Maryland Bar Bulletin
Publications : Bar Bulletin : July 2006

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WORK/LIFE
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MSBA Lawyer Assistance Program

Facing the Facts About Suicide

If you go through the tumbler of life, you can come out crushed or polished.

- Elizabeth Kubler-Ross, MD

The subject of death is something most of us ignore until we cannot avoid it. Conversely, a vast amount of individuals think of death differently. In fact, those individuals believe that coping with life, not death, is the challenge. For them, suicide is a more attractive alternative than trying to come to terms with what is happening in their life.

Statistical Data on Suicide

  • There are more suicides than homicides each year in the United States.
  • It is the third leading cause of death for teenagers ages 15-19 (after motor vehicle accidents and unintentional injury). Suicide is increasing, particularly for those under 14 and for those over 65.

It is further suggested in current studies that in all groups, men commit suicide successfully more than women (around four times as often). And for the legal profession, the news gets increasingly worse. In a 10-year study conducted by the National Institute for Occupational Safety and Health, death certificate data for 26 states from 1979-1988 for employed white males, aged 20-64, were compiled and studied. In a case-control analysis of more than 26,000 suicides, lawyers were found to be at increased risk for suicide, ranking fourth among the top five professional groups in terms of elevated odds ratios.

In compiling information from other lawyer-assistance programs throughout the country, it is found that suicide among male lawyers is approximately two times more likely than among men in the general population. As Don P. Jones and Michael J. Crowley stated in Bar Leader magazine: "The cold, hard figures bearing upon instances of suicide are sobering in the extreme."

Other studies that support these findings are found in research conducted by:

  • Campbell University in North Carolina, which indicated that 11 percent of the lawyers in that state thought of taking their own life at least once a month.
  • Johns Hopkins University, whose 1991 study of depression in 105 professions ranked lawyers number one in the incidence of depression.
  • Researchers affiliated with Johns Hopkins University found statistically significant elevations of major depressive disorder (AMDD) in only three of the 104 occupations: lawyers, pre-kindergarten and special education teachers and secretaries. Lawyers topped the list, suffering at a rate 3.6 times higher than non-lawyers who shared their key socio-demographic traits.

Other studies support that one out of three lawyers suffers from clinical depression, alcoholism or drug abuse. Consequently, it is not surprising that data indicates lawyers commit suicide and think about committing suicide more than non-lawyers.

Risk Factors

The factors that determine whether a person will attempt suicide are complex. These factors include both personal vulnerabilities and resilience factors. For example, depression and alcohol/drug-use are two of the most significant factors of risk for completed suicide. Other risk factors include, but are not limited to:

  • Prior attempts
  • Availability of means by which to commit suicide (i.e., gun, prescriptions, etc.)
  • Family history of suicide
  • Personal history of psychiatric illness, especially mood disorder or alcoholism
  • History of violent behavior
  • Medical illness
  • Rigid cognitive style
  • Emotional over-arousal, perturbation
  • Low tolerance for pain/distress
  • Lack of future goals and/or plans
  • Lack of social support
  • Negative attitudes towards seeking help (counseling).

These risk factors provide a lethal predisposition to despair and hopelessness, constricted thinking and a withdrawal from others. Even with the absence of alcohol and/or drug use, negative expectations or feelings of hopelessness are important predicators of suicidal behavior.

Furthermore, suicide may look like an attractive (and perhaps the only) option when pressure from stressful events causes anticipated or actual loss, humiliation or threat to one's self-esteem. As stated by Irwin G. Arason and Barbara R. Sarason in Abnormal Psychology:

Factors for suicide include one or more previous suicide attempts and having a psychiatric illness, especially mood disorder or alcoholism. A series of life events may be an important precipitating factor.

Precipitating factors can subsequently affect the overall mood of the individual. Such factors include (but are not limited to) the following:

  • Divorce, separation
  • Altered states due to drug and alcohol excess
  • Overwhelming feelings or concerns about self and family
  • Financial stress (litigation, disciplinary or other legal problems, such as bankruptcy)
  • New job assignments
  • Grief from the loss of a loved one/friend
  • Loss of self-esteem/status
  • Rejection (loss of a job/relationship)
  • Retirement

Ironically, the very personality traits that draw individuals to the legal profession may also contribute to lawyers being particularly vulnerable to suicide. Job stress, external pressures and internal performance demands, deadlines, public scrutiny, anxiety about referrals and billable hours, the isolation of everyday work – all may be contributing factors to make lawyers more susceptible.

Suicide Warning Signs: Feelings, Actions, Change & Threats

  • Expressions of hopelessness, powerlessness, worthlessness, shame, guilt, self-hatred or inadequacy
  • Declining performance and interest in work
  • Change in sleeping and eating habits (either direction)
  • Loss of interest and participation in social activities, hobbies or relationships
  • Isolation
  • Explicit statements of thoughts or feelings about suicide
  • Self-destructive, reckless behavior (i.e., reckless driving, self-inflicted injuries)
  • Inappropriately saying goodbyes (especially to people not seen in a while)
  • Suddenly "putting all affairs in order" (making a will, giving away cherished possessions)
  • Hints about suicide ("You won't have to worry about me anymore," or "It just doesn't seem worth it anymore.")
  • Acquiring the means with which to commit suicide (buying a gun, stockpiling prescription drugs)
  • Working out a plan (where, when, how).

[Excerpts from "‘I Wish I Would Have Called You Before': Depression and Suicide' ( www.mobar.org/law/iwish.htm )]

Suicide is a preventable death. Moreover, every threat of suicide is a call for help; whenever anyone displays suicidal signs, take them seriously. It is better to be wrong and embarrassed than remorseful that you failed to help. You help an individual by listening – ask them if they are suicidal, if they have a plan, and encourage them to seek professional help (or even offer to help them make that first call). More specifically, it the individual has a plan and is threatening immediate action, do not leave them alone. Take whatever action is necessary to get them into professional hands. If you have to, take them to the emergency room of the closest hospital.

The MSBA Lawyer Assistance Program stands ready to provide confidential assistance, understanding and referral resources. Suicide happens, but it need not. If you or someone you know need help, call the MSBA Lawyer Assistance Program for more information at (410) 685-7878 or (800) 492-1964, ext. 3041, or e-mail cwaldhauser@msba.org.

The subject of death is something most of us ignore until we cannot avoid it. Conversely, a vast amount of individuals think of death differently. In fact, those individuals believe that coping with life, not death, is the challenge. For them, suicide is a more attractive alternative than trying to come to terms with what is happening in their life.

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Publications : Bar Bulletin: July 2006

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