Learn how depression, substance use may influence each other

By Stacy Parmer, MOLAP director

Note: If you are in an emergency situation, please call 911. Call or text the Suicide & Crisis Lifeline at 988 for free, 24/7 support.

The legal profession often requires confrontation, long hours, and “perfect” work. The pressure can cause high rates of depression and substance use, which may interact with each other.

Lawyers are more prone to experiencing depression than their non-lawyer peers, according to a 2016 study by the American Bar Association Commission on Lawyer Assistance Programs Research and the Hazelden Betty Ford Foundation.¹

Recent studies suggest that feelings of loneliness and excessive commitment significantly raise suicide risk among lawyers.²

Lawyers are also at higher risk for alcohol issues, with one study finding that 20.6% of lawyers screened positive for hazardous, harmful, and potentially alcohol-dependent drinking.³

When two illnesses or disorders occur in the same person, either at the same time or one after the other, they are known as comorbid conditions. Comorbidity indicates that these conditions may affect each other by influencing their development and prognosis.

Depression can lead to substance use as a form of self-medication, while substance use can worsen or trigger depressive symptoms. Both conditions share a common set of risk factors, such as genetic predispositions, environmental influences, and trauma. 

The American Addiction Centers found there was a strong connection between major depression and alcohol use disorder. A nationwide study found that over 20% of individuals surveyed suffering from a current alcohol addiction also met the criteria for that of a comorbid major depressive disorder.⁴

Alcohol is a central nervous system depressant that may initially function as a stimulant but quickly intensifies feelings of lethargy, drowsiness, and depression. Alcohol use, which lowers inhibitions and impairs judgment, can also increase the risk that a depressed individual will attempt suicide.

Alcohol and drug use can aggravate the symptoms of depression, increasing the likelihood of hospitalization and interfering with treatment including medications.⁵

The culture of the legal profession sometimes normalizes heavy drinking and substance misuse as stress coping mechanisms, leading to increased alcohol use and drug consumption, which exacerbates depressive symptoms and creates a cycle that is difficult to break.

If you or someone you know has been struggling with depression and/or substance misuse, the Missouri Lawyers’ Assistance Program is here to help. MOLAP can help you develop alternative coping strategies to break that cycle and deal with the unique challenges and stressors of the legal profession.

Cognitive behavioral therapy, motivational interviewing, trauma-informed therapy, and dialectical behavior therapy are several evidence-based therapies that have been proven to be effective in treating co-occurring depression and substance use disorders. Additionally, therapy can help identify your specific symptoms and triggers and tailor coping skills for those symptoms.  

Here are a few coping skills to manage depression symptoms:⁶

1. Behavioral activation — engaging in an activity that you enjoy, even if it’s only for a short amount of time, such as exercise, hobbies, or personal care.
2. Gratitude or focusing on positive experiences can counteract the unhelpful thinking patterns associated with depression. Make it a point to begin or end your day by writing down three things you’re grateful for or three positive experiences you had and why you are grateful for them.
3. Mindfulness can help keep you grounded in the present and reduce rumination and worry by noticing your thoughts and feelings without judgment.
4. Increased social support can reduce the isolation associated with depression by connecting with others. MOLAP offers peer support through volunteers and can refer you to a community support group in your home area. You can also volunteer through MOLAP. Helping others can generate a positive mindset, reduce feelings of loneliness, and provide a sense of purpose.  

MOLAP also offers regular mental health assessments, substance use assessments, and strategies for promoting prevention, which can enhance the overall well-being among lawyers and help them even better serve their clients and communities. 

Talk with someone about coping mechanisms or other challenges you are facing at no cost by emailing MOLAP@MoBar.org or calling 1-800-688-7859. Learn more about MOLAP’s services at MoBar.org/MOLAP.

Endnotes: 

1 Patrick Krill, et. al, The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys, 10 J. OF ADDICTION MED. 46 (2016).

2 Patrick R. Krill et al., Stressed, Lonely, and Overcommitted: Predictors of Lawyer Suicide Risk, 11 HEALTHCARE 536, (2023).

3 Patrick Krill, et. al, The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys, 10 J. OF ADDICTION MED. 46 (2016).

4 Laura Close, Depression & Substance Use Disorder, American Addiction Centers (March 31, 2025), https://americanaddictioncenters.org/co-occurring-disorders/depressive-disorders.  

5 Id.

6 Coping Skills: Depression, therapistaid (2020), https://www.therapistaid.com/therapy-worksheet/coping-skills-depression.