The (Drunk) Elephant in the Room
This piece by Amy E. Davis, Esquire was featured in the Vermont Bar Journal, Winter, 2016-17, Volume 42, No. 3.
In a recent episode of “How to Get Away with Murder,” hot-shot defense attorney Annalise Keating has her law license temporarily suspended following an incident where she slapped a client across the face in the District Attorney’s office. Attorney Keating agrees to enter an approved alcohol treatment program for the reinstatement of her law license, citing her battles with alcohol as the reason for her behavior. Unfortunately, this is not just a made-for-TV scenario. Many members of the legal profession struggle with drug, alcohol, and mental health problems. The Vermont bar is no exception.
During my third year of law school, Vermont Law School lost four people to mental health-related issues: Cheryl Hanna, John Trombly, John’s mother Elizabeth, and Erika Lewis. Not only did news of each death rock our community, but it was an eye-opener for those of us preparing to graduate, take the bar exam, and head out into the legal community. Cheryl’s death was most surprising. An established professor and a well-respected legal commentator with a loving family, Cheryl had everything we would strive for in a legal career. Yet there was no indication to the public that she struggled with her success. Shortly after her death, her husband, Paul Henninge reported to Seven Days Magazine: “I think if there’s any lesson that needs to be considered it’s that the subject of depression needs to be kind of put more out in the light of day.”
The Hazelden Betty Ford Foundation Study
In January 2016, the American Society of Addiction Medicine published a study entitled The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys. The study, funded by the Hazelden Betty Ford Foundation and the ABA Commission on Lawyers Assistance Programs, looked at alcohol use, drug use, mental health, treatment utilization, and barriers to treatment. The study surveyed 12,825 licensed and employed attorneys across the United States.
Of those that participated in the study, men, younger attorneys, and newly-employed attorneys had higher problematic usage than their counterparts. These participants scored at levels consistent with problematic drinking. Previous studies had shown an increased prevalence of problematic drinking to correlate with an increased number of years in practice, whereas this study showed the opposite. A larger number of those citing a drinking problem stated that it began within the first 15 years of practice.
When it came to hazardous drinking or possible alcohol abuse or dependence, women were more affected than men. Twenty-seven percent of the participants reported problematic use before law school, 14% during law school, 43% within 15 years of completing law school, and 14% more than 15 years after completing law school. In regards to drug use, the study showed that stimulants had the highest rate of weekly usage (74%), followed by sedatives (51%), tobacco (46%), marijuana (31%), and opioids (21%).
On issues of mental health, the study found that men had higher rates of depression, and women had higher rates of anxiety and stress. The most common conditions reported were anxiety (61%), depression (45%), social anxiety (16%), ADHD (12%), panic disorder (8%), and bipolar disorder (2%). A little over 11% of the participants reported suicidal thoughts at some point in their career. Just under 3% reported self-harming behaviors, and less than one percent reported at least one prior suicide attempt.
When it came to treatment, of the participants who reported past treatment for drug or alcohol use, only 20% of them used a treatment program tailored to legal professionals. Participants who both had and had not sought treatment reported that the biggest barriers were not wanting others to find out, and concerns about privacy or confidentiality. The study provided the following conclusion: there is a greater need for lawyer assistance programs, as well as publicity surrounding the confidential nature of those programs, and the expansion of attorney-specific prevention and treatment interventions.
When it comes to issues surrounding mental health and substance abuse, it’s a chicken-and-egg scenario. Does the drinking start off as innocent fun then lead to the depression? Or, is there an undiagnosed issue there that we try to self-medicate with alcohol? Rather than speculate about these statistics, I spoke with several colleagues either currently enrolled in law school or recently admitted to practice to get their take on the subject. Many have struggled with alcohol or illegal drug use, and some had diagnosed mental health conditions such an anxiety, depression, and bi-polar disorder.
I am not surprised that so many in the legal profession struggle with issues of anxiety. My colleagues all shared the same theme as to what contributes to the anxiety: pressure.
Nathan is a recent graduate of Vermont Law School. He and his wife, Carolyn, now live out of state. They have one child and are expecting a second in the coming months. He believes that the stresses he faced while in law school are ones that many men his age tend to face early in their career: getting married, starting a family, and wanting to provide for that family. For Nathan, these stressors all occurred while he was in law school.
Carolyn’s pregnancy with his first child during his 1L year sparked a lot of anxiety that he did not know how to deal with. Nathan thought about how he was about to be a dad while still having to deal with the pressures from law school. He would seek socialization by going out and drinking with his colleagues during his first year of law school, and eventually drinking became less of a social function and more of a way of coping with that pressure. Once he realized the drinking had become an issue, he says he sort of “willed” himself out of drinking. “I have to be a strong person for my family and my child,” he says.
But as Nathan starts his legal career, he feels pressure that goes along with the “traditional male roles” of the husband being the provider for the family. Money and status play a large role in the pressure he feels to be successful. “Coming out of law school, you’ve accomplished a lot, but you’re back at the bottom again.” He acknowledges it is a stereotype – when the woman becomes pregnant, the man feels he needs to provide – but it is his reality. He and his wife have decided that once the new baby comes, his wife will leave her job and stay home with the two little ones. “If I hadn’t passed the bar exam, she would still have to work,” Nathan says. Now, he will be the sole earner and he has to earn enough so his wife can stay home with their children.
A current law student, Alyssa describes her struggles with alcohol as starting nearly a decade ago. She had her first child when she was young, was married briefly, and then divorced. She felt as though she missed out on “having fun while you’re young.” She went back to school, but found that she was older than her classmates. Over the next four to five years, she tried to juggle going to school full time, working full time, and being a single parent. She managed her stress with alcohol and marijuana use, but the drinking soon became problematic. Alyssa was able to justify her partying by telling herself that she was getting A’s in school, the kids were healthy, and the bills were paid, so the drinking can’t be that bad. Even if she stayed out until 4 or 5 in the morning, she still made it to work at 8AM. “I never hit the ‘rock bottom’ you always hear about – where DCF drags your kids away or you wind up homeless.” But then she started drinking on her lunch break and putting vodka in her morning coffee. She asked for a referral for a therapist from her primary care provider, but nobody called her.
One day, she was doing a political fundraiser. Her children were with a babysitter (as they always were when she was out drinking). She thought that since the kids were gone for the night, she would let loose even more than usual. She got incredibly drunk. Then her babysitter called with an emergency and needed Alyssa to come get her kids. She drove under the influence to get her children, then drove them the few blocks home. All she could think was, “What if I died? What if I had killed my kids?” She decided to accompany a friend to an AA meeting, where a light switch went off. She has been clean and sober since July 8, 2012.
Alyssa founded an AA chapter when she started at Vermont Law School because she had success with the program back home. She acknowledges a program like AA is difficult in Vermont because it is such a small community. You run the risk of seeing your own clients or opposing counsel at meetings, which can be awkward. In her home state, there was a “Professionals Only AA” that was just for doctors and lawyers to help cut down on these encounters. She acknowledges Vermont may not have the ability to have such meetings here due to geographic concerns and a lower population, but it’s another possible solution to getting attorneys help with alcohol abuse issues.
Kayleigh is a new attorney who graduated from VLS a few years back and now practices in a larger Vermont law firm. She always believed anxiety and depression were interwoven, and she has struggled with both. “There are higher expectations for women,” she believes. “We have all of the same stressors as men, but we are scrutinized more than our male counterparts.” Kayleigh used anti-depressants to help with her anxiety and depression, but found the pills messed with her body and decided to use other methods to treat her mental health, such as meditation. “Part of it is being able to choose to be happy and how you respond to a situation. You need to recognize what does and does not work for you.” Kayleigh is lucky enough to be at a firm that allows her to do transactional work, which she enjoys more. “I found the litigation was driving me to drink and shut down. I was burning out fast. My firm gave me the option of choosing my career path, so I switched to transactional work.” Her law gave her a path to a better quality of life where she did not need alcohol to cope with the day-to-day grind.
Annie has been diagnosed with bi-polar disorder. She experienced sexual abuse as a young child, which lead to several diagnoses before her current one. She says that she believes part of her diagnosis causes her to crave chaos and self-harming behaviors. Self-harming behaviors can be more than just behaviors like cutting. The entire idea of going through law school seems self-harming. So is drinking excessively. For Annie, it took the form of an affair while in law school. But her desire for unbalance and chaos lead to her becoming a lawyer. “I tried to have a different career. I’m an arguer, an overachiever, and I’m adversarial.” Being an attorney has afforded her an opportunity to argue, excel, and oppose at every corner, which actually works with her bi-polar disorder.
When asked what the legal community could do to address issues of substance abuse and mental health issues, Nathan’s response was: “you can always do more, but it needs to be effective.” His local Bar Association and Supreme Court has an open dialogue about substance abuse and mental health issues. They offer a program that allows an attorney to keep his or her license if that attorney follows certain protocol for reporting the substance abuse problem or a mental health issue.
Kayleigh has seen a number of different counselors, and she saw one throughout law school. She reports not needing a counselor since she received her law license. She said that if she did seek help, she would not do group counseling or go through a lawyer-specific program, but would instead seek help from a private or solo psychiatrist.
Nathan thinks that prevention starts with the individual law firms and the environment the senior partners create there. He has an employer who seems to care a lot about him and his personal feelings. “The leadership of those who hire and fire and those who have contact with young attorneys should be charged with creating a healthy community. If you have leadership that deals with stress by drinking or taking pills, the younger attorneys will too.” His employer even offers mental health treatment as party of his employee benefit package.
Kayleigh agrees with the sentiment that it runs deeper than a treatment program, and likens counseling to “putting a Band Aid on a wound.” “The private practice model needs to adjust to the modern era, including the billable hour model.” She does not know what the solution is, but says the current model does not give new attorneys a chance to balance work and qualify of life. The model is a huge demand on people’s times.
Overall, my colleagues and I share the same sentiment: we need to remove the stigma surrounding anxiety and other mental health issues. “They’re invisible diseases that do not get the same attention as cancer or diabetes,” says Alyssa. “When you can’t show your symptoms on the outside, and when people aren’t open to discussing it, you cannot get the help you need.” So while I miss Cheryl Hanna terribly and think of all of the students who will miss her spirit and wisdom, I thank her for sparking a dialogue about this silent killer, depression. I hope that we can open up with one another about our struggles in order to create solutions for the Vermont bar and the legal community as a whole.