Depression is a dangerous disease, and lawyers are more prone to it than members of any other profession. Consider these numbers:
A 1990 study at Johns Hopkins University found that of 28 occupations studied, lawyers were the most likely to suffer depression, and were more than 3.6 times more likely than average to do so. A Harrison Barnes, Builders and Destroyers (citing W.W. Eaton, J.C. Anthony, W. Mandel & R. Garrison, Occupations and the Prevalence of Major Depressive Disorder, 32 J. Occupational Med. 1079 (1990).
A research study of 801 lawyers in the State of Washington found that 19% suffered from depression. Barnes, supra (citing G.A.H. Benjamin, E.J. Darling & B.D. Sales, The Prevalence of Depresion, Alcohol Abuse, and Cocaine Abuse Among United States Lawyers, 13 J. Law & Psychiatry 233 (1990).
A quality-of-life survey by the North Carolina Bar Association in 1991 revealed that almost 26% of respondents exhibited symptoms of clinical depression, and almost 12% said they contemplated suicide at least once a month. Michael J. Sweeney, The Devastation of Depression.
Left untreated, depression can be fatal. According to the National Institute of Mental Health, 15% of people with clinical depression commit suicide. Don P. Jones & Michael J. Crowley, "I wish I would have called you before...." Surveys of lawyers in Washington and Arizona showed that most lawyers suffering from depression also have suicidal thoughts. Joan E. Mounteer, Depression Among Lawyers, 33 Colo. Lawyer 35 (Jan. 2004). One study found that lawyers have a much greater risk of acting on their suicidal thoughts and succeeding in doing so. Id. Suicide ranks among the leading causes of premature death among lawyers. Richard G. Uday, That Frayed Rope, Utah State Bar J., Aug./Sept. 2003 (citing Meyer J. Cohen, Bumps in the Road, GPSOLO, July/Aug. 2001, at 20). The 1992 Annual Report of the National Institute of Occupational Safety and Health reported that male lawyers are twice as likely as the general population to commit suicide. Lynn Johnson, Stress Management, Utah State Bar J., Jan./Fed. 2003.
Why are lawyers more prone than anyone else to this dangerous disease? Psychologist Lynn Johnson points to two personality traits many lawyers have: perfectionism and pessimism. Johnson, Stress Management.
It's no secret that the legal profession attracts perfectionists and rewards perfectionism. Perfectionism drives us to excel in college, in law school, and on the job. But perfectionism has a dark side; it can produce "a chronic feeling that nothing is good enough." Johnson, Stress Management. Perfectionists "are driven by an intense need to avoid failure.... [T]hey are unable to derive satisfaction from what ordinarily might be considered even superior performance." Don P. Jones & Michael J. Crowley, "I wish I would have called you before ..." (citing Blatt, Sidney J., Ph.D. “The Destructiveness of Perfectionism: Implications for the Treatment of Depression,” American Psychologist, Vol. 49, No. 12, pp.1003-1020 (1997)). According to Johnson, perfectionism raises levels of the stress hormone, cortisol, and chronically high levels of cortisol lead to various health problems, including depression. Id. And when we make the inevitable mistake, perfectionism magnifies the failure. "Perfectionists are more vulnerable to depression and anxiety, harder to treat with either therapy or drugs, and much more likely to commit suicide when things go very wrong." Johnson, Stress Management.
Less intuitive than the prevalence of perfectionism is the prevalence of pessimism among lawyers. A Johns Hopkins study in 1990 showed that in all graduate-school programs in all professional fields except one, optimists outperform pessimists. The one exception: law school. Richard G. Uday, That Frayed Rope, Utah State Bar J., Aug./Sept. 2003. As Uday points out, pessimism helps us excel: it makes us skeptical of what our clients, our witnesses, opposing counsel, and judges tell us. It helps us anticipate the worst, and thus prepare for it. But pessimism is bad for our health: it leads to stress and disillusionment, which make us vulnerable to depression.
How can you distinguish depression from ordinary sadness? Here are the classic symptoms:
- Diminished interest or pleasure in most activities.
- Significant weight loss or weight gain without effort, or loss of appetite.
- Difficulty sleeping, or sleeping too much.
- Psychomotor agitation or retardation.
- Feelings of worthlessness or excessive or inappropriate guilt.
- Diminished ability to think or concentrate, or indecisiveness.
- Recurrent thoughts of death or suicide, or a suicide plan or attempt.
Terry Harrell, Depression and the Legal Profession; see also Joan E. Mounteer, Depression Among Lawyers. For some self-assessment questionnaires, see Lynn Johnson, Stress Management; LawCare, Depression.
If you think you might have depression, get help. Talk to your family doctor; after all, depression is a health problem. And don't be ashamed or afraid of the treatment, whether it's antidepressant medication, therapy, or both. When treated, depression usually goes away. When untreated, it can kill you.
About the Author: Raymond P. Ward, a recovering perfectionist, is an appellate lawyer with Adams and Reese in New Orleans. He blogs on Minor Wisdom and occasionally contributes to Naked Ownership, Appellate Law & Practice, and the New Orleans Metroblog. He serves as publications chair for the DRI Appellate Advocacy Committee and edits the committee's semi-annual newsletter, Certworthy. He writes frequently about legal writing, usually for DRI publications, and has collected many of those articles on his legal-writing website, The Legal Writer.