Since the 2016 publication of the landmark American Bar Association study on the state of mental health of U.S. attorneys, everyone seems to be talking about how much lawyers are struggling. This post on the Beyond Billables blog claims that lawyers are the “most unhappy group of professionals in the western world.” It’s hard to argue with that. The research results reveal mental health problems for lawyers at significantly higher rates than the general population, with 61% reporting anxiety, 45% reporting depression, 16% social anxiety, and 12.5% reporting attention deficit disorder over the span of their careers. Problematic drinking was reported for over 20% of respondents. Each of these statistics is an alarming call to action for de-stigmatization and treatment of mental health for U.S. lawyers.
And, indeed, the media has responded with a call to action. This article in Forbes elucidates the disturbing findings of the ABA study and recommends that “we start tackling these issues head on and think more holistically not only about mental illness in the legal profession but also about mental health.” This post and this one, both by Karen Sloan, report on the ABA’s task force resolution calling for more action to help lawyers who are struggling.
I am as dismayed by these numbers as the next person, but I am even more dismayed by the lack of media and ABA response to the staggering number of lawyers reporting ADHD. Not one of these recent posts or calls to action discussed ADHD or launched pleas for increased awareness, diagnosis, or treatment of ADHD. Even the ABA’s adopted resolution in 2018 on well-being in the legal profession neglects to mention the high incidence of ADHD in the cited ABA study. Why are we ignoring the fact that lawyers are struggling with ADHD at more than 2½ times the rate of other adults?
A Quick Review: What is ADHD
ADHD is a complex system of neurological executive function impairments that causes problems with our brain's ability to manage itself. ADHD significantly interferes with functioning in many aspects of daily life: work, home, relationships, and health. And, ADHD is not just for kids anymore, affecting about 4.5% of U.S. adults – a statistic that climbs way up to 12.5% for lawyers.
The executive function impairments of ADHD make it difficult for the adult with ADHD to:
Get organized, prioritize, and get things done,
Focus on tasks and shift focus from one task to another,
Process information efficiently and make decisions,
Manage frustration and emotions,
Use working memory and access long-term recall,
Regulate sleep and alertness,
And, monitor and self-regulate their own actions.
Why it is important to talk about lawyers with ADHD
The task force on lawyer well-being calls for two clear tactics to increase lawyer well-being: 1. more aggressive emphasis on lawyer well-being in law schools, law firms, and state bars, and 2. the de-stigmatization of mental health problems for legal professionals. I think this is a helpful yet incomplete plan. They discuss the identification and treatment of problematic drinking, depression, and anxiety. But what about ADHD? The Bar Association and authors of those various blogs seem to be missing the fact that ADHD seldom travels alone. It typically co-occurs with other mental health issues, like problematic drinking, depression, and anxiety, and certainly is related to high stress and burnout. In fact, two-thirds of those with ADHD have other, co-occurring conditions along with their ADHD. This is of critical importance when we consider that lawyers are having all of these problems at many times the rates of non-lawyers.
In addition, we know that treatment is much more effective when it addresses all mental health concerns – a whole person approach to treatment. Imagine seeking treatment for depression or anxiety and keeping your ADHD in a secret box in the corner. How will your depression and anxiety fare when you continue to struggle with the executive functions listed above – struggling to get things done, organize, prioritize, make decisions, manage your own actions? In fact, this report suggests that, “In many cases when an individual has both ADHD and a co-occurring condition, the health care professional may elect to treat the ADHD first because primary treatment of ADHD may reduce stress, improve attentional resources and may enhance the individual’s ability to deal with the symptoms of the other condition.”
We also know that ADHD comes with a ridiculous amount of stigma and misunderstanding. Some people still believe that ADHD is a made-up disorder, just an excuse for medication, or just for kids, and hyperactive ones at that. In fact, the contrary is true. We now know that ADHD is a very complex neurological syndrome that, for most, persists into adulthood. But, as a lawyer, would you want to publicize the fact that you have trouble paying attention, resisting distractions, starting or finishing work, or managing your time efficiently? Of course not. But what’s the alternative? Continue to suffer in silence and hope that you can make it through one more week without any major setbacks?
The good news is that ADHD is very responsive to treatment. Studies have shown that ADHD medications substantially improve the functioning of 70 to 95% of ADHD sufferers. And, non-pharmacological treatments, like ADHD coaching and cognitive behavioral therapy, have also been shown to be very effective. But, we can’t expect lawyers to feel safe exploring these treatment options until ADHD is included in the de-stigmatization. Until then, we’re only encouraging them to suffer in silence.
By keeping quiet about the huge numbers of lawyers with ADHD, we are helping to perpetuate the stigma, encouraging the over 167,000 lawyers in the U.S. with ADHD to keep their condition a secret and not seek diagnosis and treatment.
A call to action to stop ignoring the numbers
ADHD awareness, diagnosis, and treatment should be part of the ABA’s call to action. So, here is my call to action: Lawyer assistance programs should be screening for ADHD when lawyers seek help for stress, depression, anxiety, or problematic drinking and substance abuse. It simply cannot hurt to check for ADHD. Assistance programs should also hold ADHD support groups, like they do in Oregon. Law schools and law firms should be providing ADHD awareness programs and ADHD coaching to assist lawyers. We should be including ADHD awareness in CLE events, like K & L Gates did in their recent Under the Wire Event. And, authors and task force committees that are attempting to address the distressing problems faced by today’s lawyers need to stop ignoring the statistics on ADHD as if they were unimportant. By ignoring the staggering rates of ADHD amongst lawyers, we are missing an essential piece of the puzzle of lawyer well-being.
The entire legal field needs to be challenged to stop stigmatizing ADHD and to re-think how it conceptualizes the diagnosis. Lawyers with ADHD are a unique bunch who bring enormous strengths like creativity, out-of-the-box thinking, and passion to the table. Trust me, I’ve worked with enough lawyers with ADHD to know how talented they are.
If you’re a lawyer with ADHD and are struggling to stay organized, manage your time effectively, and stay on top of the job, there’s help for you. Learn more about individual coaching if you work better one-on-one. Or, check out The Focused Lawyer, an online group coaching program, if you think a group forum would be more helpful to you. And know that you don’t have to struggle with this alone. I’m here for you.