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Law and a disorder

As profession changes, support group sees more attorneys seeking mental health help

When it was founded nearly 30 years ago, Boston-based Lawyers Concerned for Lawyers functioned as a support group for attorneys with drinking problems. Callers to the nonprofit organization were usually steered to Alcoholics Anonymous.

But over the decades, as the pressures of the legal profession have multiplied, the reason lawyers seek its services has dramatically changed.

Today, attorneys and other legal professionals contact LCL mainly for help battling depression. The shift mirrors a trend at lawyer assistance programs across the country, and reinforces state and national studies showing that lawyers are more depressed than those in any other occupation.

It also reflects what many lawyers and mental health professionals say is a disturbing consequence of the increasingly competitive nature of the practice of law.

"People come to you with their problems and they want you to solve them, but you're not supposed to have your own problems," said Gayle S. Ghitelman, a Boston lawyer who sought LCL's help for depression three years ago. "There's this impression that if you're a lawyer, you're Superman and you can do it all. You're not allowed to say this is a brutal profession."

To better address depression's crippling effect on lawyers -- which ranges from missed court appointments to unraveling personal lives to negligence that can lead to malpractice claims -- LCL recently revamped its marketing to encourage lawyers to seek help for any type of personal issue, not just substance abuse.

An old LCL advertisement shows a law stu dent drinking alone at a bar; a newer ad features a man walking a beach by himself on a gray day. Its caption reads: "Depression, stress, career issues and addictions . . . we understand what it's like to face personal problems within the profession."

The group is also working to reduce the perceived stigma of mental health struggles and has begun reaching out to law schools, where depression often takes root.

There is a myriad of reasons why lawyers find themselves spiraling into despair.

Heavy law school debt frequently forces graduates into high-paying jobs at private firms, where intense deadlines, staggering billable-hour requirements, and grinding hours are routine. Even veteran lawyers often find themselves disillusioned by the increasingly business-like practice of law.

The conflict-driven nature of the profession also plays a role, as does traditional legal training, which conditions lawyers to be emotionally withdrawn, a trait that can help them professionally but hurt them personally.

And the personality type frequently drawn to the law -- perfectionist, high-achieving -- is particularly vulnerable to becoming depressed, said Lawrence T. Perera, a lawyer at the Boston firm Hemenway & Barnes and former co chairman of the Boston Bar Association's Peer Support Committee.

"You add those up and it's a huge toll on a person -- even a very, very stable and capable person," Perera said. "Excessive pressure causes depression. It breaks people in one form or another."

The definitive study on lawyers and depression, a survey of 104 occupations published by Johns Hopkins University in 1990, found that lawyers are more likely to be depressed than those in any other profession -- 3.6 times the norm. More recent studies conducted by numerous state bars reached similar conclusions.

At Lawyers Concerned for Lawyers, depression and anxiety have equaled or surpassed alcohol and drugs as what the group calls a "presenting problem" for five of the past 10 years. In 2005, depression or anxiety were cited by 26 percent of all lawyers who sought counseling, while alcohol or drugs were cited by 21 percent.

The number of lawyers seeking depression counseling jumps to 60 percent when the tally includes those wanting help with "career/practice management." That catch all category encompasses a broad array of frustrations and often includes depression as a symptom, according to Ellen Murphy, executive director of LCL, which is funded by lawyer registration fees and employs three staff clinicians.

Ghitelman, who attends an LCL counseling group twice a month, credits the group with her continuing recovery.

"I wouldn't have gotten back to practice without their help," said Ghitelman, 49, whose law license was suspended for a year after she neglected a case and fabricated legal documents, misconduct she attributes in part to depression caused by her father's illness and by conflicts with her law colleague at the time. Her license to practice law was reinstated in December 2005.

Depression often afflicts small-firm lawyers and solo practitioners, like Ghitelman, because they have fewer co-workers with whom to discuss the pressures of practice. And although large firms offer a wider peer network, some depressed lawyers are reluctant to confide in their peers, especially senior partners, because they fear asking for help may be seen as a sign of weakness, said Perera.

In some states, including Connecticut, bar exam applicants are required to disclose whether they have been treated for mental health issues. Such mandatory disclosures have become a hot-button issue in the legal community, since critics believe they could discourage law students from getting counseling if they think it may jeopardize their bar eligibility.

As a result, "many of them decide that they may be going crazy, but they'll tough it out till they get past the bar," said Richard A. Soden, a lawyer at the Boston firm Goodwin Procter and chairman of the American Bar Association's Commission on Lawyer Assistance Programs. "They don't want to raise questions about whether they're suitable for practice, so one way students might perceive they could avoid that is to not seek treatment."

But for Ghitelman, contacting LCL for assistance was invaluable.

Getting help for depression "is not a stigma at all," she said, "because it's a sign of strength to recognize that you have a problem and to know that you need help solving it."

Sacha Pfeiffer can be reached at pfeiffer@globe.com.

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