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Why Does the Practice of Law Tend to Challenge Mental Health?

Jennifer C. Zampogna, M.D., Director of Operations, Lawyers Concerned for Lawyers of Pennsylvania

A significant trove of data collected since 2016 indicates that the prevalence of mental health disorders and problematic alcohol use are significantly higher (upwards of two- and three-fold higher) among the legal profession compared to the general population and even when compared to other highly educated professionals outside of the legal field. 

It appears that for many, these issues develop in law school and are exacerbated by the significant stressors of legal practice. Students who begin law school with no major pre-existing mental health conditions frequently develop mental health challenges before their 3L year and do so at rates higher than other graduate students. 

For legal professionals with pre-existing mental health issues (such as depression, anxiety, an eating disorder, etc.), and those in recovery from mental health and/or substance use disorders, the stressors of law school and legal practice frequently exacerbate these conditions. It is common for individuals to self-soothe or ‘self-medicate’ symptoms of stress, anxiety, attention deficit disorder, and many other mental health issues with alcohol and other substances or maladaptive behaviors (e.g., excessive gambling, eating, shopping, etc.). Furthermore, lawyers in their first ten years of practice experience the highest rates of problematic alcohol use and mental health struggles as compared to their peers with more practice experience. 

The practice of law tends to attract traditionally ‘Type A’ high achievers with perfectionistic traits who often struggle to meet their own self-imposed and often impossibly high standards, which in turn may lead to self-defeating thinking, anxiety, and depression. Law school and legal practice are often hypercompetitive, conducive to black and white, ‘all-or-nothing’ or ‘win-lose’ thinking and adversarial in nature. Lawyers often develop a degree of skepticism or cynicism both as a result of practicing law and in order to successfully anticipate all potential negative outcomes while representing their clients.

It is particularly challenging to ‘leave’ this kind of thinking and approach behind at the office when heading home each day without letting it bleed into and negatively affect one’s personal life, mental and physical health, and relationships over time.

Legal professionals often embrace self-reliance to an extreme, work long hours under significant pressure, and report low levels of autonomy and self-efficacy as well as exceedingly elevated levels of stress and burnout. Lawyers are trained and paid to have ‘all the answers’ and to solve other people’s problems which often makes it challenging for such professionals to reach out for help for themselves, often falsely believing they can just ‘suck it up’ and fix their mental health issues on their own. Fear of damage to reputation and standing and the stigma associated with these issues make it even harder for lawyers to admit that they may need support.

These are but a few contributing factors to the high levels of mental health and alcohol use disorders found among lawyers. The historical culture of law practice and its permissiveness towards frequent alcohol use are significant contributors to the development of problematic drinking as well. The results of a 2016 landmark survey of over 12,000 practicing attorneys in the U.S. revealed that up to 21% of all attorneys and 32% of those attorneys under age 30 exhibited at-risk, problematic drinking with possible dependence based on medically-accepted screening tests, compared to rates of only 12% found in other highly-educated professionals assessed by the same criteria. A startling 28% of lawyers met criteria for the diagnosis of depression (vs. 8.4% prevalence in the general population per the 2020 National Survey on Drug Use and Health), 19% met criteria for an anxiety disorder, and a disconcerting 11.5% reported having suicidal thoughts at some point in their career.

Lawyers Concerned for Lawyers (LCL) is a confidential and safe resource for Pennsylvania attorneys and their family members who may be struggling with their mental health or substance use. Since 1988, LCL has confidentially assisted and supported thousands of individuals who have faced a myriad of challenges (including grief, stress, anxiety, depression, eating disorders, gambling problems, problematic alcohol or prescription drug use, etc.), helping them navigate through dark and difficult times. If you or someone you know is struggling, please call LCL’s 24/7 confidential hotline, call 1-888-999-1941. You may save a life. There is help, and there is hope.

This article is part of a month-long series exploring lawyer well-being as misconduct prevention. Topics include challenges to mental health, stress and burnout, preventative strategies, employer support, and seeking support through LCL.

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