Insight

The Silent Epidemic

Obsessive-compulsive and anxiety disorders are far more common among lawyers than other professionals. It’s past time to address the problem.

Mental Health in Female Lawyers
Kelly S. Hughes

Kelly S. Hughes

April 23, 2019 12:45 PM

In 2010, I was a busy employment lawyer at a national firm, struggling to balance motherhood—I had two small children—and a career. My job didn’t require a significant amount of travel, but one time I had to deliver a presentation out of town.

I was still nursing my son, and I realized I’d need to bring my pumping equipment to ensure I kept up my milk supply. I was exhausted, though, and concluded that I simply couldn’t continue nursing. Contrary to what every lactation consultant and OB/GYN would surely advise, I decided to stop nursing cold turkey.

That one decision changed my life.

During my presentation the next day, I started to feel dizzy and lightheaded. I felt a wave of panic throughout my body. Though I continued to speak, I wondered whether I might faint. I somehow made it through the presentation and immediately packed my things to drive home. On the road, I began to replay what had just happened, engaging in what I now know was “catastrophic thinking”: What if this feeling never goes away? What if I become unable to give presentations, or incapacitated and unable to work? What if I become mentally unstable and lose my job, my husband leaves me, and he takes away my kids? This uncontrollable worry continued, escalating into the terror that I might physically attack my infant son. (I didn’t want to hurt him, I hasten to add; I was afraid I would become psychotic somehow and hurt him.)

I arrived home late that night after the children were asleep, and I sobbed while trying to explain to my husband what had happened and how I was feeling. I was terrified of how he might react, but I told myself it was worth the risk of going to a mental institution or jail; I needed to protect my children and keep them safe, and thus disclosed to my husband, in hysterics, that I was scared I might go crazy, lose control, and kill our son. To my husband’s credit, he remained calm, held me, and reassured me that I was not crazy, that I would not lose control, and that he was not concerned about me hurting our son. He speculated (correctly, as it turned out) that perhaps my hormones were in disarray due to my abrupt cessation of nursing, and that I needed to try to get some sleep.

I remember asking him if he was sure the kids would be safe and that I didn’t need to go to a mental hospital. Yes, they would, he said, and no, you don’t. His answers failed to convince me that I was not a danger to my child; I remained awake and panicked the entire night. When my husband came downstairs in the morning, I begged him to take the kids to preschool to “protect” them from me. “I have a meeting, and you’re fine,” he said. “I’m going to my meeting, and you’re going to take the kids to school.”

It seemed like tough love—and indeed my doctors have since said repeatedly that my husband’s response couldn’t have been better. When I’d dropped the kids safely at school, I went to see my lactation consultant. She brought in a pediatrician, and they explained that they suspected I was experiencing postpartum obsessive-compulsive disorder.

I soon made the first of many appointments with a variety of specialists. They determined I was having “intrusive thoughts”—a form of OCD. I was no stranger to OCD; a family member had been diagnosed with it in the 1980s. Yet that person’s ailment manifested itself in a more common fashion—as “contamination OCD,” which included, among other things, rituals regarding laundry (repeated washing and rinsing of each load, showers before each load, disposing of clothes considered “contaminated”) and avoidance of bug sprays and other chemicals.

What if this feeling never goes away? What if I become unable to give presentations, or incapacitated and unable to work?

Refusing to believe I had OCD, I met with a leading authority on the condition. He explained that everyone has strange, unwanted thoughts every now and then. Most are able to disregard them. People with OCD, though, attach special significance to the content of those thoughts, provoking extreme anxiety and causing them to engage in compulsive rituals or avoidance tactics in an attempt to reduce the anxiety.

What Is OCD?

As Dr. Jonathan Abramowitz—a top clinician and founder of the OCD and Anxiety Disorders Program at the Mayo Clinic—explains in his 2009 book Getting Over OCD: A 10-Step Workbook for Taking Back Your Life, the obsessions that mark OCD typically concern danger, violence, mortality, or one’s responsibility for harm. They typically fall into a half-dozen broad categories:

  1. Responsibility for harm or mistakes
  2. Contamination
  3. Symmetry and order
  4. Violence and aggression
  5. Sex
  6. Religion and morality

(There are also miscellaneous obsessions, such as an extreme preoccupation with having, or being diagnosed with, a serious illness.)

Compulsions, or “compulsive rituals,” are behaviors you perform repetitively to reduce obsessive anxiety and restore a sense of personal safety. They can include checking (to make sure a door is locked, for example), decontamination (washing hands repeatedly), other repetitive action, and ordering and arranging. Rituals, too, like the ones my family member performed—mental rituals or those through which one seeks reassurance.

Why Is This Important?

It’s natural to want to know you’re not alone when suffering something like OCD, so I would always ask my health-care providers, “Do you have other patients like me who have been able to recover and lead successful, normal lives? Am I the only attorney who is dealing with these horrible, anxiety-inducing thoughts?”

Without fail—and without breaching patient confidentiality—my psychiatrist, psychologists, and other doctors would tell me they had seen attorneys with OCD (intrusive thoughts like mine, primarily) and anxiety (including panic attacks), and that anecdotally they’d witnessed an increase in OCD and anxiety diagnoses among their lawyer patients.

In February 2016, the Journal of Addiction Medicine published “The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys,” which described how lawyers have higher rates of mental distress than other professionals. It cited a recent survey of 12,895 licensed, employed attorneys, which revealed that while men had significantly higher incidence of depression, women had higher levels of anxiety and stress.

According to the North Carolina Lawyer Assistance Program, studies indicate that about 40 percent of lawyers struggle with anxiety, twice the rate of the general population. A variety of treatments are available, but because lawyers place such a premium on confidence, competence, and invulnerability, we often incorrectly interpret physical or mental maladies as signs of weakness, frailty, or incompetence. This faulty belief might dissuade us from seeking treatment—and with many of these conditions, the earlier treatment is sought, the better the outcome.

How Is OCD Treated?

Based on my research and my experience battling OCD, the primary treatment is Cognitive Behavioral Therapy (CBT), defined by the American Psychological Association as “a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness.” It usually entails efforts to change one’s thinking and behavioral patterns.

In addition to CBT, medications called selective serotonin reuptake inhibitors (SSRIs) are FDA-approved for OCD treatment. SSRIs can be effective for some people, both alone and in tandem with CBT. They can have side effects, of course, which vary from person to person. Diet and nutrition vigilance, as well as meditation and mindfulness, can also help.

Treatment is highly personalized, of course, and what works for one may not work for another. My goal in speaking out here is that other attorneys will begin to come forward and talk about their struggles so we can begin to eradicate the stigma of OCD—in particular, the less common forms of OCD, such as intrusive thoughts—and similar anxiety disorders. Only then can the conversation turn to what individual lawyers and firms can do to support their colleagues and enable them to continue to thrive—professionally and personally.

------------

Kelly Hughes has spent her career advising and supporting private and public employers across numerous industries, to include manufacturing, pharmaceutical, chemical, energy, construction, hospitality, automotive, computer/software, retail, real estate, and biotech, among others. She is also well experienced in working with local governments, colleges, and universities. Within Ogletree, Kelly is the co-chair of the Retail Industry Group, a member of the EEOC Litigation Practice Group and the Higher Education Group, and the co-chair of the Business Resource Group ODFamily.

Related Articles

Raising the Bar for Legal Industry’s Response to Mental Health Crisis


by Megan Edmonds

McGlinchey Launches ‘Wellness Works’ Initiative

Raising the Bar for Legal Industry’s Response

How To Help A Lawyer Who Is Struggling With Anxiety


by Stan Popovich

Character traits like perfectionism and pessimism, along with the long hours and intense cases, may make attorneys more prone to anxiety. Here's how to help the lawyers in your life who are struggling with anxiety.

7 Tips On Helping A Lawyer With Anxiety

Top of the Mountain


by LaVon M. Johns and Patricia Brown Holmes

Making partner, ginning up huge business, earning peer respect and industry influence are laudable goals—but it’s important to pursue them methodically and mindfully. One dynamic duo who have reached the mountaintop show how it’s done.

Red flag sitting on the top of a mountain summit

A Beautiful Mind: Motown Beginnings, Top Dealmaker


by Sara Collin

Motown scion Farah Fakir Cook has achieved her own stardom away from the klieg lights, helping clients navigate ever-changing currents in intellectual property and technology. One crucial topic looms especially large for her in the years ahead: How current law will contend with the rise of artificial intelligence.

Woman wearing pink suit standing against desk

Progress and Potential


by Michele M. Jochner

Women have undeniably made great strides in our profession in recent decades, but much remains to be done. What’s the current state of the industry, what lies ahead—and what do lawyers (male and female alike) say are the most important issues going forward

Watercolor image of person on a mountain looking at night sky

Crucial Alliances


by Jane E. Young

Workplaces everywhere have changed since the start of the pandemic in ways that can be highly beneficial to women. Here’s a road map for consolidating recent gains—and making the most of them going forward.

Woman at desk working with roadmap behind her

The Breadwinner


by Courtney E. Ervin

Two lawyers, one big life decision: How my husband and I are working to eradicate the stigma of putting my career first.

Silhouette of women in suit stands in the middle of equal scale

Canadian Women in the Legal Profession: From Non-‘Persons’ to Chief Justices


by Sara Collin

We take an in-depth look at the challenges and optimistic future of women in the Canadian legal sector.

Canadian Women in the Legal Profession

The Future of Litigation Is Changing for Female Solicitors in the U.K.


by Catherine Baksi

The support of entire law firms, organizations and senior counsel members will be the key to encouraging female solicitors and positive change in the industry.

Changing Litigation for UK Female Solicitors

New Sheriff in Town on ESG


by Patricia Brown Holmes

Various regulatory agencies within the Biden Administration are stepping up enforcement of corporate malfeasance in the ever-trendy ESG space.

ESG Enforcement in the Corporate Environment

Follow the Money


by Rachel F. Sifuentes

Women are the future of fintech—but in the here and now, they’re still being underserved in an industry otherwise marked by explosive growth. Here’s why that must change.

Women and the Future of Fintech

Privacy Practice


by Casey Waughn

Data protection is all the rage among tech companies and state, national (and even transnational) governments alike. Is it a passing fad or here to stay? And how should businesses and groups of all sizes handle compliance with a blizzard of new laws?

Data Protection Prompt New Privacy Laws

The Upcycle Conundrum


by Karen Kreider Gaunt

Laudable or litigious? What you need to know about potential copyright and trademark infringement when repurposing products.

Repurposed Products and Copyright Infringemen

IN PARTNERSHIP

The Compensation Situation


by Liz S. Washko

Pay discrimination has been outlawed for decades. Yet the issue has taken on new salience in recent years. Here’s what to know about compensation equity—and where the legal risk lies for companies.

Pay Discrimination and Equity in Legal Indust

Remote Controls


by Cynthia Morgan Ohlenforst

How law firms, lawyers and taxing authorities must adapt to remote work

Law Firms Adapt to Remote Work

Changes and Challenges


by Megan Norris

As the pandemic ebbs and many people return to the office, midsize law firms in particular must navigate a host of unprecedented questions about costs, culture and client expectations.

Changes, Challenges and Cost of the Pandemic

Trending Articles

Presenting The Best Lawyers in Australia™ 2025


by Best Lawyers

Best Lawyers is proud to present The Best Lawyers in Australia for 2025, marking the 17th consecutive year of Best Lawyers awards in Australia.

Australia flag over outline of country

Best Lawyers Expands 2024 Brazilian Awards


by Best Lawyers

Best Lawyers is honored to announce the 14th edition of The Best Lawyers in Brazil™ and the first edition of Best Lawyers: Ones to Watch in Brazil™.

Image of Brazil city and water from sky

The Best Lawyers in Mexico Celebrates a Milestone Year


by Best Lawyers

Best Lawyers is excited to announce the 15th edition of The Best Lawyers in Mexico™ and the second edition of Best Lawyers: Ones to Watch in Mexico™ for 2024.

Sky view of Mexico city scape

How Palworld Is Testing the Limits of Nintendo’s Legal Power


by Gregory Sirico

Many are calling the new game Palworld “Pokémon GO with guns,” noting the games striking similarities. Experts speculate how Nintendo could take legal action.

Animated figures with guns stand on top of creatures

How To Find A Pro Bono Lawyer


by Best Lawyers

Best Lawyers dives into the vital role pro bono lawyers play in ensuring access to justice for all and the transformative impact they have on communities.

Hands joined around a table with phone, paper, pen and glasses

Announcing The Best Lawyers in New Zealand™ 2025 Awards


by Best Lawyers

Best Lawyers is announcing the 16th edition of The Best Lawyers in New Zealand for 2025, including individual Best Lawyers and "Lawyer of the Year" awards.

New Zealand flag over image of country outline

Presenting the 2024 Best Lawyers Family Law Legal Guide


by Best Lawyers

The 2024 Best Lawyers Family Law Legal Guide is now live and includes recognitions for all Best Lawyers family law awards. Read below and explore the legal guide.

Man entering home and hugging two children in doorway

Announcing The Best Lawyers in Japan™ 2025


by Best Lawyers

For a milestone 15th edition, Best Lawyers is proud to announce The Best Lawyers in Japan.

Japan flag over outline of country

The Best Lawyers in Singapore™ 2025 Edition


by Best Lawyers

For 2025, Best Lawyers presents the most esteemed awards for lawyers and law firms in Singapore.

Singapore flag over outline of country

Canada Makes First Foray Into AI Regulation


by Sara Collin

As Artificial Intelligence continues to rise in use and popularity, many countries are working to ensure proper regulation. Canada has just made its first foray into AI regulation.

People standing in front of large, green pixelated image of buildings

Commingling Assets


by Tamires M. Oliveira

Commingling alone does not automatically turn an otherwise immune asset into an asset subject to marital distribution as explained by one family law lawyer.

Toy house and figure of married couple standing on stacks of coins

How Much Is a Lawyer Consultation Fee?


by Best Lawyers

Best Lawyers breaks down the key differences between consultation and retainer fees when hiring an attorney, a crucial first step in the legal process.

Client consulting with lawyer wearing a suit

The Hague Convention and International Custody Battles


by Alexandra Goldstein

One family law lawyer explains how Joe Jonas and Sophie Turner’s celebrity divorce brings The Hague Convention treaty and international child custody battles into the spotlight.

Man and woman celebrities wearing black and standing for photo

Presenting the 2024 Best Lawyers Employment and Workers’ Compensation Legal Guide


by Best Lawyers

The 2024 Best Lawyers Employment and Workers' Compensation Legal Guide provides exclusive access to all Best Lawyers awards in related practice areas. Read below and explore the legal guide.

Illustration of several men and women in shades of orange and teal

New York Passes 9/11 Notice Act


by Gregory Sirico

Best Lawyers highlights the newly enacted 9/11 Notice Act, which seeks to find individuals eligible for medical care coverage under different federal programs.

Firefighter stands with their back turned with flames in the background

Filing For Divorce in North Carolina


by Melody J. King

Family law lawyer Melody King answers some of the most important questions individuals may have about filing for divorce in North Carolina.

Illustration of man and woman on paper that has been torn apart