BROKEN-HEARTED IDEALISTS: THE EMOTIONAL AND MENTAL DRAIN UPON LAWYERS

Transcription

1 BROKEN-HEARTED IDEALISTS: THE EMOTIONAL AND MENTAL DRAIN UPON LAWYERS CLE Credit: 1.0 Thursday, June 19, :35 p.m. - 3:35 p.m. Meeting Rooms 1-3 Northern Kentucky Convention Center Covington, Kentucky

2 A NOTE CONCERNING THE PROGRAM MATERIALS The materials included in this Kentucky Bar Association Continuing Legal Education handbook are intended to provide current and accurate information about the subject matter covered. No representation or warranty is made concerning the application of the legal or other principles discussed by the instructors to any specific fact situation, nor is any prediction made concerning how any particular judge or jury will interpret or apply such principles. The proper interpretation or application of the principles discussed is a matter for the considered judgment of the individual legal practitioner. The faculty and staff of this Kentucky Bar Association CLE program disclaim liability therefore. Attorneys using these materials, or information otherwise conveyed during the program, in dealing with a specific legal matter have a duty to research original and current sources of authority. Printed by: Evolution Creative Solutions 7107 Shona Drive Cincinnati, Ohio Kentucky Bar Association

3 TABLE OF CONTENTS The Presenters... i Rash of Lawyer Suicides Worries Colleagues... 1 Broken Hearted Idealists... 5 When Depression Turns Deadly: The Impacts of Addiction and Depression on Suicide among Lawyers and How to Recognize the Warning Signs... 9 Kentucky Lawyer Assistance Program (KYLAP)... 31

4

5 THE PRESENTERS Justice Bill Cunningham Supreme Court of Kentucky 103 West Court Street Post Office Box 757 Princeton, Kentucky (270) JUSTICE BILL CUNNINGHAM was elected to the Supreme Court of Kentucky in November 2006 to serve the 1st Supreme Court District. Prior to joining the Supreme Court, Justice Cunningham served as a circuit court judge for fifteen years. He served as the Eddyville City Attorney from 1974 to 1991 and the Public Defender for the Kentucky State Penitentiary from 1974 to In addition, he served as Commonwealth's Attorney for the 56th Judicial District from 1976 to During his tenure in that position, he was voted the Outstanding Commonwealth Attorney of Kentucky by his peers. Justice Cunningham also served as a hearing officer for the Kentucky Board of Claims from 1981 to 1985 and as a trial commissioner for Lyon County District Court from 1989 to Justice Cunningham earned his bachelor's degree from Murray State University and his J.D. from the University of Kentucky College of Law. He is a veteran of the U.S. Army, having served in Vietnam, Korea and Germany. Len W. Ogden 111 South Fourth Street Paducah, Kentucky (270) lenogden@gmail.com LEN W. OGDEN maintains a private practice in Paducah and concentrates his practice in the areas of criminal defense, personal injury for the plaintiff and civil rights for the plaintiff. Prior to opening his own practice, he practiced law with Frank Haddad and Associates in Louisville. Mr. Ogden received his B.A. from the University of Virginia and his J.D. from the University of Louisville Louis D. Brandeis School of Law. He is also a graduate of the U.S. Army Armor School for Commissioned Officers and the National College of Criminal Defense Lawyers and Public Defenders, with special honors in trial practice. Mr. Ogden is admitted to practice before the United States District Court for the Eastern and Western Districts of Kentucky and the United States Court of Appeals for the Sixth, Seventh and Federal Circuits. He is a Kentucky Bar Foundation Life Fellow and contributes time to the Kentucky Lawyer Assistance Program. i

6 ii

7 RASH OF LAWYER SUICIDES WORRIES COLLEAGUES Andrew Wolfson Dec. 31, 2013 Reprinted with permission from the Courier Journal One was a former University of Kentucky basketball player who practiced in Leitchfield, Ky. Another had been commonwealth's attorney in Kenton County. A third was a Louisville lawyer who helped battle the Roman Catholic Archdiocese of Louisville over cases of priest abuse and whose Facebook photos still show him snowboarding, scuba diving and sightseeing with his family. Jim Dinwiddie, Harry Rankin and Ross Turner all died in a similar way: They killed themselves. So did Michael Jamison and Brent Travelsted of Bowling Green, Tod Megibow of Paducah, William P. Whalen, Jr. of Fort Wright, Finis Raymond Price III and Dan Thomas Schwartz of Louisville, David Andrew of Crescent Springs, Leroy "Lee" Rowland of Lexington and Brad Goheen of Calvert City. They are among at least a dozen lawyers in Kentucky who have committed suicide since 2010, including three in Louisville and three in Northern Kentucky. Half died in the past 12 months. All were men, their average age 53, and most were trial lawyers. Kentucky doesn't track suicides by occupation. But citing his recollection from 38 years of practice and amid studies that show lawyers are six times more likely to kill themselves than the general population Kentucky Bar Association President Doug Myers said the number of suicides among the state's 17,500 lawyers is "disproportionate" and "disconcerting." Myers, who was so concerned that he wrote about the issue in a recent edition of the bar association's quarterly journal, said in an interview that he doesn't remember any similar spate of suicides by lawyers earlier in his career. In a recent post, legal blogger Shannon Ragland, publisher of the Kentucky Trial Court Review, called the suicides by "middle-aged trial lawyers" an "apparent epidemic" and said the issue deserves serious attention and study by the KBA and the Kentucky Justice Association, the state trial lawyer group. 'Broken-Hearted Idealists' The KBA's Kentucky Lawyer Assistance Program offers confidential help to attorneys with depression, but citing its confidentiality rules, director Yvette Hourigan said she couldn't say how many if any of the lawyers who have killed themselves in recent years had sought its aid. 1

8 Myers said that suicide by lawyers is shrouded in stigma and needs to be "out in the open." Bar officials say they believe that stress is at the root of the recent suicides. "You take on the burden of your clients' problems, then pile them on your own, and it takes a toll," Myers said. State Supreme Court Justice Bill Cunningham, who wrote about the topic in the Russellville News Democrat Leader last year, said some lawyers ("broken-hearted idealists," he calls them) just give up. "They learn that justice is not always done. Innocent people are abused and some go to prison. People guilty of terrible wrongs go free," Cunningham wrote. "They worry that all the lost hours and missed holidays with family and friends... do not matter.... They become like a weak-kneed boxer in the 15th round. They keep flailing away. But they lose purpose. They lose hope." Lanny Berman, director of the Washington-based American Association of Suicidology, said the competitiveness and perfectionism that make good lawyers and the lack of fulfillment many lawyers feel in practicing law put them at high risk of alcoholism, drug use, depression and suicide. There are no recent studies of the suicide rate nationally for lawyers, in part because most states don't track suicide by occupation. But some older studies suggest it is higher and that lawyers are far more likely to suffer from depression, which is often linked to suicide. Lawyers acknowledge that few will sympathize with their plight. "Everybody hates lawyers," said Louisville trial lawyer Hans Poppe, "except for their own lawyer." Myriad Reasons Possible for Suicide Interviews with family members and friends of Kentucky lawyers who took their own lives suggest there was no single thread that explained their actions. One of the lawyers had recently found that his wife had been unfaithful, while another was discovered to have been unfaithful to his wife. One was out of work, while another, Travelsted, a Bowling Green personal injury lawyer who shot himself on April 21, was highly successful. Friends such as state Court of Appeals Judge Kelly Thompson said he was despondent over a broken engagement. One of the lawyers jumped off a bridge, while the rest ended their lives in their homes or offices. Experts caution that the reasons for suicides sometime are never known, although some seem more obvious: 2

9 Louisville lawyer Harry B. "Hank" Diamond, for example, was a fugitive who had been indicted for allegedly filing false income tax returns he had failed to pay federal taxes for 10 years when he shot himself in the head on April 17, 2009, in the parking garage of a casino in Gulfport, Miss. Justice Department attorney Nicholas Marsh, a St. Xavier High School graduate who wasn't licensed in Kentucky, took his life in September 2010 after he came under investigation with other prosecutors for possible misconduct in the conviction of former U.S. Sen. Ted Stevens of Alaska. Stevens' conviction was set aside after allegations that prosecutors had failed to disclose evidence. Marsh's lawyer, Robert Luskin of Washington, said after his death that "Nick loved being a prosecutor, and I think he was incredibly fearful that this would prevent him from continuing to work for the Justice Department." Turner, 48, served as a law clerk to U.S. District Court Judge Joseph H. McKinley, Jr. and was regarded as a brilliant legal writer, but struggled for years with substance abuse, said Poppe, who practiced with him when they both worked for lawyer William McMurry. Another trial lawyer, Larry Jones, said Turner struggled with running a solo practice and never recovered from the emotional scars of fighting the priest-abuse cases. "Ross never seemed the same to me," Jones said. Rankin, 58, who served as Kenton commonwealth's attorney in 1983, faced a "perfect storm" of "medical, family and financial issues," according to his former lawyer partner, Mike Sutton, president of the Northern Kentucky Bar Association. Attorney Eric Deters, who had offered Rankin a job just before his death, said he was depressed in part because he couldn't get enough cases. Deters said he learned later that Rankin had sought help from the Lawyer Assistance Program and that he was being treated at a psychiatric hospital in Bowling Green when he hanged himself. Megibow, 61, a transplanted New Yorker who once was fit enough to play for the Paducah Flood rugby team, had undergone several back surgeries and suffered through terrible pain, said Andrew Coiner, who previously rented space from him. "He stated to me that he didn't want to be a burden," Coiner said. Dinwiddie, 63, who returned to his hometown of Leitchfield after his career playing guard from 1968 to 1971 for UK coach Adolph Rupp, suffered from depression, said his son, James "Jay" Dinwiddie, who lives in Atlanta. The younger Dinwiddie said he believes his father's practice a mix of grim criminal, divorce and domestic-violence cases contributed to his father's suicide. "Just reading his cases I got depressed," said Jay Dinwiddie, who reviewed them as executor of his father's estate. "I got a crash course in law, and it is not what it is cracked up to be." 3

10 Dinwiddie's brother, Bill, a retired licensed clinical social worker who worked for 40 years in the mental health field, said his brother suffered from depression. He ran for county attorney and was devastated when he lost, then had a chaotic marriage that collapsed. While depression was his underlying problem, his practice as an attorney "irritated" it, Bill Dinwiddie said. "I think there are certainly personality structures drawn to law a determination to win and a need to see black and white," he said. "And life is not always black and white." Helping Others Myers, the bar president, said Kentucky's lawyers must be alert to the problems of fellow lawyers and "take on a responsibility for our peers" in part by referring them to the Kentucky Lawyer Assistance Program, which has launched a depression support program in Louisville. "As lawyers, we are very good at referring other troubled people for help," Myers wrote in the bar journal. "We need to do the same for ourselves." Reporter Andrew Wolfson can be reached at (502) How to Get Help The Kentucky Lawyer Assistance Program offers confidential assistance to help attorneys cope with depression, substance abuse and dependence, work-related stress, compulsive gambling and eating disorders. All communication with KYLAP is confidential. Call (502) More information is available at: Lawyers and Suicide From 1999 to 2010, suicide rates for American adults age 35 to 64 increased 28 percent, from 13.7 to 17.6 for every 100,000 people, the Centers for Disease Control and Prevention reported recently. For men in that age range, the rate is 27.3 percent. There are no recent studies of the suicide rate nationally for lawyers in part because most states don't track suicide by occupation. But some older studies suggest it is higher: A 1997 study of life insurance data found that lawyers in Canada were six times more likely to kill themselves than the general population. A 1991 study of lawyers in North Carolina found that 26 percent had symptoms of clinical depression and 12 percent said they contemplated suicide at least once a month. A 1991 study at Johns Hopkins University of 12,000 workers found that lawyers were the most depressed of 28 occupations and 3.6 times more likely to be depressed than average. 4

11 BROKEN HEARTED IDEALISTS Justice Bill Cunningham June 25, 2012 Reprinted with permission from (last visited March 28, 2014) A couple weeks ago, a friend of mine committed suicide. He was a little younger than me. And he was a lawyer. I've had four friends commit suicide in recent years. All lawyers. Is there any link between these horrible events and their profession? Only God knows. Suicide is the most unfathomable of tragedies. But I do know this. According to a major study conducted twenty years ago by the National Institute for Safety and Health, lawyers were twice as likely to commit suicide as the general population. Members of the legal profession most at risk were males between the ages of All my deceased friends were men. A survey by John Hopkins University among 10,000 adults showed that, of all occupational groups, attorneys suffered from the highest signs of clinical depression. Most lawyers tend to focus on the problems of their clients and let their own mental and emotional needs go unattended percent of that group are alcoholics, as opposed to 10 percent of the general population. While the research is limited in this area, indications are that lawyers are more likely to divorce than members of other professions. There are two types of pressure in the practice of law. First is the pressing need that is found in all professions the heavy obligation of getting it right. Whether it's making the proper diagnosis in medicine or designing a bridge that won't collapse, the lawyer is likewise faced with the pressure of getting it right every day. At next Thursday's closing of a multi-million dollar real estate deal, the lawyer had better make certain all liens have been released and there is no misprint or missing signatures in the paper work. A misstep could cause the client delays and thousands of dollars. Or it may be the criminal defense lawyer standing by his client as the jury returns to the courtroom with a verdict. The client will either go out the front door with mama or out the back door with the sheriff to prison. That defense lawyer only hopes and prays that, if his client is convicted, it's because of the evidence and not his mistakes. I could go on and on with endless examples where the lawyer is expected to perform every day at top speed. There is an endless line of people with a smorgasbord of problems, constant phone calls to return. A lot of people call with problems. Few call with solutions. And then there is the second most oppressive burden of a lawyer. I'm speaking of the arena of human tragedy in which each of my suicidal friends worked. 5

12 Every lawyer worth their salt comes out of law school as an idealist. Someone has said that lawyers are "humanists who fight." Young lawyers believe. They think they can make a difference. They want to make a difference. To use the lance of the law to pierce injustice and evil. To summons down the majesty of the law into courtrooms and board rooms so that people will always be treated fairly and justly. To make the world a better place because of their efforts. Once out in the day to day practice of law, they learn that justice is not always done. Innocent people are abused and some go to prison. People guilty of terrible wrongs go free, laughing at the very system of which they are a part. Bad things happen to good people. Bad people are unjustly enriched. They learn that the system is not perfect, judges are not infallible, and even their own skills are inadequate to take on the vast sea of troubles on which they are afloat in their small boats. But they keep fighting because there are, in fact, people they help; burdens they lift; lives that are changed and made better. They live from one small victory to another. If my lawyer friends are able to keep things in perspective and endure, they will spend a life time doing much good and leave behind a better world. There will be countless people who will have been blessed by these barristers of American democracy. Lawyers most of them are heroic. You go home at night with your problems. They go home with the problems of many. And then they deal with their own personal problems sick children, an alcoholic spouse, or a parent who is deep in Alzheimer's layered over by the demands of clients and judges and other lawyers. But worst of all for practicing lawyers is the sinking feeling which settles upon them that in all the struggles, in the thick of battle, it all amounts to nothing. The growing suspicion that all that they do makes no difference. That all the worry, all the late hours and missed holidays from family and friends, and all the endless hours of worry, do not matter. They become a weak-kneed boxer in Round 15. They keep flailing away. But they lose their purpose. They lose hope. And unfortunately, in some instances, they have reason to despair. In my thirty-five years in the justice system years and years of sending people to prison for trafficking in illegal drugs the scourge of illegal drugs is as bad today as when I started. Maybe worse. Drug abuse infests families of all social and economic class and spreads its malignant cancer into all crevices of our society. No one, no family, is immune. But, we keep flailing away with no hope in sight. The ballast in the hold for all successful and well-balanced lawyers was articulated by the famous Confederate General Stonewall Jackson, "Duty is ours; consequences are God's." The practice of law is not for the emotionally short-winded. After a while, some lawyers burn out. They become broken-hearted idealists. Some become jaded, cynical, even bitter. In short, they give up. 6

13 The great Victor Hugo wrote, "The human heart cannot contain more than a certain quantity of despair. When the sponge is soaked, the ocean could pass over it without its absorbing one drop more." This begs the darker question. What becomes of the sponge? 7

14 8

15 WHEN DEPRESSION TURNS DEADLY: THE IMPACTS OF ADDICTION AND DEPRESSION ON SUICIDE AMONG LAWYERS AND HOW TO RECOGNIZE THE WARNING SIGNS Yvette Hourigan, Director, KYLAP "Suicide is not a blot on anyone's name; it is a tragedy." First Things First: The question you never ask: Kay Redfield Jamison, Night Falls Fast: Understanding Suicide "You're not thinking about committing suicide or harming yourself, are you?" It's the wrong question. When this form of the question is used, you are conveying to the distressed individual that you want or need them to answer "no." They are not invited to be truthful. Don't ask the question this way. Read on for instructions on how to be an effective helper to someone in crisis. I. INTRODUCTION The purpose of this program is to encourage and educate those who are suffering from anxiety and depression and who may be at risk for suicide, as well as to educate all Kentucky Bar members, who must acknowledge the severity of the problem here in Kentucky, and who must be willing and able to identify warning signs among our colleagues. Kentucky is the third most depressed state in the country. Only two states have higher rates of depression than Kentucky: West Virginia at number two, and Utah at number one. (Mental Health America: Ranking America's Mental Health: An Analysis of Depression across the States). On average, people with depression go for nearly a decade before receiving treatment. Id. It is likely that lawyers go much longer without seeking help than the average person. We as lawyers perceive that because we help others, we must be able to help ourselves. Of course this is a myth. II. THE ROLE OF STRESS IN DEPRESSION "Stress" may be defined as anything in our environment that knocks our bodies out of their homeostatic balance. The stress response is the physiological adaptations that ultimately reestablish balance. Recently, scientists have been focusing in on the connection between stress and anxiety and the role they play in producing and maintaining depression. For a high-stress profession like practicing law, this link is alarming and should cause great concern. "If stress is chronic, repeated challenges may demand repeated bursts of vigilance. At some point the vigilance becomes overgeneralized leading us to conclude that we must always be on guard even in the absence of stress. And 9

16 thus the realm of anxiety is entered." Dr. Robert Sapolsky, Lawyers with Depression, The Stress Depression Connection, May 11, 2008, See if this description sounds familiar: Stress went on too long in my own life as a litigator. I had, indeed, entered the realm of anxiety. For me, this anxiety felt like I had a coffee pot brewing twenty four-seven in my stomach. I became hyper-vigilant, each of the files on my desk felt like ticking timebombs about to go off. Over time, the litigation mountain became harder to climb as the anxiety persisted over a period of years. Dan, Lawyers with Depression Unfortunately, if the chronic stress is (or even seems to be) insurmountable, it gives rise to helplessness. This helplessness may be so generalized that the person is unable to accomplish tasks they could actually master. Helplessness is a pillar of a depressive disorder. It becomes a major issue for lawyers because we aren't supposed to experience periods of helplessness. Studies are showing that the presence of co-morbid anxiety disorders and major depression is very frequent, and according to some studies, as high as 60 percent. This may shed light on why the depression rates for lawyers are so much higher than everyone else's. We work in a chronically anxious and stressful state. Lawyers with Depression, The Stress Depression Connection, May 11, 2008, Over time, this type of chronic anxiety causes the release of too much of the fight-or-flight hormones, cortisol and adrenaline. Research shows clearly that prolonged release of cortisol damages areas of the brain that have been implicated in depression, the hippocampus (involved in learning and memory), and the amygdala (involved in how we perceive fear). Id. III. THE ROLE OF ADDICTION IN DEPRESSION An intense retrospective study performed in 2002 of the clinical case files of chemically dependent lawyers, judges and law school graduates at a rehabilitation facility in Florida gives great insight into the picture of the impaired attorney. 1 Based upon this research, the typical attorney entering treatment is a successful male trial lawyer in his early forties, often with a polysubstance addiction (often alcohol and cocaine), who also has a co-occurring mood disorder (60 percent also suffered from either depression, bi-polar disorder or anxiety, in that order), as well as a personality disorder complicating treatment. 2 About 60 percent used alcohol as their drug of choice; 25 percent chose cocaine. Opiates and benzodiazepines were farther down the list, followed by meth- 1 Sweeney, Timothy J., "A Clinical Look at the Chemically Dependent Lawyer", The Florida Bar News, November 16, Id. 10

17 amphetamine and marijuana. Despite its prevalence in Kentucky, marijuana was at the bottom of the list (only 1 percent). It is presumed that with the surge in use of oxycodone and other opiates throughout the United States in general, but in Kentucky in particular, which leads the nation in abuse of narcotic medication for non-medical purposes, opiates would be much higher on the list in today's study. 3 Of course, active alcoholics love hearing about the worse cases, we cling to stories about them. Those are the true alcoholics: the unstable and the lunatic; the bum in the subway drinking from the bottle; the red-faced salesman slugging it down in a cheap hotel. Those alcoholics are always a good ten or twenty steps farther down the line than we are, and no matter how many private pangs of worry we harbor about our own drinking, they always serve to remind us that we're ok, safe, in sufficient control. Caroline Knapp, Drinking: A Love Story 4 In her informative book, Understanding the High-Functioning Alcoholic, Sarah Allen Benton provides an extensive list of qualities which may be exhibited in the high-functioning alcoholic or addict. These are separated into nine different areas in which the attributes may be observed. They are as follows: A. Denial 1. Have difficulty viewing themselves as alcoholics or addicts because they don't fit the stereotypical image. 2. Believe that they are not alcoholics or addicts because their lives are still manageable and/or successful. 3. Avoid recovery help. 4. Label their drinking as "a habit," "a problem," "a vice," or as "abuse." 5. Compare themselves to alcoholics or addicts who have had more wreckage in their lives to justify their drinking. 6. Make excuses for drinking or using or feel entitled to drink or use because they have worked or studied hard (use alcohol or drugs as a reward). 7. Think that drinking expensive brands of alcohol or at sophisticated events implies they are not alcoholic. 3 Burke, Commander John, "Kentucky Leads the Nation in Pharmaceutical Drug Abuse for Nonmedical Purposes in 2008." Pharmacy Times, published online on October 15, Knapp, Carline, Drinking: A Love Story (New York: Delta, 1996), p

18 8. Experience strong and lasting denial by themselves, their loved ones, and their social set. B. Double Life 1. Appear to the outside world to be managing life well. 2. Skilled at living a compartmentalized life. 3. Set up lifestyles in such a way that negative feedback from others can be avoided (they leave the firm). 4. Appearances contradict the alcoholic or addict stereotype (e.g., fashionable, physically attractive, elegant, refined mannerisms). 5. Hide alcohol consumption or use by methods such as drinking or using alone or sneaking alcohol or drugs before/after a social event. C. Drinking/Using Habits and Behaviors 1. Experience cravings for alcohol or drugs. 2. Have immediate or increased levels of tolerance. 3. Drink or use despite adverse consequences (emotional, physical). 4. Experience blackouts (memory lapses). 5. Feel shame and remorse from drunken or high behavior. 6. Attempts to control drinking or drug use. 7. Have the ability to abstain for month(s)/year(s). 8. Lack of interest or ability to drink or use moderately. 9. Compulsion to finish alcoholic drinks, even someone else's. 10. Deceiving themselves and/or others about the portion and alcohol content of their drinks. 11. Increased sex drive and promiscuity when drinking or using. D. Employment and Academics 1. Capable of showing up for work and/or school and having above average attendance. 2. Able to maintain consistent employment and/or gain education. 12

19 3. May excel at job and/or school. 4. Succeed financially and academically. 5. Well respected for job/academic performance and accomplishments. E. Financial Status 1. Pay bills on time (e.g., rent, mortgage, car lease, utilities). 2. Do not have significant debt. 3. Have not filed for bankruptcy. 4. Avoid financial problems because of obtaining money from job, inheritance, marriage, or luck. 5. May have above-average credit. F. Interpersonal Relationships 1. Sustain friendships and family relationships. 2. Have romantic relationships (but may struggle to stay faithful because of drunken or high behavior). 3. Can maintain a social life. 4. Are involved in the community. 5. Have difficulty being sexually intimate without the use of alcohol. G. Legal Matters 1. Often break the law but do not get caught. 2. Drive drunk or high and may have DUIs. 3. May get stopped for drunk driving or high, but through connections, luck, social status, or appearance, are treated more leniently. 4. Can afford proper legal representation, and charges are often dismissed (when cited). 5. Often given second and third chances by the legal system. 13

20 H. Hitting Bottom 1. Hitting bottom is defined as the point to which an alcoholic's or addict's life and/or emotions must sink before he or she is willing and able to admit that he or she has a problem and is receptive to getting help. 2. Their lives depart from their personal standards in terms of emotional losses, loss of dignity, loss of moral standards, and negative effect on relationships. 3. Their lives are negatively impacted by drinking or using. 4. Experience few tangible losses and consequences from their drinking (again, by luck). 5. Often hit bottom(s) and are unable to recognize it. 6. Experience recurrent thoughts that because they have not "lost everything," they have not hit bottom. I. Level of Functioning 1. Able to function in society. 2. Engage in some self-care; eat healthily and regularly, exercise, sleep, maintain personal hygiene. IV. SUICIDE WITHIN THE PRACTICE OF LAW As set forth herein, risk factors for suicide include depression, anxiety, substance abuse, divorce and stress. Lawyers experience ALL of these risk factors at a higher rate than the general population. Lawyers are also more likely to be perfectionists and competitive personality traits which make a person considering suicide less likely to seek help. Alan L. Berman, Ph.D., ABPP Executive Director American Association of Suicidology As stated by Robin Frazer Clark, Georgia Bar President, in her President's Page of the Georgia Bar Journal, December, 2012, "[F]ailure is not an option in a highstakes profession such as ours. As a result, lawyers are three times as likely to suffer depression as any other profession." The natural progression of depression, when untreated, is suicide. 14