical activity. The sedentary nature of modern life probably plays a significant role in the epidemic incidence of depression today.”  Andrew Weil, M.D.

After a long winter and dreadful May of rain and cold temperatures, beautiful June is finally here. The sunlight is filtering through the green tree leaves and warm air blowing across my hair.

Summer’s a great time to start investing in your health again after winter’s hibernation.  People are out walking or working in their gardens.  This whole time of year screams “move!”  I have added weight training as part of my moving routine.  Maybe you can, too.

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