Mental Health Challenges Among Lawyers: In Defense of Conventional Medicine
The mental health crisis in the legal profession is real. Conventional medicine helps thousands of lawyers with mental illness lead successful, productive lives. To suggest otherwise is dangerous.
January 30, 2020 at 03:03 PM
4 minute read
Recent years have seen a welcome increase in attention to the topic of mental health in the legal profession. Nearly everyone agrees there is a problem, with study after study showing alarmingly high levels of anxiety, depression and substance abuse among attorneys.
Various commentators have proposed solutions, and most of that advice is good, but some of it is not. Unfortunately, the recent article "'Ian Was No Different From You': Wife Says Legal Marketer's Suicide Is a Lesson in Addressing Mental Health Challenges," by Marny Morrison Turvill, falls into the latter category.
In her article, Turvill discusses the death by suicide of her husband, who worked as the chief marketing officer for a law firm. She identifies various barriers to mental health treatment that her husband faced, including a lack of time and bandwidth for self-care and an unwillingness "to risk anyone finding out that he had any weakness."
Turvill should be applauded for her courage in writing about her family tragedy and for identifying barriers to treatment that affect many lawyers facing mental health challenges.
Turvill is neither a lawyer nor a mental health professional, which is not necessarily a problem. We should welcome the contributions of anyone with relevant information or advice on this important topic.
But her unconventional approach to eschew medication and instead focus on "root causes" is inconsistent with available medical evidence. Turvill writes, "Medications mask symptoms rather than treating their root cause."
Consider schizophrenia, which Turvill specifically mentions in her article. According to a 2010 study, clinical research "has consistently shown the importance of genetic factors in schizophrenia." (Depression also has a strong genetic component.) Other risk factors for schizophrenia include "various obstetric complications, urban birth or residence, famines, migrant status, and seasonal effects (via prenatal infections, e.g. influenza)." Environmental risk factors include advanced paternal age, cerebral hypoxia, and other pregnancy complications.
There is simply no way to "remedy the root cause" of schizophrenia. The National Institute of Mental Health's website mentions antipsychotic medications, psychosocial treatments, and coordinated specialty care as effective treatments for schizophrenia; nowhere does it mention the need to "find and resolve the root causes" or anything similar.
More generally, people who are managing their mental health by taking medication prescribed by their doctors are following a course of treatment widely accepted as effective in controlling symptoms and enabling patients, including many lawyers, to lead productive, successful lives.
Turvill also writes that one cannot be "truly successful in the law without optimal mental health." This generalization is belied by the thousands of successful attorneys who, through no fault of their own, fight daily battles with depression, bipolar disorder, schizophrenia, anxiety, and addiction.
One need not look far to find examples of such people: Kathy Flaherty is a prominent Connecticut attorney who is bipolar. Mark S. Goldstein, who in 2017 was diagnosed with severe depression, obsessive-compulsive disorder, and anxiety, was recently promoted to counsel in Reed Smith's New York office. Daniel Lukasik built a successful personal injury practice and was named one of "Legal Elite's Top 10" by the Buffalo Law Journal despite suffering from severe depression. Elyn Saks, the Orrin B. Evans Distinguished Professor of Law at USC, has written extensively about living with schizophrenia. As James T.R. Jones, a bipolar law professor, wrote in 2007, "those with mental illness can have full and satisfying professional and personal lives, and they need and should not endure stigma or doubt as to their ability to perform their personal or employment duties."
As with other medical conditions, careful medical management in conjunction with personal decisions and counseling are critical to living with these mental conditions. In addition, exercise, meditation, yoga and other personal wellness practices have been shown to decrease the symptom burden of anxiety and depression. However, these practices are most effective as part of a comprehensive strategy that includes, where appropriate, medication and counseling.
The mental health crisis in the legal profession is real. Conventional medicine helps thousands of lawyers with mental illness lead successful, productive lives. To suggest otherwise is dangerous.
Peter Nemerovski is a clinical associate professor at the University of North Carolina School of Law.
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