Attorney Wellness in a Nutshell
8.1.2019
We can take judicial notice that the law is a stressful profession. Lawyers work long hours juggling multiple matters, often under short deadlines. Clients present them with bad facts, opponents belittle their arguments, and courts disagree with them. Their carefully drafted deal documents come back from the counterparty marked up with comments. On top of that, lawyers are expected to bring in business and then must actually collect their fees from the clients they find. Along the way, they are expected to work for free pro bono and otherwise be involved in community activities. This does not even include the normal stresses of life from having a mortgage or raising a family.
All that stress takes its toll. Humans are still designed to be hunter gatherers and stress sets off the fight or flight reaction. When our ancestors saw a saber-toothed tiger, their blood pressure would rise, their heart rate would increase, their bodies would release the stress hormones adrenaline and cortisol, and their blood sugar level would go up to have extra energy available. They would then either fight the tiger or run from it. If they escaped the threat, the stress would be released and their bodies would calm down.
Now, while we no longer face saber-toothed tigers, our body perceives the stress of having a brief due or 20 e-mails to answer the same way and the fight or flight mechanism kicks in – but it is not released by fighting or running. We sit and write the brief or answer the e-mails and then move on to the next pressing matter. The perceived threat never ends. The stress builds up and we become anxious, irritable, and depressed. We can develop high blood pressure and heart disease, as well as diabetes from high blood sugar. Our body craves calories to keep its energy level up so we turn to calorie dense junk food which can lead to our becoming obese. Obesity presents its own health problems such as heart disease, certain types of cancer, and even arthritis.
The nature of lawyers’ work adds to the health problems caused by stress. Hunter gatherers got exercise by walking around all day hunting and gathering and carrying their prey back to camp. Lawyers sit all day typing on the computer, talking on the phone, and attending meetings. Unfortunately, research has shown that people who sit for more than eight hours a day with no physical activity have a risk of dying similar to the risks posed by obesity and smoking. Sitting too much itself also causes heart disease, cancer, and diabetes.
To make matters worse, most lawyers are probably dehydrated. Sitting in a heated or air-conditioned office can cause dehydration well in excess of 1.5% as we lose water while our lungs moisten the dry air we breathe. Severe dehydration can lead to effects such as muscle weakness, cramping, lowered blood volume, higher blood pressure, and decreased mental function. Even a 1.5% water loss leads to fatigue, difficulty concentrating, headaches, and impaired memory, none of which are good if you are wading through deal documents.
Also, most lawyers probably do not get enough sleep. Studies have shown that people who do not get between seven and nine hours sleep a night have a higher risk of developing high blood pressure, heart disease, diabetes, and obesity. Not getting enough sleep has also been found to impair attention, alertness, concentration, reasoning, and problem solving and cause anxiety, depression, and suicidal thoughts.
In some professions where there are high levels of stress such as police, firefighters, and the military, people can retire after 20 years and get a pension. For most lawyers, 20 years is only halfway into their careers. They have not even reached their peak of responsibility or seniority. Instead of retiring and getting a pension, they are faced with seemingly endless stress as they age.
Many lawyers have turned to drugs, alcohol, or worse to cope. According to a 2017 survey by an ABA working group, 21% of lawyers reported problematic alcohol use. 28% reported depression. A survey by the National Institute for Occupational Safety and Health found that the suicide rate for lawyers is 1.33 times the norm, higher than for the military or veterans. Suicide is the third leading cause of death for lawyers after cancer and heart disease. The top three causes of death for lawyers can be attributed to stress. It seems like everything lawyers do leads to high blood pressure.
It does not have to be this way. While we may not be able to eliminate the sources of stress such as opposing counsel who serve an order to show cause on a Friday afternoon, there are easily achievable ways you can reduce or eliminate many of the health effects of stress. First, you have to take on one new client: yourself.
MAKE YOURSELF YOUR OWN CLIENT
You must make yourself your own client and improve your approach to exercise, hydration, nutrition, and sleep. Instead of putting all your other clients ahead of your own health, make yourself your number one priority. While lawyers have been trained to put their work above everything, as the statistics show, that model does not work. If you take care of yourself, however, you will be healthier, happier, and more productive in the long run.
STAND AND MOVE
For better health and wellness, first go after the low-hanging fruit. The cure for sitting too much is to stand and move, so build standing and moving into your day. Stand during phone calls. Set the alarm on your phone or computer and stand for five minutes every hour. Get a standing desk. Walk down the hall to speak with a colleague instead of sending an e-mail. Take the stairs instead of the elevator. Park across the parking lot and walk in instead of using a reserved spot near the door. Hold walking meetings and improve the health of your whole team. You don’t have to run a marathon. All that simple movement adds up to counter the effects of too much sitting.
DRINK WATER
The simple cure for dehydration is to drink more water. You should make hydration part of your routine and drink throughout the day, not just when you are thirsty. While you may have heard that you should drink X glasses of water a day, there is no one set amount that works for everyone because different people are affected by different factors such as bodyweight, activity level, and even the weather. Instead, you should take in enough fluids so that your urine is clear or slightly yellow-tinged. If you eat a balanced diet, fluids can also come from a variety of sources such as juicy meat and fish and fruits and vegetables. A smoothie with whey protein and fruit checks a lot of boxes by giving you protein, carbohydrates, fiber, and water. You should avoid sugary or diet sodas as they have been linked with obesity and diabetes. Sports drinks may be helpful in replacing electrolytes such as sodium and potassium, although they may also contain sugar.
EXERCISE
Once you have started to move more and hydrate, you need to exercise to reverse the effects of the fight or flight reflex. Lifting weights or going for a run after drafting a contract or brief acts as a substitute for an encounter with a saber-toothed tiger. Afterwards, your blood pressure, heart rate, and blood sugar will be lower. Exercise will also cause your brain to produce endorphins, which are chemically similar to opiates and stimulate the brain’s pleasure centers, so you will feel happier and less anxious. You will be less stressed.
You should exercise at least three days a week in a well-rounded exercise routine which involves weightlifting for strength, stretching for flexibility, and some aerobic exercise for cardiovascular health. In addition to alleviating the effects of stress, exercise will improve your overall health. It will help to prevent obesity by raising your metabolism so you will burn fat. It will also cause you to build more muscle and bone, slowing or reversing the natural loss of muscle and bone density that occurs as people get older. You will be stronger and have more stamina to deal with the demands of being a lawyer.
Your first thought may be how are you going to exercise three times a week when you are already billing 2,500 hours, attending functions to meet potential clients, and want to watch your children’s Little League games. It can be done if you commit with the same discipline that got you through the bar exam and enables you to work long hours. If you commit to client service by returning phone calls the same day, commit to serving yourself and exercising. If you commit to billing eight hours a day, commit to exercising one hour a day, three times a week. The time is there, you just have to use it efficiently. Maybe cut back on social media.
To aid you, develop an efficient workout routine. For example, you could stretch as part of your warmup before lifting weights, which will take care of both flexibility and strength. You could use the rowing machine, which improves both cardio and strength. You can also adopt a sliding Monday, Wednesday, Friday, Sunday schedule. If you have to miss Monday because of a work commitment, go to the gym Tuesday. If you can’t make Wednesday because you have a brief due, go Thursday. Even if people are going to work all weekend on a deal, they usually take Friday evening off, so go to the gym before dinner. Sunday is always good to catch up.
To help you keep exercising, come up with a trigger that will reinforce your going to the gym. For example, you could post a picture of your children because you want to be healthy for them or a picture of a park you want to be in shape to hike on vacation. You can collect inspirational quotes and read them. Or you can use money as a motivator. Buy a premium gym membership or an expensive pair of sneakers. You will feel guilty if you do not use them and will want to get your money’s worth.
Another strategy is to exercise with a colleague and hold each other accountable. You can enter a 10K or a Bench Press meet and train for it. Enter a Spartan race and test your mettle.
Another way to stay motivated is to set realistic goals. If you want to lose 20 pounds, break it up into smaller milestones. Losing that much weight is difficult and can take a long time and you may get frustrated. You can keep the 20 pounds as your ultimate goal, but to start say you want to lose two pounds a month. That is achievable and as you accomplish it month after month, you will stay excited and motivated. Also, at some point you will suddenly realize you have lost 20 pounds.
The more you exercise, the easier it will be to keep at it, because your body will want to move. Your body will develop a positive feedback loop and you will start to feel logy and edgy if you miss a day. You brain will want the endorphins. Soon you will find yourself scheduling meetings and calls around the gym.
EAT WELL
To be well you have to eat well. There are many diets out there, low carb, no carb, paleo, Bronze Age, and lots of seemingly conflicting advice. The best diet is one you can follow without being a slave to it and which will give you the energy to get through a busy day of law and exercise and be well and fit at the end of it. You should eat a balanced diet of protein, carbohydrates, and fats. You need protein because your muscles and organs are made of protein. You should eat about 1g of protein for every 2 pounds of bodyweight daily from lean meat, chicken, and fish spaced out over three meals and a healthful afternoon or post exercise snack. Try a filling whey protein smoothie or peanut butter on whole wheat bread instead of a 500 calorie Grande latte.
You need carbohydrates for energy. Your muscles need carbs for glycogen to burn during exercise. More importantly, the brain runs on glycogen and being a lawyer puts lots of energy demands on the brain. That is why you crave those conference room sticky buns during a long meeting. Instead, give your brain and body the fuel they need with good carbs such as fruits, vegetables, and pasta.
Your body also needs fat for fuel and to maintain the brain, nerves, and other organs. Your brain is made of fat. Eat good fats such as from olive oil and oily fish like salmon.
When you eat a balanced diet, you will not feel like you are denying yourself and it will become part of your routine, like exercise. Also, when paired with exercise, 80%-90% compliance is enough. There is room for pizza and wings at a Super Bowl party or hot dogs at a summer cookout. As with exercise, your body will develop a positive feedback loop and will feel logy if you eat too much junk and you will want to go back to wholesome food again.
To help you eat well, always eat a breakfast of protein, carbs, and fat such as eggs with toast or oatmeal and fruit. This will keep your blood sugar level and give your brain the fuel it needs so you won’t crave sugary junk later. Stay away from fast food. It is just empty calories. Be wary of those premium coffeehouses. Some of their drinks have as many calories as eating 10 Oreo cookies. Try an exotic tea with lemon instead.
SLEEP WELL
The final piece to support your wellness is to get seven-and-a-half hours of sleep a night. Sleep helps in so many ways from enabling your body to recuperate from exercise to improving memory to preventing obesity. You will be sharper the next day. Getting five hours or less a night causes the same impairment as having two drinks.
To doctors, it is hornbook medicine that people should not sit too much, stay hydrated, exercise regularly, eat a balanced diet, and get enough sleep. If we make it hornbook law that lawyers should follow those principles, it will enable us to cope with the effects of stress. We will be happier and healthier and better able to serve our clients, including ourselves.