The Role of Stress and Anxiety in Depression in the Legal Profession
By Dan Lukasik
Lawyers suffer from clinical depression at an alarming rate. I have been
a litigator for more than 20 years and am one of them. In the beginning
of my career, however, I didn’t suffer from depression. But I did
have trouble managing the stress of my practice. Over time, this constant
stress developed into anxiety. I started feeling like I couldn’t control
everything. I would go to bed fearing what problems and disasters were to
confront me the next morning. After years of this, the pendulum swung. I
went, more and more, from states of anxiety to states of depression. Why
did this happen? It took me a long time to understand.
Depression develops because of a complex interplay of genes,
neurochemistry, emotional history, and personality. Recently,
scientists have been focusing in on the connection between stress
and anxiety and the role they play in producing and maintaining
depression. This subject should be of great concern to lawyers
who frequently report feeling stressed or burned out in their
practices.
“Stress” is anything in our environment that knocks
our bodies out of their homeostatic balance. The stress response
is the physiological adaptations that ultimately reestablish
balance. Most of the time, our bodies do adapt, and a state of
balance is restored. However, Dr. Robert Sapolsky, an expert
on stress-related illnesses, warns: “If stress is chronic,
repeated challenges may demand repeated bursts of vigilance.
At some point, this vigilance becomes overgeneralized leading
us to conclude that we must always be on guard—even in
the absence of stress. And thus the realm of anxiety is entered.” (Scientific
American, Robert Sapolsky, Ph.D., Volume 289, No. 3, September
2003 at p. 88.)
Stress went on too long in my own life as a litigator. I had,
indeed, entered the realm of anxiety. For me, this anxiety felt
like I had a coffee pot brewing 24/7 in my stomach. I became
hypervigilant; each of the files on my desk felt like ticking
time bombs about to go off. Over time, the litigation mountain
became harder to climb as the anxiety persisted over a period
of years.
Dr. Sapolsky states: “If the chronic stress is insurmountable,
it gives rise to helplessness. This response, like anxiety, can
become generalized: a person can feel they are at a loss, even
in circumstances that she can actually master.” (Ibid.)
Helplessness is a pillar of a depressive disorder. It becomes
a major issue for lawyers because we aren’t supposed to
experience periods of helplessness. We often think of ourselves
as invulnerable superheroes who are the helpers and not the ones
in need of help. Accordingly, lawyers often don’t get help
for their depression and feel ashamed if they do.
Many lawyers do not appreciate this connection between their
stress and anxiety and the risks they pose for the development
of clinical depression. Indeed, the presence of comorbid anxiety
disorders and major depression is frequent and, according to
some studies, as high as 60 percent. Maybe this connection helps
explain the studies that find such high rates of depression for
lawyers. In many ways, we are too stressed and anxious too much
of the time. The human body was not designed for such punishment.
Dr. Richard O’Connor, author of the best-selling book, Undoing
Perpetual Stress: The Missing Connection Between Depression,
Anxiety and 21st Century Illness (Berkley
Trade, 2006), states that depression “is stress that has
gone on too long” and that many people with depression
have problems dealing with stress because they are not “stress
resilient.” Depression is not the result of some central
character flaw or weakness, but because of a complex interplay
between genetics and one’s experience over a lifetime.
This interplay is played out daily for lawyers in how their bodies
and brains deal with stress and anxiety.
Our bodies haven’t changed much in the last ten thousand
years. We have a wonderful defense mechanism wired into our nervous
system called the fight-or-flight response. Dr. Sapolsky, in
his acclaimed book, Why Zebra’s Don’t Get Ulcers (Holt
Paperback; 3rd edition, 2004), walks us through the connection
between this ancient defense mechanism and depression. When confronted
with a threat—whether real or perceived—this
response kicks in and floods our bodies with powerful hormones
that propel us into action. This was an essential survival device
for our ancestors who lived in the wild and would have to flee
beasts that were trying to eat them or fight foes that were trying
to kill them.
Lawyers don’t face these types of real life-or-death threats.
Instead, lawyers perceive life-or-death threats in their
battles with opposing counsel while sitting in a deposition or
sparring in the courtroom. Our bodies respond as if they
were being chased by that hungry lion. Accordingly, the stress
response can be set in motion not only by a concrete event but
also by mere anticipation. When humans chronically and erroneously
believe that a homeostatic challenge is about to come, they develop
anxiety.
Over time, this type of chronic anxiety causes the release of
too much of the powerful fight-or-flight hormones, cortisol and
adrenaline. Research has shown that prolonged release of coritisol
damages areas of the brain that have been implicated in depression,
the hippocampus (involved in learning and memory) and the amydala
(involved in how we perceive fear).
If we don’t as litigators learn better ways to deal with
stress and anxiety, we expose ourselves to multiple triggers
that can cause or exacerbate clinical depression. It is in turning
and facing those things that make us stressful and anxious that
we provide ourselves with the best protection against depression.
Dan Lukasik helped form the partnership of Cantor Lukasik Dolce & Panepinto, P.C. Mr. Lukasik is currently a partner and represents plaintiffs in personal injury cases and civil rights matters in state and federal court. He is the recipient of the Distinguished Alumni Award for Community Service from the University at Buffalo Law School Alumni Association for his work in helping lawyers with depression. In addition, he and the Erie County Bar Association were given the New York State Bar Association's Award of Merit for the creation of the Committee to Assist Lawyers with Depression in Erie County. Please visit his website, www.lawyerswithdepression.com.
© Copyright 2009, American
Bar Association.
