This is the first article in a three-part series on aspects of the legal profession that contribute to high rates of mental health problems and addiction in the industry.

Let's face it. Becoming a lawyer, much less succeeding in the practice of law, is an enormous task.

It's not the only profession that requires rigorous academic study followed by extreme dedication in order to excel. And it's not the only career where failure can mean disaster for those counting on a practitioner's expertise.

But the challenges and demands specific to being a lawyer can lead individuals down a path toward mental health struggles. A 2016 study by the Hazelden Betty Ford Foundation and the American Bar Association found that 28% of lawyers have depression at some level, and 19% have symptoms of anxiety.

"Does becoming a lawyer cause depression? I'm often asked that. And I say no, it does not. But is it a significant risk factor for depression? Yes. It is," said Dan Lukasik, founder of LawyersWithDepression.com, and director of the Workplace Well-Being for the Mental Health Association in Buffalo, New York.

Lawyers in each corner of the profession—prosecutors and public defenders, in-house counsel, government lawyers, solo practitioners, and lawyers at firms large, medium and small—all face some of the same universal pressures.

"You have this constellation of issues that create tremendous stress and then really put lawyers at the risk of being vulnerable to mental health or substance abuse issues," said Eileen Travis, director of the New York City Bar Association's Lawyer Assistance Program.

Industry watchers and psychologists pointed to several deeply ingrained features of the legal profession: lawyers must always be ready to do their job at the drop of a hat; they must vigorously represent their client or cause at all costs, but may not do the same for themselves; forsaking one's own well-being in favor of embodying a lawyer's mindset at all times is a badge of honor.

Taken to the extreme, these realities have created a population of tired and lonely lawyers.

"It's kind of like an endurance contest or something. This big reservoir of resentment … fills up with rage," said William Meyerhofer, a psychotherapist and former Sullivan & Cromwell lawyer. "It leaks out in all these behaviors where you scream at your girlfriend, or go home and get stoned every night, or spend the whole night playing video games."

The First Casualty: Sleep

Want happier, healthier lawyers? Let them go home and turn off their phones.

Yes, it's easier said than done. Many lawyers get into the law—which they view as a profession, not just a job—because they view it as their calling.

They are typically high-achieving people for whom sleep is just one of many sacrifices along the course of their advancement. That begins even before law school and continues well afterward, said Tyger Latham, a clinical psychologist in Washington, D.C., who counts numerous lawyers among his clients.

"'If I'm going to get this brief done, I'm going to have to pull an all-nighter'—if that's your frame of reference, that's presumably what you're going to end up doing … and it probably continues until it no longer works," Latham said.

Lukasik referred to this as a lack of "good coping skills," that often predates a person's entry to the legal industry.

"They're overachievers, they're used to living their life with their pedal on the gas the whole time," Lukasik said. "Just like with a car, you can't run your engine at full force and expect it not to fall apart."

Health effects aside, functioning on too-little sleep can also stunt performance, both in the short and long term.

"When you're overtired you do a lot of unconscious acting out on unexamined feeling," Meyerhofer said. "You have a very short fuse. You start bursting into fury … suddenly crying.

"I used to wonder as a lawyer, if they had just given me a couple days to sleep for 15 hours, I would have been a different person," he said.

Sleep deprivation has a similar effect to intoxication, said Jarrett Green, who works with lawyers to address the problems of a high-stress environment. Green is also a co-founder of the Mindfulness, Stress Management and Peak Performance Program at the University of Southern California Gould School of Law and a former associate of Skadden, Arps, Slate, Meagher & Flom.

"If you were walking around saying it's 11 a.m. and I'm wasted and I'm going to go work on this $2 billion transaction, the firm would be fired. People are overtly boasting about something that's not only super dangerous health-wise, but also super dangerous professionally," Green said.

And the deprivation can feed on itself.

"It can be a bit of a chicken-and-egg phenomenon," Latham said. "Stress can make people lose sleep, but lack of sleep makes you more susceptible to depression and anxiety."

Dr. Shelby Harris, a psychologist who specializes in behavioral sleep medicine, said sleep-deprived people start to see cognitive deficits. And sleepiness, which may seem like a minor problem in the short term, can create some bad habits with major consequences over time.

"We start to see issues with depression, anxiety increase," Harris said. "More risky behaviors as well. … People start to rely more on things to either help them sleep or feel less depressed."

A lack of sleep is sometimes the first reason a person turns to harmful substances, Latham said, to stay up later, or to silence the anxious thoughts that keep them up at night. Harris said the same. She said she has patients who are addicted to Xanax or Klonopin, or alcohol, because of insomnia.

"About half my patients are addicted to something that helps them sleep," Harris said.

Step Away from the Smartphone

At law firms, billable hour requirements certainly play a role in sleep deficits. When a person is expected to bill over 2,000 hours a year, that alone takes up nearly eight hours a day, virtually ensuring that lawyers will be working after hours. And that eats into time for basic physiological needs, such as sleep.

But the billable hour alone isn't to blame.

"It's not the 2,000 hours that kills us. … It's all the time people are working around the clock that we can't bill for," Green said.

Billing a certain number of hours per day isn't a problem in itself, Green said, but it all comes down to how long it actually takes to bill those hours.

Lawyers who get no time to rest when they're not billing—because they are constantly at-the-ready, checking email every few minutes—generally take a lot longer to get around to the work that's actually billable, Green said.

The question is whether that sense of urgency is really always necessary.

"In general our culture is becoming more and more a 24-hour, seven-days-a-week society. We just don't know how to turn off," Harris said. But lawyers who never disengage from work can actually become less effective.

That's not just limited to the legal industry. Laptops and cellphones have made it easier for clients to reach their lawyers, and partners to reach their direct reports, at any time of day. So many feel the need to be constantly ready to work.

Dr. Elizabeth Tillinghast, a former practicing lawyer who is now a psychiatrist in New York, said she actually felt a relief when she became a doctor. In medicine, she said, "you are on call sometimes, but you know when you're going to be on call."

"When you're a lawyer … you're always on call. And the workload is so unpredictable," said Tillinghast, who treats many lawyers and remains involved in bar associations.

Bagging the billable hour would require a major overhaul to the typical law firm business model and lawyer-client dynamic, one that many firms would find impossible, at least as a near-term solution.

But the billable hour alone isn't the issue, experts said. After all, it's been a cornerstone of the business model for decades. The newer entrant, for a number of professions, is the constant attachment to work through smartphones, laptops and remote network access.

With that in mind, Green said firms can work toward improving lawyers' mental health without abandoning the billable hour. The key is helping lawyers find ways to detach and reattach to their work more efficiently. That means allowing them to send calls to voice mail or let email go unread for a certain number of hours each day. Having that time to recharge makes it easier to focus during the true workday, Green said, so they can complete eight billable hours, for example, in an 11.5-hour day, instead of a 13.5-hour day.

"Distractibility is the No. 1 issue we talk with all attorneys about. … One of the No. 1 coping mechanisms for stress is distractibility and entertainment," Green said.

Just as having too little sleep builds on itself, so too does getting enough rest, he said. Getting rest makes lawyers more productive during work hours, which makes the day shorter, then allowing for more rest, and even better productivity.

"You have to actually pull away from the work, so we can accomplish more in less time," Green said. "We can become a lot healthier within it. We can have a lot less work time, while still hitting the goal."

But, Harris warned, law firms have to really allow their lawyers to disconnect if they want to see results.

"Firms are having me start to come in and give talks on wellness and sleep … but then we're still giving the signal of 'you also have to produce,''' she said. "It's a mixed message these firms are giving."

Some other firms, she noted, want to talk about wellness, but when sleep enters the conversation, they ignore it. But well-rested people are both more productive and less depressed, she said. "It's a cycle that has to get broken at some point," she said.

One way to help break the cycle? Lawyers should stop taking their smartphones to bed every night.

"We need to start there … just setting hours where you say, 'I'm not on call right now,'" Harris said.

Part two of this series will discuss isolation and loneliness in the legal profession.

Read More

Minds Over Matters: An Examination of Mental Health in the Legal Profession