Lawyers face elevated rates of both substance use and mental health disorders. This comparison holds true both against other white-collar professionals and the general population. Elevated mental health and substance use in lawyers can seriously impact their professional responsibilities and personal wellness.
But what makes legal professionals particularly susceptible to mental health and substance use disorders, and what can we do to help them get the treatment they need?
Prevalence of Behavioral Health Issues in Lawyers
Multiple studies have investigated the behavioral health of legal professionals in the last several years, both in academic and professional legal settings. The data shows that lawyers face complex mental health concerns that can seriously impact their everyday lives and trigger substance misuse.
The Data: Lawyers and Mental Health Disorders
Research from the Journal of Addiction Medicine investigated the rates of mental health disorders among 12,825 licensed, employed attorneys. Throughout their legal careers, participants reported struggles with the following mental health conditions:
- Anxiety: 61.1%
- Depression: 45.7%
- Attention deficit hyperactivity disorder (ADHD): 12.5%
- Panic disorder: 8.0%
- Bipolar disorder: 2.4%
In addition, 11.5% of lawyers struggled with suicidal thoughts at some point in their careers.
Depression and Anxiety Rates in Lawyers
At the time of the study, depression was the most common mental illness among lawyers: 28% said that they were experiencing some form of depression, with 9.5% experiencing mild depression, 10.4% experiencing moderate depression, 4.0% experiencing severe depression, and 4.4% experiencing extremely severe depression.
Anxiety was another common occurrence at the time of the study, with 19% of lawyers reporting anxiety-related issues. Ranked by severity:
- 8.8% reported mild anxiety
- 8.2% reported moderate anxiety
- 4.4% reported severe anxiety
- 1.3% reported extremely severe anxiety
Both anxiety and depression rates were higher for younger and less experienced attorneys.
Substance Use Disorders Among Lawyers
The same study from the Journal of Addiction Medicine found that more than 1 in 5 lawyers screened positive for problematic drinking. An even higher proportion said that they felt their alcohol use had been problematic at some point in their lives.
When it comes to weekly recreational drug use among lawyers, the results were even more troubling:
- 74.1% used stimulants
- 51.3% used sedatives
- 46.8% used tobacco
- 31.0% used marijuana
- 21.6% used opioids
Certain groups were at higher risk than others for alcohol problems. Men had higher rates of alcohol use disorders than women, and like with anxiety and depression, younger lawyers had significantly higher rates of alcohol-related problems than older lawyers.
For comparison, the study reported drinking rates among a similarly educated workforce: among medical professionals, only 11.8% of the population screened for problematic drinking on the same instrument.
Causes of Mental Health and Substance Issues in Lawyers
There is no single cause for the elevated behavioral health concerns among attorneys. Instead, several general factors can increase the risk of mental health and substance use issues.
Stress
Stress is perhaps the most significant cause of behavioral health problems among lawyers. Lawyers have several different occupational factors that add to their stress levels above and beyond the general population, which can put them at risk of mental health conditions and substance use disorders.
Attorneys typically work long hours, with more than 60% of the attorneys who participated in the study working more than 40 hours a week. They often have extensive caseloads and demanding schedules that keep them from taking the time they need to connect with friends and family, catch up on sleep, and recover from stress.
In addition, lawyers work in a system that is adversarial in nature and deals with difficult situations. They see clients in their most vulnerable moments and may even have to represent the defense in cases that contradict their own personal values, resulting in moral injury. This constant conflict and proximity to traumatic events can take a severe toll over time and even cause secondary trauma.
This combination of demanding schedules and constant exposure to sensitive content is a recipe for burnout.
Substance Use as a Coping Mechanism
Many lawyers turn to substance use to cope with the stress of the legal profession, but using substances as a coping mechanism can quickly make the situation worse.
There is a proven link between alcohol and anxiety disorders. While drinking may temporarily relieve occupational stressors, over time, it worsens your ability to deal with these stressors on your own. Drinking to cope is a predictor of the development of alcohol use disorder, which can trigger symptoms of mental health disorders.
The data collected on substance use and mental health among lawyers shows that those who met the criteria for hazardous drinking had significantly higher rates of depression, stress, and anxiety than those in other groups.
Outside of alcohol misuse, lawyers may turn to other substances to cope with stress. Stimulants (like methamphetamine and cocaine) energize the central nervous system, which can feel like an escape for someone struggling with depression. Depressants (like alcohol and opiates) dampen the experience of anxiety and stress.
However, repeated exposure and increased tolerance can cause the central nervous system to rebound in the other direction, making people more sensitive to stressors.
Workplace Culture Normalizes Drinking
A workplace drinking culture may also play a significant role in substance use and mental health disorders among lawyers. Permissive workplace norms around drinking have long correlated with higher incidences of alcohol-related problems, and many legal establishments have embraced alcohol use as part of the workplace culture.
Firms that keep alcohol in the office are particularly risky, but even those that discuss work at bars or supply drinks at workplace parties contribute to the likelihood that their attorneys will deal with alcohol addiction down the line.
Barriers to Behavioral Healthcare for Lawyers
Lawyers struggling with alcohol use or mental health concerns face unique challenges when seeking treatment. Despite the high rates of mental health issues and substance misuse, lawyers fear repercussions from disclosing their struggles and seeking the treatment they need.
While addiction treatment centers go to great lengths to keep their services confidential, lawyers may still fear having their situation become public knowledge if they see a client, friend, or community member at treatment.
Treatment centers with specialized programs can do a lot to alleviate these fears. Small treatment populations and limited peer group sizes can help lawyers feel more secure seeking professional help.
Tailoring the Treatment Process
While the high rates of mental illness and substance use disorders among lawyers are concerning, the good news is that addiction and mental health treatment is extremely effective for helping people achieve abstinence and live healthier lives in recovery.
A specialized treatment program for lawyers and other professionals provides total confidentiality and privacy to ensure that professionals can keep their jobs, work toward holistic health, and overcome the challenges that have held them back.
Specialized treatment programs can help professionals who may have experienced a workplace impairment find a path forward. The Professionals track at All Points North prioritizes accountability, fosters healthy communication, recommits to industry ethics, and creates a strategy for successful reintegration.
Substance use treatment typically occurs in several distinct tiers across the continuum of care, and in each phase, treatment experts target a particular aspect of behavioral health. For clients struggling with active addiction to alcohol and other substances, the first step is medical detox.
Medical Detox
At a medical detoxification facility, clients receive targeted medical treatment to help deal with the physical symptoms of substance use disorders and withdrawal. Attempting to quit a substance use disorder at home can often be dangerous, and the medical professionals at a detox center can mitigate any safety concerns.
Residential Treatment
Residential treatment occurs after detoxification and is where people begin evidence-based therapies and treatments to help them overcome their addictions and mental health issues.
At All Points North, we create a custom treatment plan for each client that utilizes a combination of individual and group therapy as well as other evidence-based techniques, including:
- Cognitive behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
- Eye movement desensitization and reprocessing (EMDR)
- Mindfulness training
Other complementary treatments that can facilitate healing include:
- Spa and relaxation services
- Yoga, meditation, and breathwork
- Deep transcranial magnetic stimulation (dTMS)
- Hyperbaric oxygen therapy (HBOT)
- Ketamine-assisted therapy (KAT)
- Neurofeedback
- Quantitative electroencephalography (qEEG) brain mapping
Our dual-diagnosis treatment approach simultaneously treats the primary concern and any co-occurring conditions to help people recover from mental health challenges and substance use disorders. It simply isn’t enough to treat one problem in a vacuum; to create true long-term sobriety, a person needs more holistic health care.
Outpatient Treatment
Outpatient treatment is a step down from inpatient care to help people stay accountable after moving out of a residential facility. Some lower acuity clients may join an outpatient program instead of entering residential treatment first.
Clients can attend sessions either in person or virtually using tools like the APN Connection app. Either way, outpatient treatment offers the same therapies as residential programs but in a more flexible format that can fit around busy schedules.
Specialized Treatment Programs for Lawyers
Despite the stressors placed on lawyers, recovery is possible. Decades of research and new improvements in technologies and treatment have made overcoming a substance use disorder and managing mental health issues more accessible. The important part is that lawyers, like any other clients, reach out for help when needed and get the treatment they deserve.
If you’d like to learn more about how All Points North creates customized treatment plans for lawyers struggling with behavioral health, reach out to our team using the online contact form or call 855.235.9792.
Reference
- Krill, Patrick R., et al. “The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys.” Journal of Addiction Medicine, vol. 10, no. 1, 2016, pp. 46–52., https://doi.org/10.1097/adm.0000000000000182.
- Podgers, James. “Younger Lawyers Are Most at Risk for Substance Abuse and Mental Health Problems, a New Study Reports.” ABA Journal, American Bar Association, 7 Feb. 2016, https://www.abajournal.com/news/article/younger_lawyers_are_most_at_risk_for_substance_abuse_and_mental_health_prob.
- Heelan, Melissa. “ANALYSIS: Lawyers Report Surprisingly Low Substance Abuse Rate.” Bloomberg Law, 24 Feb. 2022, https://news.bloomberglaw.com/bloomberg-law-analysis/analysis-lawyers-report-surprisingly-low-substance-abuse-rate-1.
