The increased focus on attorney stress/mental health over the past few years has been a welcome and much needed evolution. A lot of discussion has focused on associates who are "working their way up" in law firms, which is understandable given the pressures they face. As a legal recruiter, however, I bear witness to another category of attorneys that suffer more silently: partners. Yes, partners who generate multi-million—or often tens of millions—dollars in revenue and seem like they are on top of the world from outside appearances face similar struggles as associates when it comes to depression and anxiety.

Because I work closely with partners during critical junctures in their careers, I gain a unique insight into what goes on behind the scenes regarding their mental health. Here are my observations:

1. The Stress Does Not Go Away:  Partners with the largest books of business are certainly not immune from depression and anxiety that results from constant stress. Not only do they have to generate top quality work product, but they have to be there 24/7 for their clients. The thought of not responding to a text or email almost immediately can create constant angst. For every client, there's a line of other firms trying to rip that same client away. And living with this pressure to keep clients happy by providing faster, more responsive service is, in one partner's words, "beyond exhausting at times."  I had one partner tell me, "I was eating dinner with my family and saw a client email. For the first time, I chose to put my phone away and wait until after dinner to respond. When I responded an hour later, the client had already spoken to another firm and decided to hire them. It ruined my weekend."  The money and power do not make the stress go away. The stress these partners felt as associates simply transforms into a different type of pressure as a partner.  According to Ed Honnold, a counselor and professional coach for lawyers in Washington, D.C., "Competitive and other external pressures throw many partners into crisis. It compels some of them to find depths of self-insight and maturity that they have not previously developed, and they may seek a crash course in 'growing up.'  They may find the capacity to know themselves more deeply, experience a calm place within themselves despite the external pressures, and find patience and kindness within themselves to complement their ambition and intellect." He goes on to note that, "Others are driven to escape themselves, seek to outrun the pressures, by working even harder, buying multiple expensive homes, and exceeding their earlier ambitions, until their time runs out."
2. Imposter Syndrome is Still Present:  Many highly accomplished partners still have threads —or swaths—of imposter syndrome. For example, sometimes partners are stuck in truly negative work situations but they are reluctant to leave their current firm because they are deeply afraid they will ultimately fall short of the new firm's expectations. I've had a number of partners confide to me that the courting process created excitement but also anxiety and self-doubt. In their most vulnerable moments they confided, "I'm concerned I'm not as much of a superstar as the (new) firm is making me out to be. What if all of my business does not follow and I'm not who they think I am?" The pressures on partners to retain business during a lateral move—which can contain variables outside of their control—is significant and can sometimes lead to professional paralysis and staying put for the wrong reasons, and this "settling" can result in various levels of unhappiness.
3. The Lawyer Brain is Prone to Higher Levels of Stress.  Partners have been rewarded— and are often hired—for being uniquely skilled at finding the problems. Dr. Larry Richard of LawyerBrain LLC states, "According to my research, lawyers have dramatically higher levels of skepticism than average. While this is an essential trait for the high-quality practice of law, the very same trait makes it much more challenging to be an effective leader and even harder to sustain high levels of well-being."

When associates advance to partner, they don't suddenly become glass-half-full people when the glass-half-empty thinking was often the key to their success. For me, I am blessed and cursed with a lawyer brain, and am open with candidates that I'm not immune from this myself.  I have been taking antidepressants since I was 18 (my grandparents were Holocaust survivors, so worrying/vigilance is part of my DNA). The part of my brain that enables me to focus on the smallest of details, anticipate what could happen three steps ahead, and quickly tune into the feelings of others is a blessing in my professional life and has directly contributed to my success. But it also has ancillary impacts that can make the bumpy parts more rocky at times, which is why the medicine is a wonderful thing. It's a small shock absorber for those of us who may have a little less padding in our DNA for when life throws sharp curveballs. And many partner candidates have confided the same to me when we "get real" about our lives. The truth is that antidepressants and seeing therapists are much more common at the highest levels of success than people may fully realize. To quote Dr. Richard again, "Lawyers are also low in psychological resilience—they're thin-skinned. This makes them cautious about revealing or even acknowledging their shortcomings."