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Georgia Bar Journal
December 2020, Vol. 26, No. 3

Bar Members—Check Your Pulse

These tumultuous and unpredictable times have brought immeasurable stress, anxiety and pain to many of us, leaving very few in our profession unaffected. We are in a crisis as individuals, as human beings and as a profession.

Days before I chose what I would write about for this Journal article, I received an email sent to the president@gabar.org email address, notifying me of the untimely death of an assistant district attorney in Columbus that had occurred the day before. He drove to his office one day and took his own life. I did not know this Bar member, but the news caused an unexpected visceral, emotional response from me. I cried. I cried for him, for his family, for his colleagues and for those of us who will never have the opportunity to know him.

Every article I read about his suicide after that email contained similar comments from those who knew him. He reportedly seemed happy and gave no indication that he was not. He reportedly did not tell anyone that he was thinking about hurting himself and seemed content in his work. These comments were familiar to me, having read other similar stories over the years. For some reason, with everything going on in the world, in our country and in our state today, the news of this lawyer’s death hit me particularly hard.

One of the most common means of determining someone’s health are vital signs. Blood pressure, heart rate, breathing rate, pulse oximetry—all of these measurements are taken to help immediately determine the state of one’s health. However, beyond the numbers, even more critical and helpful information can be found when looking at the quality of those numbers. Is the blood pressure stable over time, is the breathing deep and regular, is the pulse regular and strong, is the oxygen saturation consistently within “normal” range on room air? These measurements are aptly called “vital signs” because they in fact readily reflect one’s vitality, or lack thereof. But those objective numbers alone do not provide a complete picture of health.

How a person feels is as important to their health as are their vital signs. Is there any pain? Are there any difficulties completing normal daily tasks? Can care for oneself be completed without assistance from other people or assistive devices? How is stress managed? Any trouble sleeping? Any memory issues? Any mobility issues? These and other important subjective questions also play a large part in determining the state of one’s health.

Over the course of the last six months, I have had the absolute pleasure of virtually meeting and speaking with innumerable attorneys and judges throughout the state. One common theme that has run through each of those conversations has been mental health, well-being and self-care. A lot of us are concerned about our own health and well-being, a lot of us are concerned about each other, and based on the individual conversations I have had over these last six months, a lot of us may have thought about hurting ourselves. That is called “suicidal ideation,” and if you have had these thoughts, you should seek help immediately. We must ensure that we are safe and healthy, even in these challenging times. And we have a better chance of accomplishing this if we work together.

As far as I can see, lawyers are not well known for our great self-care. Not in the least. Hopefully though, we are working to become better at it, thanks to so many wellness-focused programs and activities offered by your Bar every year, and this year in particular. Every Bar member understands that some level of stress comes with the practice of law; actually, that fact is first evident in law school. We also understand that managing that stress is important to our physical and mental well-being. However, we find discussions about stress, anxiety and even depression difficult, even though we know these issues are understandably more prevalent today. A study completed by Johns Hopkins of more than 100 occupations revealed that, in 2011, lawyers led the nation with the highest incidence of depression. Since then, I suspect little has changed in our profession to positively affect that finding.

Depression is too often stigmatized and misunderstood, especially in the legal profession.

Depression often involves persistent sad, anxious, or empty mood; feelings of hopelessness or pessimism; and feelings of guilt, worthlessness, or helplessness. It can also involve loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex. Decreased energy, fatigue, or a sense of being “slowed down” are also common, as are restlessness, irritability, and difficulty concentrating, remembering, or making decisions. Many with depression have thoughts of death or suicide.1

We not only have to deal with stress, anxiety and depression as a regular part of our daily lives, but we also must figure out how to deal with them in healthy, productive ways while enduring global health crises and practicing law, too. Prior to the pandemics we currently face, lawyers were not so great at handling stress, anxiety or depression, at least not the profession as a whole. And there is no evidence we are doing a better job of managing them now. Lawyer assistance and lawyer well-being will continue to be our top goals this Bar year, and for good reason.

In 2016, a study was conducted by the Hazelden Betty Ford Foundation and the American Bar Association Commission on Lawyer Assistance Programs that showed “substantial and widespread levels of problem drinking and other behavioral health problems in the U.S. legal profession.”2 Approximately 15,000 lawyers from 19 states around the country participated in this study. In part, this study also revealed that 21% of licensed, employed attorneys qualif[ied] as problem drinkers, 28% struggle[d] with some level of depression and 19% demonstrate[d] symptoms of anxiety.” The study also found that “younger attorneys in the first 10 years of practice exhibit[ed] the highest incidence of these problems.”

Even more revealing, this study showed that, “[W]hen focusing solely on the volume and frequency of alcohol consumed, more than 1 in 3 practicing attorneys are problem drinkers.” Attorney and clinician Patrick R. Krill, an architect of the project and lead author of the study, deemed this study a call to action and said, “[T]his long-overdue study clearly validates the widely held but empirically under supported view that our profession faces truly significant challenges related to attorney well-being. … [A]ny way you look at it, this data is very alarming, and paints the picture of an unsustainable professional culture that’s harming too many people. Attorney impairment poses risks to the struggling individuals themselves and to our communities, government, economy and society. The stakes are too high for inaction.” By comparing lawyers with other professionals, it was determined that “lawyers experience alcohol use disorders at a far higher rate than other professional populations, as well as mental health distress that is more significant. … [T]he most common barriers for attorneys to seek help were fear of others finding out and general concerns about confidentiality.”

According to the World Health Organization (WHO), for every person who has successfully committed suicide, there may be up to 20 people who had unsuccessfully attempted suicide.3 In 2016, WHO ranked suicide as the 18th leading cause of death.

Please understand, with all the extraordinary challenges, pain and loss we each face in our personal and professional lives every day, my goal in writing this article is not to further depress you or create added stress or anxiety for you. My hope is that we become more comfortable saying out loud and speaking to others about all the “stuff” we carry around with us inside, fearing someone will think less of us, blame us, shun us or judge us. That “stuff” can and is killing us, so it must be dealt with, somehow. I am not a therapist, psychologist or psychiatrist. I only know we must help each other, and I believe having these types of discussions openly and frequently is a big step in the right direction.

Do me a favor and check your pulse; find out how you are doing. Get help if needed. Ask for help when needed. Then, check your colleagues’, neighbor’s and judge’s pulse, and see how they are doing. Be the keeper of your sisters and brothers in the law. To access your six free one-hour counseling sessions as a member of our Bar, please call 800-327-9631. You can access more information about the State Bar of Georgia’s Lawyer Assistance Program at www.gabar.org/LAP. 

Happy Hanukkah, Merry Christmas, Happy Kwanzaa and a blessed New Year to all! Be safe and stay well this holiday season, as we work together to #SustainaSoundBar.

Endnotes

1 What is Depression? Psychology Today (2020) <https://www.psychologytoday.com/us/basics/depression>.
2ABA, Hazelden Betty Ford Foundation Release First National Study on Attorney Substance Use, Mental Health Concerns, Hazelden Betty Ford Foundation (2016) <https://www.hazeldenbettyford.org/about-us/news-media/press-release/2016-aba-hazelden-release-first-study-attorney-substance-use>. 
3Mental Health and Substance Use, World Health Organization (2020) <https://www.who.int/teams/mental-health-and-substance-use/suicide-data>.