Physicians are learning that depressed people are at risk for cardiovascular disease, and that heart disease patients are at risk for depression. Read the Story
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.