A primer on mental health for the legal community

by Kevin E. Joyce, Esq.

This article originally ran in TBA News.

Those of us who work in the legal profession know how stressful and demanding our jobs can be. So we shouldn’t be surprised when studies show the high rate at which attorneys experience mental illness.

Sixty-one percent of lawyers experience anxiety during their careers, forty-six percent experience depression and twelve percent experience suicidal thoughts.

A Johns Hopkins University study of more than one hundred professions found that lawyers have the highest incidence of depression. Attorneys have overtaken dentists with the highest rate of suicide. Only six percent of the U.S. population exhibits signs of problematic drinking, while twenty-one percent of attorneys do.

Some experts point to billable hours and workloads as the biggest causes of mental illness among attorneys. The adversarial nature of the profession can also be a source of stress. But the issue of causation is hardly that simple.

Signs and symptoms of mental illness include: problems with alcohol or drug use; feeling sad or down; reduced ability to concentrate; low energy or problems sleeping; major changes in eating habits; suicidal thinking; sex drive changes; and, detachment from reality or hallucinations.

Beyond interfering with day-to-day functioning, mental illness can interfere with an attorney’s ability to provide legal services to clients at the appropriate standard of care.

Legal professionals are advised to see a physician or mental health professional if they experience signs or symptoms of mental illness. Those experiencing suicidal thoughts should call the National Suicide Prevention Lifeline at 800-273-8255 or use the web chat at suicidepreventionlifeline.org/chat.

Stigma, the shame associated with a person’s having a mental illness, is a significant impediment for individuals with mental illness, regardless of whether they are members of the legal community. The stigma and secrecy that may surround a lawyer’s mental illness can delay the lawyer from seeking help or, tragically, can lead to suicide.

There is no reason for a lawyer to be ashamed of having a mental health disorder. One of our greatest U.S. presidents, Abraham Lincoln – who was an outstanding lawyer – fought depression throughout his adult life. One historian, Joshua Wolf Shenk, has chronicled how Lincoln’s depression contributed to his amazing achievements in the biography Lincoln’s Melancholy.

The mental illnesses that can strike attorneys, and others, include:

  • Addiction – a compulsion to use substances such as alcohol or prescription opioid medications to excess, until they become destructive

  • Major depression – a constant sense of hopelessness and despair. It can lead to suicide.

  • Anxiety disorders – a group of mental disorders characterized by significant feelings of anxiety and fear, including social anxiety disorder

  • Bipolar disorder – a mental illness causing low (depression) and high (mania, hypomania) moods

Treatment for all of these mental illnesses includes talk therapy and medication. A psychiatrist’s primary role is to prescribe the appropriate medications to his or her patient with a mental illness. A psychologist or social worker (LCSW) often is the provider of therapy services.

Prescriptions and therapy aren’t the only treatments for mental illness. For example, a person with major depression whose illness is not responsive to medication or therapy may require administration of electroconvulsive therapy (ECT) at a hospital. This is the procedure administered to Randle McMurphy, Jack Nicholson’s character in One Flew Over the Cuckoo’s Nest. Unlike Cuckoo’s Nest, because a physician now administers anesthesia during the procedure, the modern ECT patient experiences essentially no pain.

In addition to visiting your physician, a psychiatrist or a therapist, there are several programs to help attorneys with mental health issues. The Member Assistance Program (MAP) at the TBA is a confidential and voluntary program providing professional counseling for problems that can include mental illness.

The Ohio Lawyers Assistance Program (OLAP) helps Ohio judges, lawyers and law students obtain treatment for addiction and mental health issues.

The Toledo Bar Lawyers’ Assistance Committee offers confidential information for dealing with alcohol and drug abuse and addiction. More information can be found at toledobar.org.

The next time you attend a CLE concerning mental health, be sure to listen carefully, even if you are fully confident in your own mental health. You never know when a friend, colleague or family member may have to deal with a mental health impairment – and you can be there to help guide them in the right direction.