June 24, 2019 Feature

Depression and the Practice of Law: Signs of Struggle and Avenues of Relief

Joshua Rooks

Among highly competitive and demanding occupations such as the practice of law, a dedication to perfectionism, long hours, and isolation are often expected. In the pursuit of success, great effort is naturally made to overcome one’s perceived weaknesses and conceal any sign of vulnerability. Unfortunately, difficulties with emotional pain and distress are often not easy to surmount. Further, these stressors are strongly linked to mental illness. Research suggests that roughly three out of ten lawyers currently experience elevated levels of depression and that nearly half report suffering from depression at some point during their career (Patrick R. Krill, Ryan Johnson, and Linda Albert, “The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys,” Journal of Addiction Medicine, February 2016 (10:1), at 46–52).

depression

depression

However, because depression is a personal and internal experience, many suffering it falsely believe this problem is uniquely theirs, further perpetuating the silence, isolation, and stigma surrounding it. This is what makes stories like that of Javier Lopez (see his article here) so powerful and important. His personal testimony provides a much-needed reminder to those in this field struggling with depression that they are not alone, that speaking out and seeking help are not signs of weakness but of strength, and that returning to one’s full self is truly possible. In an effort to build upon Javy’s story, I hope to shed additional light on what is often an unspoken struggle for many legal professionals.

What Is Depression?

Although the concept of depression carries a relatively ubiquitous connotation, its severity and presentation can look vastly different from one person to another. When you hear people say that they are feeling depressed, it likely evokes personal memories associated with emotions of sadness, discouragement, or feeling down, blue, and so on. In this regard, it is no surprise then that sadness is one of the common symptoms associated with depressive disorders, but this is not always the case. Many individuals with depression may also, or alternatively, develop a complete lack of interest and enjoyment in life and activities. For example, the satisfaction from winning a big case may feel blunted, the excitement of taking up a new challenge at work is absent, and perhaps even the simple pleasure of a good cup of coffee feels like a distant memory. It is this feature of depression that can often develop insidiously and slowly start to feel like the new normal.

I have found that one of the basic forces underlying depression is a feeling of inertia. Fatigue, loss of energy, and exhaustion are pervasive among those with this mental illness. When combined with a sense of apathy and lack of interest, depression can dramatically affect how one behaves in nearly every aspect of life. Client phone calls are ignored, dinner parties are avoided at all costs, and household obligations and personal care are no longer prioritized. This can lead to greater isolation and inactivity, behaviors also found to further perpetuate the cycle of depression. Because of this, I frequently encourage those I work with who struggle with depression to do what they can to fight this inertia and to begin by taking small steps each day to become more active and socially engaged.

Perhaps unlike any other mental illness, depression has a way of negatively distorting people’s view of themselves and their current circumstances. In addition to inactivity, depression is often fueled by the development of obsessive preoccupations over past failings and mistakes. Unfortunately, added efforts to fix or solve these problems often lure one further into a process of recycling these same thoughts and memories, over and over again. It is so easy to develop tunnel vision and lose sight of how distorted one’s thoughts have become. Furthermore, when consumed with these ruminations, one often becomes highly internalized and detached from the world, making it difficult to attend to details from conversations, meetings, or events. This can lead some depressed individuals to feel they have serious problems with their concentration and memory as well.

Additional symptoms not always thought of as being related to depression include disturbances in appetite and sleep. Some individuals may lose all interest in food, while others may find themselves eating all day, yet never feeling fully satisfied. Similarly, changes in sleep patterns may also swing in both directions. Some sleep problems present like insomnia, where falling and then staying asleep feel impossible. In contrast, spending entire days in bed is sometimes a hallmark sign of depression. In some cases, depression also changes how one physically moves about the world. Some individuals may appear very fidgety, with frequent pacing and an inability to sit still. Alternatively, others may show significant slowing of their speech, thoughts, and/or body movements.

Establishing a Safety Plan

Depression can also lead to a deep sense of futility and hopelessness. When this is the case, thoughts of death and suicide may also develop. While these thoughts and impulses often vary greatly in terms of both frequency and intention to act, they should always be taken seriously. Amid this kind of thinking, it can be difficult to remember that the act of suicide is a permanent solution to a temporary problem. Because of this, it is very important that those at risk of harming themselves have a plan in place that allows a trusted other to help them when they are incapable of caring for themselves. This may mean talking to a friend or family member, discussing these concerns with a therapist or medical provider, speaking with a trained professional via the National Suicide Prevention Lifeline (800/273-8255), or calling 911. These are all understandably terrifying choices, but they may become even harder to make when they are most needed. This is why having a safety plan in place is so important.

What Can We Do about It?

There are likely multiple variables contributing to the high rates of depression among attorneys; however, as Javy describes, one of the primary factors is the high demands and stress inherent to this work. Chronic stress has a way of slowly, yet persistently, eating away at one’s resilience to adversity. When resilience is depleted, and negative events inevitably occur, it is much easier to succumb to the negative thought patterns and destructive behaviors that perpetuate this illness. As such, prioritizing healthy self-care practices is an important way for lawyers to protect themselves from these concerns. The easiest way to do this is to re-engage in activities you may have done in the past that provide a sense of joy and fulfillment. For Javy, that meant prioritizing time spent with his family and practicing his faith. What might that look like for you?

As a caveat, it’s important to note that consuming alcohol does not count as recommended self-care practice. Similar to depression, rates of alcohol use disorders are exceptionally high among those in the legal profession, particularly for those working in private firms (Krill et al., supra). Given its accessibility and social acceptance, drinking is often the first place to look to find relief from occupational stressors. However, while alcohol can temporarily numb the pain, it does little for the underlying causes of suffering. In contrast, frequent and excessive alcohol use may exacerbate both the physical and interpersonal factors that were in part the source of one’s depression to begin with.

If you’re looking for a new self-care practice, Mindfulness-Based Cognitive Therapy (MBCT) is an exercise that continues to grow in both public awareness and scientific support as a way to protect oneself against the potential development of depression. Mindfulness is a meditation-based practice that helps individuals to orient their attention to the thoughts, emotions, and physical sensations of the present moment. Guilt, shame, and self-rejection are part and parcel of the internal struggle of depression. However, with practice, mindfulness exercises can help one to cultivate a more compassionate and non-judgmental relationship with both these experiences and oneself. Additionally, greater awareness of one’s negative thinking styles can provide an opportunity to challenge these thoughts before they spiral into a deeper depression. As an MBCT instructor, I have witnessed the profound impact these practices can have on one’s emotional and interpersonal well-being. If you currently or previously have struggled with depression and are looking for a new approach to managing these concerns, mindfulness may be an option worth exploring.

Ask for Help

In the middle of a depressive episode, it is common to feel as if it will never end. However, there is great reason to be hopeful of finding relief, as many effective evidenced-based treatments exist for this illness. If the signs of depression identified in this article particularly resonate with you, I strongly recommend that you seek consultation with a medical or mental health professional to discuss what treatment options might be best for you. Lawyer assistance programs are great resources to learn more about strategies for dealing with depression and to find mental health providers available in your area. The ABA Commission on Lawyer Assistance Programs (ambar.org/colap) has compiled a directory of all state lawyer assistance programs: tinyurl.com/yxseomur.

Although there are many common features of depression, it can also look very different from one person to the next. Similarly variable, however, is the path that each individual takes to recover from this illness. The field of mental health includes providers with specialized training in multiple different theoretical orientations and patient populations. It is important to find the right fit for you. n

Resources

  • National Suicide Prevention Lifeline: 800/273-8255
  • Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline: 800/662-HELP (4357)
  • ABA Commission on Lawyer Assistance Programs (CoLAP) Directory of Lawyer Assistance Programs: tinyurl.com/yxseomur
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Authors

Joshua Rooks 

Dr. Joshua Rooks is a neuropsychology postdoctoral fellow at the University of Miami (UM) Department of Neurology. He completed his doctorate in clinical psychology at UM, studying the impact of mindfulness training on the cognitive and emotional functioning of those in high-demand occupations, including elite athletes and military personnel. Additionally, Dr. Rooks has received advanced training in mindfulness-based cognitive therapy, and his clinical interests include the assessment and treatment of a wide range of neurocognitive and psychiatric illnesses.