Recognizing Mental Health Awareness Month

By: Andrea Ciobanu, Ciobanu Law, P.C.

Since 1949, the United States has dedicated May as National Mental Health Awareness Month. All of us can benefit from focusing on our mental health, as this incorporates our physical health, how we deal with stress, our work-life balance, our relationships with others, and how we feel, think, process, practice, perform, and behave.[1]

Lawyers seem to have a particular reluctance to seek help for depression and mental health issues because they are concerned about appearing weak or negatively affecting their reputation. Some lawyers pride themselves in how much they work – both in terms of hours per week, and years in duration, without retirement in sight. That can be a combination of the work culture, society, the profession, and at your core --your main identity is a hardworking lawyer. It may be difficult to separate the lawyer from ourselves after years of practice. Lawyers we may be, but we are human, after all. And even more than that, as a member of the WLD, you may be a Mother, Wife, Sister, Daughter, Caretaker, Caregiver, and much more.

According to the National Institute of Mental Health, nearly one in five U.S. adults live with a mental illness.[2] According to the National Institute of Mental Health, in 2020, over 21% of adults aged 18 and older experienced some form of mental illness, representing an array of diagnoses, causes and types, ranging from mild to severe impairment in functional wellbeing for those impacted.[3] Estimates from the National Institute of Mental Health suggest that only half of people with mental illnesses receive treatment. According to the CDC, most Americans will suffer from a diagnosable mental illness at some point in their lives.[4] Further, 20% of children currently or at some point during their life, will have a seriously debilitating mental illness.

The U.S. Surgeon General Dr. Vivek Murthy led the first-ever Mental Health Youth Forum, joined by 30 mental health activists and other others to address this “national mental health crisis” among our youth this month in honor of Mental Awareness Month.[5] At this Forum, Dr. Murthy commented:

Suicide is an incredibly painful crisis in our country. People like me and many others have lost family members to suicide and it feels very personal, even though years pass. [. . . ] What we've got to do is make sure number one that people don't feel like they have to suffer in silence and in shame if they are in fact having thoughts of suicide.

The suicide rate among young people had increased 57% in the decade prior to the pandemic, Dr. Murthy explained, and the pandemic has also exacerbated a mental health crisis among adolescents. "It starts with making sure people feel that it's OK to ask for help," he says. "Secondly, we've got to make sure that help is there. This is where peer support communities can be so powerful, as well, because one of the greatest challenges about struggling with mental illness is the isolation that comes from that."[6]

Prior to the COVID–19 pandemic, suicide rates and overall mental health concerns had already been on the rise for a decade.[7] In 2018, for young adults ages 20-24, dying by suicide was the second leading cause of death.[8] 

The American Academy of Child and Adolescent Psychiatry reports that due to the social isolation, fear, disruption, grief, and loss that the pandemic caused for so many children, in 2021 visits to the emergency room for mental health emergencies were up by 31% for children ages 12-17 and attempted suicides were up by 51% for girls in this same age group when compared to 2019 data.[9] Proportionately, rates of depression, anxiety disorders, suicidality, loneliness and a host of other mental health issues continue to rise.

On April 30, 2021, The White House posted a proclamation from President Biden that emphasized how significantly the COVID-19 pandemic has impacted the mental health of many while simultaneously creating barriers to treatment. Many lawyers have reported increased stress as a result of the pandemic – juggling even more, working from home with children, serving as the children’s facilitator and teacher, as well as Zoom Fatigue. Even if your children are back to school, many are still dealing with the aftermath of that stress, or children playing some “catch-up learning” when they go back to school.

Stress can manifest itself through mental health issues and physical symptoms such as: headaches, muscle pain, and digestive issues. Left unchecked, excessive stress can contribute to long-term mental health issues. These conditions may include: depression, anxiety, insomnia, burnout, as well substance-addiction problems—all of which are prevalent in the legal profession. 

Certainly, lawyers are not immune from the adverse consequences of stress and excessive stress. Lawyers are high achievers by necessity. To succeed in the competitive, pressure-filled legal industry, successful attorneys have exceptional work ethic and perseverance. But that heightened capacity, competition, pressure to perform and achieve, mounting deadlines, juggling work life balance, and dealing with a pandemic as well as other stressors, unfortunately, also contributes to increasing levels of lawyer stress. Other factors that increase lawyer’s stress are difficult clients, difficult matters, long working hours, family challenges, changing laws, cybercrime and data security, inadequate support, law school debt and the constant need to achieve and succeed.

Even if this work schedule does not lead to serious mental health issues, it can lead to burnout.  Burnout is a state of chronic physical, mental, and emotional exhaustion resulting from prolonged stress.[10] Burnout can be characterized by feeling constantly overwhelmed and having more difficulty mentally meeting the demands of work and personal obligations. It normally leads to a loss of motivation and interest in work, life and activities you typically enjoy. Lack of control over your work, excessive workload, unclear jobs or expectations, lack of manager support recognition, unchallenging or monotonous work, and a stressful environment can all lead to burnout.[11] Attorneys suffer from a high rate of burnout.  If we are burnt out, our clients suffer, our practice suffers, our families suffer, and we suffer.

Lawyers can also suffer from compassion fatigue.  Believe it or not, lawyers have feelings, and those feelings can be draining. According to the Chief of Psychology for the University of Vermont Health Network, compassion fatigue is “a biological and physiological response where you are so exhausted—physically, emotionally, psychologically—that you no longer have the personal reserve to feel for other people.”[12] It can lead to detrimental health effects like headaches and chest pain. It can also lower job performance, productivity, and morale.[13] 

Compassion fatigue originally described the experience of professionals in high-stress and emotionally demanding jobs, and this can also lead to professional burnout. While compassion fatigue had high levels in the medical field, it can happen in the legal field as well, because we are dealing with our client’s problems, trauma, pain, and legal battles. We are also often dealing with our clients at the worst time – and very stressful time in their lives as we are navigating legal battles with them.

This form of fatigue is sometimes called a “secondary stress reaction,” “secondhand shock,” “secondary traumatic stress,” or “vicarious trauma.”[14]

Whatever we refer to it, the general feeling is the same and the stress levels are high and the negatively affects our relationships and our work productivity. Compassion fatigue occurs when these triggers and experiences start to affect your thoughts, moods, and well-being outside of work. Being affected by your work is a normal part of caregiving professions, but when the feeling becomes overwhelming, you may experience compassion fatigue. Some additional symptoms of compassion fatigue also include: drastic shifts in mood, becoming pessimistic or cynical, becoming overly irritable or quick to anger, experiencing detachment, addition, as well as feelings of anxiety or depression.[15]  You may feel demoralized or question your effectiveness as a professional. You may experience trouble concentrating or being productive in your personal or professional life.[16]

Additionally, when we are stressed, our relationships with friends, family, and even ourselves suffer. Stressed-out lawyers get into a perpetual cycle of constant working and working their minds constantly—especially with the constant barrage of work-related message to our smartphones even on the weekends and holidays, or when attempting to spend time with loved ones. If stress leads to overwork that tips the scale of your work-life balance in a negative way, that means less time—or less quality time—with the people you care about.[17]

Acute bouts of stress and chronic stress can manifest into physical symptoms like fatigue, insomnia, exhaustion, fatigue, changes in appetite, muscle tension and pain, stomach and digestive issues, headaches, and more.[18]

The reason for these negative manifestations of stress in your body is because stress activates a human “fight-or-flight” response in the body and the release of stress hormones. An overabundance of stress hormone in your body can lead to physical symptoms.[19] 

Certainly, an overly stressed lawyer can adversely affect our clients and practice, as well as our personal lives.  However, there are a variety of resources and coping mechanisms we can implement in our lives to cope with the stress or lessen the stress in our lives.

One shift we can all make is to begin to view mental health the same as we do our physical health. When we get sick or become at risk for ailments such as diabetes, kidney disease, or suffer from a broken bone, in most cases, we would get it checked out by a medical professional and look for ways to heal. We would not think ourselves as weak to repair a broken bone. Likewise, we do not have to suffer in silence or shield ourselves from the reality that we are human too. We do not have to think of ourselves as weak by taking care of our mental health.

Additionally, just as there are ways to maintain good physical health by eating a balanced diet and being active, there are routines we can do to maintain our mental health. These include practices like maintaining a healthy diet, drinking sufficient water/hydration, getting a sufficient amount of sleep, taking short breaks throughout the day for a work, getting outside, remembering to slow down and find our pause, treating ourselves, talking positively to ourselves, practicing gratitude and self-compassion, connecting with others, dancing, engaging in art, sports or other hobbies, playing and listening to music, exercising/staying active, knowing your limits and draw boundaries, taking time for yourself, going on a family vacation, getting massages, keeping your hobbies, making time for loved ones, practicing mindfulness, not placing too much pressure or guilt on ourselves, as well as setting reasonable goals for yourself. Yes, sometimes it is better said than done, and in practice, and in reality, it can be difficult to implement.

There are small steps we can take, such as: getting a small bike peddler for under the desk, an adjustable standup desk, taking a short walk during lunch, having a gallon of water at our desk to drink throughout the day, encouraging networking and meeting up with others in an active way (walking together, working out together, etc.), parking further out to get more steps throughout the day, taking a bike to work (if feasible), and the like.

In comport with these efforts and goals, if you are planning to visit the IndyBar Bench Bar & Conference in Louisville, please join the WLD at 7am for an early morning walk/run, on Friday, June 17th.  We will meet in the lobby of the Omni hotel.  It will be great to get together and implement some of the suggestions for promoting our mental and physical health, all the while networking with WLD Members!

If you think the stress in your life is too overwhelming, there are several resources for lawyers.  Our WLD has an amazing mentoring program. If you want to confide in someone, please confide in your mentor or reach out to another experienced WLD member that you may trust.

IndyBar has a HEAL (Helping Enrich Attorneys Lives) aims to provide support and/or assistance during times of personal and professional crisis.[20] HEAL was created to assist lawyers, judges and paralegals in the Indianapolis metropolitan area who are personally experiencing a crisis or are affected by the crisis of someone close to that person, such as a spouse or professional colleague. The HEAL program is available to all legal professionals practicing in the Indianapolis area and is not exclusive to IndyBar members. The HEAL program is available to individuals experiencing matters such as health conditions, a death of a loved one, weather or other disaster related events or a major life crisis or setback. While The HEAL program is not an appropriate vehicle to assist those struggling with substance abuse, severe mental health issues, gambling issues or other problems that require more specialized assistance, HEAL may assist in matters that are causing severe stress in your life, such as death of loved one or caring for a sick loved one.[21]

For more severe mental health issues, you may reach out to the IndyBar Lawyers Assistance Program. The Lawyers Assistance Program provides information, assistance and support for attorneys, and to those who are aware of attorneys who are struggling with possible substance abuse, mental health issues, gambling addictions and temporary disabilities.[22]

Our JLAP is a wonderful resource, and they can assist on the phone or email, and even often do so after hours.[23] The program is completely confidential and has a variety of volunteer lawyers and judges assisting.  There is no charge, and they will listen, provide support, provide resources, and answer questions.  You can agree to be paired with a JLAP volunteer for additional support at no cost to you.

Whatever the case, please seek support if you need it, and be a friend and support to our fellow lawyers that are going through stressful events in their lives, or other serious health issues. Please know that we also care about all our WLD Members. If you need help, please reach out, and we are here to help the best that we can. 

Sending everyone well-wishes and happy vibes for Mental Health Awareness Month and beyond!