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This story may start like a fairy tale, but it’s anything but. Once upon a not-too-distant time, a corporate attorney from Austin whom we’ll call Jessica (because she is reluctant to use her real name) lost her job during a corporate restructuring. While considering new job opportunities, Jessica confronted a startling fact: She was suffering from depression and had been for some time. For Jessica, the actual practice of law fell far short of the idealistic expectations of helping others that prompted her to attend law school. In fact, dealing with clients — instructing and urging them to comply with the law, haggling over bills — wore her down. Moreover, although she had mastered various areas of the law, Jessica never found an area that particularly interested or excited her. “Something was definitely missing,” she says. “Things started to surface that were probably already there,” she says. “But I’d been too busy to notice. I suddenly realized that I couldn’t become happy no matter what. I’d have something very wonderful happen in my life, and I couldn’t muster up enough enthusiasm to even react. It frightened me because I couldn’t find my way back” to the way things used to be. A sense of overwhelming sadness and loss of appetite led Jessica’s husband to suggest she get help. Jessica called the State Bar’s Texas Lawyers’ Assistance Program, which recommended several counselors, beginning what she describes as a slow process of recovery from depression. Today, she serves as an attorney volunteer for TLAP, to whom other distressed lawyers can turn. Jessica is hardly alone. And her wish for anonymity is not unusual. Because society tends to stigmatize mental illness, attorneys suffering from depression frequently do so in silence rather than risk exposure by seeking help. Unfortunately, lawyers may go from having feelings of great sadness to being self-destructive to addiction — drugs and alcohol often are used to self-medicate — to committing suicide. Why? Because they see no way out of the devouring pit called depression, says Jane Pendergraft, a Houston-based psychotherapist who counsels a number of Texas attorneys. “Depression is really hard to spot and is as strongly denied — if not more strongly denied — than alcoholism or [other] addictions,” says Tim Sorenson, a civil litigator with Sorenson & Hach in Dallas and a member of Lawyers Concerned for Lawyers, a privately funded program found in Texas’ major cities. The TLAP frequently refers lawyers in distress to LCL, which reaches out to those suffering from addiction or depression. Sorenson, who describes himself as “an alcoholic who sobered up back in 1981,” spiraled headlong into depression in 1994 after physically collapsing during a demanding trial. “Everyone thought it was a heart attack,” says Sorenson. “What we found out was I had dehydrated myself through stress. I remember looking up at the emergency lights thinking, ‘Is this all there is? Forty-eight years old and nothing to show for it?’ For the next six months there was not a single day that passed that I didn’t think of killing myself,” recalls Sorenson. “My kids are the only thing that kept me from doing it.” At the time of his collapse, Sorenson was a solo practitioner. From 1982 to roughly 1986 he primarily did transactional work and real estate law, which he says was not particularly stressful, but he returned to litigation when the real estate market fell apart in Texas. “Let there be no doubt,” Sorenson says, “trial work tends to be very stressful. Whether it be criminal or civil, you’re dealing with deadlines, dealing with clients’ egos, dealing with so many different variables that it’s extraordinarily stressful. In addition, you can’t just try one lawsuit. You may have as many as 12 or 15 going at one time, and that adds to chaos.” Yet Sorenson says being a lawyer didn’t make him depressed. “If anything, it was what I clung to. I love it. It is my passion in life,” he says. The riddle of his depression is that he doesn’t know where it came from. Yet it became so debilitating he could scarcely work. Although in hindsight he recognizes a number of factors symptomatic of his depression — lack of concentration, lack of socialization, inattention to the physical demands of his body, financial concerns — Sorenson says that before the collapse it never occurred to him that he was depressed. Sorenson spoke with an attorney from LCL who has been a mentor, ostensibly to get advice on his career. After about five minutes, the attorney mentioned that Sorenson looked depressed. “That’s all it took,” says Sorenson. “I opened up to him, told him I’d been thinking about suicide. We got on the phone and made an appointment to see my doctor, a psychiatrist.” The doctor put Sorenson on an anti-depressant medication and explained the dynamics of depression. Although the medication helped abate his thoughts of suicide, Sorenson’s doctor recommended cognitive therapy that would help combat his feelings of worthlessness and get rid of some of the “bad thoughts” that plagued him. “He told me point blank that medication was only part of the solution, and I was going to need to get therapy, I was going to need to do some work . . . [but] he assured me there was a solution.” CHICKEN OR THE EGG? Texas attorneys have grappled with depression since, well, since as long as there have been Texas attorneys. Take, for example, James Collinsworth (1806-1838) for whom Collingsworth County is named. His r�sum� is long and varied: soldier in the Texas Army during the Texas War of Independence; delegate to the Texas Republic constitutional convention; Texas Republic secretary of state; attorney general of the Texas Republic; member of Texas Republic Senate; and justice of the Texas Republic Supreme Court. Despite these accomplishments, Collinsworth, while a candidate for the presidency of the Texas Republic, committed suicide by jumping off a boat into Galveston Bay. Similarly, George Campbell Childress (1804-1841) — lawyer, statesman, author and signer of the Texas Declaration of Independence and for whom Childress County was named — slashed his abdomen with a bowie knife and died shortly thereafter in Galveston. Don P. Jones, director of technology and strategic initiatives at the State Bar of Texas who served as director of TLAP from 1992 until 1999, says while statistics involving Texas attorneys, depression and suicide are difficult to find, general statistics relating to lawyers and depression are nothing if not depressing. “It really indicates that something is amiss somewhere — possibly with our approach to the profession,” Jones says. “It’s such a chicken and egg problem. … Does the practice of law cause depression or [do] people who are prone to depression practice law? I don’t know,” Jones says. Jones, who has studied lawyers and depression for years, believes that problems may begin as early as law school. Law students frequently are idealists. Many also are introverts. Both characteristics get challenged in law school. Idealism gets challenged when societal wrongs are reduced in torts and contracts classes to dollars and cents; moral issues appear murky when a price tag is attached. “If you’re an idealist, it rocks your world,” says Jones. For the introvert, having to respond in class — an unforgiving environment — under pressure of the Socratic method also may be jarring. You may come in idealistic but leave disillusioned, he says. Practicing law is a “strongly intellectual endeavor, with a certain degree of cultural machismo built into it,” Jones says. The result is that attorneys are encouraged to think their lives rather than feel it. “It’s worse than a doctor’s detachment,” he says. Lawyers only want to display emotion in court if it helps their case. Associates at law firms are expected to tough it out. If lawyers become alienated from emotions, they’re going to be depressed sooner or later, says Jones. After serving on an American Bar Association panel addressing attorney depression, Jones co-authored an influential article about lawyer depression and suicide, with attorney Michael J. Crowley, now deceased, whom Jones credits as the impetus behind starting the TLAP. The piece, which appeared in the ABA’s March-April 1998 Bar Leader, cites sobering statistics culled from a variety of sources and identifies warning signs a suicidal or deeply depressed individual may display. “It’s predictable that lawyers would have a high rate of depression,” says psychotherapist Pendergraft, noting depression is often triggered by stress. “Lawyers live in a very high-stress environment — that’s part of it [the job]. There’s generally a very high demand for time commitment and deadlines that often keep life out of balance with personal care-taking and relationships outside of work. That interacts to increase stress — when you don’t have time to take care of yourself or your relationships.” In addition, Pendergraft says, many lawyers go into the field because they want to “make a difference, help people,” but then find the actual practice of law is “quite disillusioning.” Foster believes one key stressor is that lawyers deal with people in crisis who come to them for solutions to problems. Because there’s a lot at stake, not only emotionally, but also financially for the clients, attorneys feel pressure to help them. But stress — clinically defined as the “internal process by which we deal with external pressure or pain” — isn’t necessarily all bad, says Irving, Texas-based therapist Dr. William Gray DeFoore, who estimates he’s treated hundreds of attorneys. “One person can channel that tension and energy into adrenaline, into motivation, into determination to win the case. Another person gets a migraine headache or a stomachache. Another person goes into a panic and cannot sleep at night. So it’s the individual differences in terms of how people deal with those particular circumstances that make the difference.” That said, DeFoore believes stress is a byproduct of the adversarial nature of the legal profession — even for attorneys who don’t go into a courtroom. “There’s a certain amount of tension related to the inherent conflict that is going to be in any attorney’s professional repertoire in their day-to-day activities,” DeFoore says. Managing stress is the key. COUNSELING FOR COUNSEL In response to a growing need, the state Bar established TLAP in 1989 to help identify, intervene and rehabilitate Texas attorneys and law students whose professional performance is impaired due to illness — mental or physical — including substance abuse. Staffed by a full-time director, attorney Ann D. Foster; a full-time assistant director, attorney Chris Long, who also has a master’s degree in social work; and Alan Lovett, who has a master’s in psychology and is a licensed chemical dependency counselor, TLAP operates a 24-hour anonymous hotline that lawyers, concerned family members and friends can call to report an attorney in distress, whether because of addiction, depression or stress. TLAP is strictly confidential and has no connection to the Bar’s disciplinary arm, so callers need not fear being reported to disciplinary authorities. There are about 600 TLAP volunteers statewide, Foster says. Since its formation, TLAP has assisted more than 3,000 attorneys for substance abuse, chemical dependency, depression and other mental, emotional and physical difficulties. Foster and Long note that there has been a significant increase over the past two years in those seeking help for mental health issues, most notably clinical depression. They attribute the rise to the fact that they have been conducting more educational programs. “The more lawyers talk about it, the more calls we get,” Long says. “People are learning that TLAP is for more than drug and alcohol dependency.” Last year, TLAP created a new category for callers who appeared to be struggling with a combination of chemical dependency and mental health issues, especially depression. “Depression is not sadness or feeling blue,” Pendergraft says. “It’s not about not being able to cope or being weak, but not being able to cope and feeling weak are symptoms of the depression. When someone is depressed, they may hate themselves for being depressed. They may ask, ‘Other people go through this and they are fine, so what is wrong with me?’ The whole disease brings such a state of hopelessness and removes the feeling of meaning and purpose and pleasure in life so that everything is affected. If nothing matters, then why bother to take care of yourself, why bother to take care of your relationships, why wake up in the morning?” Classic symptoms of depression, says Pendergraft, may include: a change in appetite (either an increase or decrease); a change in sleep patterns (either waking up frequently or having trouble waking up); a feeling of hopelessness; loss of pleasure from things once enjoyed; a decrease in libido; and a change in energy level (everything takes more effort). “Once all these things get going, they start to feed on themselves,” she says. “The less you sleep the less energy you have, the less energy, the less things matter. It’s circular.” But most attorneys don’t have time to deal with the fallout from their depression because, more than other professionals she counsels, Pendergraft says lawyers are plagued with time-management issues derived from the extreme demands of their profession — to spend more time in the office, to increase billable hours, to be prepared for every contingency. Sorenson believes that no attorney should practice law without a mentor or group of mentors. “You need to have other attorneys around you whom you trust,” he says. “If you start building barriers around yourself, that is your first sign of danger.” Entertaining passing thoughts of suicide is also a sign of trouble as is, frequently, uncontrollable rage. In addition, neglecting outside interests or practicing law to the exclusion of one’s family or friends may indicate incipient depression. And depression can kill in more subtle ways than suicide, says Pendergraft — such as heart disease and compromised immune systems — because of physiological changes in the body once depression sets in. But depression is treatable through intervention, and Pendergraft recommends intervening in “every area that makes us a human being — physically, mentally, emotionally and spiritually.” American Psychiatric Association statistics show just how treatable depression is: “The majority (80 percent to 90 percent) of people who receive treatment experience significant improvement, and almost all individuals derive some benefit from medical care.” And there are ways to reduce stress and supply balance. Obviously, exercise is essential, says DeFoore, because stress affects the physical body. If a person’s health is impaired, there will be blockages to the flow of energy, which will decrease the ability to manage stress. It’s a vicious cycle once it gets started. Learning how to relax, learning how to breathe deeply, is also important, Pendergraft says. Prayer, meditation and yoga are proven stress relievers, says Pendergraft. Recognizing negative thought patterns and changing them also is critical, Pendergraft says. For example, if you lose a trial, the “depression voice” will say, “I’m a loser. I’m never going to win.” A correct, healthy thought is, “I’ve won before, and I will win again,” Pendergraft says. Pendergraft notes the importance of learning to find meaning and purpose in your work as a lawyer. In some cases, medication is essential, Pendergraft says, because it can alleviate some of the physiological changes that people undergo during depression. Sorenson says medication and cognitive therapy can be essential for recovery from depression. When lawyers are depressed, they should get help, Pendergraft says. “It is treatable, it can get better.” Dallas lawyer Sorenson is proof. He says his recovery took three years. “I learned that I suffered from a disease instead of being a moral degenerate,” says Sorenson, who now helps other attorneys find the road to recovery through LCL. Sorenson stresses that he is not the only lawyer helping colleagues fight depression. He estimates that there are hundreds of other lawyers in Texas in some form of recovery who are actively helping other lawyers recover from “very debilitating diseases,” who do so out of a sense of duty to the bar and the public. Notes Sorenson, “I can’t go to the courthouse without running into a brother or sister, you know? It’s kind of like having a secret handshake.”

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