Thursday, June 01, 2006

Stress, Depression, Substance Abuse and Suicide

There are few people more stressed in the world than law students and lawyers (and sometimes law librarians!). While this is quite a sweeping generalization, anybody with experience of either group will absolutely agree that it's a fair one. And as time goes by, it seems that law students only get more stressed, and young associates get more pressured. When I was a law student 20 years ago, a law library intern who had "retired" from a 20 year corporate and private practice to become a law librarian commented on how much more stressed-out my classmates were than his had been. I can say the same thing now. Of course, with student debt loads piled up, tough job market, who can blame them? Turns out lawyers are probably the most depressed professionals in America, too. See the ABA report link with suggestions here.

The point of this essay is that there is a strong correlation between chronic stress and depression. See a study reported in Monitor, journal of the American Psychological Association, that very clearly shows a link between chronic stress and depression. link. But you don't have* to test rats to know that stress leads to depression, and depression leads people to rely on shortcuts such as booze and drugs to get through the day. The ABA Solo Lawyer Newsletter ran a very good article by Nancy Byerly Jones in 2001 that is available on the Web "The Dangerous Link Between Chronic Office Chaos, Stress, Depression and Substance Abuse." Jones gives several checklists, of office mis-management, hallmarks of drinking or drug abuse problems, and questions to see how far you fit into the danger zones. She notes lawyer assistance programs by bar associations as well as professional psychological treatment. Both practitioners and students, though, should look at levels of chaos that add stress to their lives, and then look for ways to reduce that stress. Easy to say, but it can be done!

Understand that you are in a self-reinforcing cycle. You are depressed, so you get less done, and are less organized. This leads to greater chaos and stress, which then continues and increases the depression. You must do something to break the cycle.

This link from WebMD starts you on several useful, short essays.

At Suffolk University's Counseling Center, they have a long, but very good page on Depression, full of information that is not tied to any drug company ads (which bothered me about the WebMD site), and is very non-judgmental, very supportive. They also have a very useful page on stress management.

And last, most ominously, most frightening to talk about, is suicide.* But it is something we should all be aware of. Law students put themselves under a lot of stress, and if they come with a dangerous pre-disposition, can become so depressed or distraught over law school or grades alone that they would consider committing suicide. Better to never have it happen, because the students don't get that stressed-out, and/or feel they have somebody to turn to! While we are dealing with older people (in law schools, sometimes, much older), I think much of what they say applies to folks of any age (this was quoted from a no longer extant page at University of Minnesota.) Now, webpages on suicide prevention specifically among college/university students can be found at The Jed Foundation and Suicide Prevention Resource Center: is critical for parents and helping adults to be aware of the factors that put a youth at particular risk, especially when stressful events begin to accumulate for these vulnerable individuals. A good starting point for identifying and intervening with highly troubled and depressed young people is the careful study of suicidal adolescents.

Family history and biology can create a predisposition for dealing poorly with stress. These factors make a person susceptible to depression and self-destructive behavior.

* History of depression and/or suicide in the family
* Alcoholism or drug use in the family
* Sexual or physical abuse patterns in the family
* Chronic illness in oneself or family
* Family or individual history of psychiatric disorders such as eating disorders, schizophrenia, manic-depressive disorder, conduct disorders, delinquency
* Death or serious loss in the family
* Learning disabilities or mental/physical disabilities

* Absent or divorced parents; inadequate bonding in adoptive families
* Family conflict; poor parent/child relationships

Personality traits, especially when they change dramatically, can signal serious trouble. These traits include:

* Impulsive behaviors, obsessions and unreal fears
* Aggressive and antisocial behavior
* Withdrawal and isolation; detachment
* Poor social skills resulting in feelings of humiliation, poor self-worth, blame and feeling ugly
* Over-achieving and extreme pressure to perform
* Problems with sleeping and/or eating

Psychological and social events contribute to the accumulation of problems and stressors.

* Loss experience such as a death or suicide of a friend or family member; broken romance, loss of a close friendship or a family move
* Unmet personal or parental expectation such as failure to achieve a goal, poor grades, social rejection
* Unresolved conflict with family members, peers, teachers, coaches that results in anger, frustration, rejection
* Humiliating experience resulting in loss of self-esteem or rejection
* Unexpected events such as pregnancy or financial problems

Predispositions, stressors and behaviors weave together to form a composite picture of a youth at high risk for depression and self-destructive behavior. Symptoms such as personal drug and alcohol use, running away from home, prolonged sadness and crying, unusual impulsivity or recklessness or dramatic changes in personal habits are intertwined with the family and personal history, the individual personality and the emotional/social events taking place in a person's life.

It is not always easy for one person to see the "whole picture." That's why it is essential that people who have "hunches" that something is wrong take the lead to gather perspectives from other friends, family members and professionals who know the young person. It is all too often true that the survivors of an adolescent suicide only "put the pieces together" after the fact, when they sit together and try to figure out what happened. How fortunate a troubled young person is to have a caring adult take the initiative to look more closely before something serious happens!

You might also be interested in this entry link on Lawyers and Depression from Minor Wisdom blog of Raymond P. Ward. He links to a study showing that academically talented children may suffer more depression from being bullied at school. I think these are the studies he refers to (from link):

Peterson, J. S., & Ray, K. E. (2006). Bullying and the gifted: Victims, perpetrators, prevalence, and effects. Gifted Child Quarterly, 50, 148-168.

Peterson, J. S., & Ray, K. E. (2006). Bullying among the gifted: The subjective experience. Gifted Child Quarterly.

Jackson, S. M., & Peterson, J. S. (2003). Depressive disorder in highly gifted adolescents. Journal for Secondary Gifted Education, 14, 175-186.

* I used to say in this post that Suffolk was a school where no student had ever committed suicide. Sadly, I can no longer say that. One of our law students took his life a year ago.


Anonymous said...

i think Stress, Depression, Substance Abuse and Suicide
is present in any field. however, the risk is higher among law students because of the environment they are in. just last year, one of my cousins' friend committed suicide because he failed one of his review classes. everybody fails not only once but over and over though failures should be handled accordingly. we should be reponsible about the consequences of our actions. so going back to that guy who committed suicide, the roomate of that guy has to go on leave from school because of the traumatic experience seeing the dead body right in his room. this is a clear example of being irresponsible in handling stress or whatever. another person has to sacrifice for other's stress...or irresponsible actions...
about substance/drug abuse, i think a lot of law students are into this, in our class alone, drinking spree is ever present whenever there's a free time.
we should learn how to handle these things since they are given part of our law school life...and be responsible not to drag anybody ito these pits!!!

Betsy McKenzie said...

How terrible! A friend of mine was married to a blind woman. He got so depressed, he killed himself with a gun. His poor wife! Think of how she discovered the body... How terrible for her. There is a lot of anger expressed sometimes by a suicide, I think, as well as despair.

My grandmother was 11 years old when she found her father where he had hanged himself in the family barn. I wonder if that sad man had contemplated at all who might find him afterwards? If you are that angry at somebody, how much better to just swish their toothbrush in the toilet! Geez.

Anonymous said...

you obviously have never dealt with the type of stress that leads people to commit suicide. I'm in law school right now and I have thought about it many times. you have no idea what we go through. the fact that your only recommendation for the depressed is to "deal" with it is ridiculous. how about a little compassion for someone who has lost their soul by killing themself.

Anonymous said...

Ironic that you quote a University of Minnesota study about recognizing the warning signs of depression. I am at the University of Minnesota Law school and we returned from winter break to the news that one of our classmates had died. I don't know how public his cause of death was made, but I was told that "he died after a suicide attempt." Very sad.

To the anonymous person who posted above me, what can I say? I've felt some of what you're feeling. Law school is not a fun place to be. It's better than being dead, though.

Anonymous said...

I don't know how it is to be in so much stress or anything. I don't even know how it feels to even been a little close to committing suicide. It really must be hard to deal with all of this. The only reason I know a little about this is because my friends died of suicide and I am recently doing a project over it. so thanks for telling me a little about this.

Anonymous said...

Dysthymic Disorder is characterized by chronic depression, but with less severity than a major depression. The essential symptom for dysthymic disorder is an almost daily depressed mood for at least two years, but without the necessary criteria for a major depression. Low energy, sleep or appetite disturbances and low self-esteem are usually part of the clinical picture as well.