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A Physician’s Guide for How Attorneys Can Avoid Burnout and Optimize Their Lifestyles


Burnout is a syndrome resulting from chronic stress typically associated with work, and it is abundant in the legal profession. It is characterized by overwhelming exhaustion, negative attitudes or a lack of commitment to clients, and dissatisfaction with job performance.

Burnout is a significant predictor of hypercholesterolemia, type 2 diabetes,coronary heart disease, hospitalization due to cardiovascular disorder, musculoskeletal pain, changes in pain experiences, prolonged fatigue, headaches, gastrointestinal issues, respiratory problems, severe injuries, and mortality below the age of 45 years. The psychological effects of burnout include insomnia, depressive symptoms, use of psychotropic and antidepressant medications, hospitalization for mental disorders, and psychological ill-health symptoms. 

I recently discovered that I have quite a few friends in the legal profession. The parallels of our craft are uncanny, yielding a distinct appreciation for the level of schooling, stress,and performance anxiety induced in our relative fields. We manage critical, life-changing situations that must be handled delicately while simultaneously maintaining client/patient confidentiality, candor, and calm. Billable hours loom, lives can both literally and figuratively hang in the balance, and now decisions must be made—what are you prepared to sacrifice?


Emotional, Mental, and Physical Exhaustion in the Legal Profession



As high performers, our daily choices are daunting, and frequently, the appropriation last on the list is ourselves. When you take a birds-eye view, it feels even more overwhelming. You are tired yet can’t sleep. You eat bags of stuff at your desk for lunch that can only be loosely considered food and is far from nutritious. You have meant to get some exercise, but your steps largely result from pacing your office, frantically trying to find the person assigned to help you, or walking in from the parking lot. You may not have seen your family or loved ones in several days. The end-of-the-day sigh of relief comes as you open the bottle or pour a cocktail. You did it. You survived another day. You tell yourself, “If I can just make it through this brief/trial/deposition/etc., it will get better.” And then it doesn’t.

Ask me how I know. 


Could You Be Suffering from Burnout?

Being the pragmatic individuals we are, we start to wonder—and Google—if the popular term “burnout” is the cause of the suffering. Maybe “adrenal fatigue”? Could my cortisol too high? Aside from being popular in the news and social media, what does that really mean?

According to a systematic review of peer-reviewed articles and cohort study addressing physical, psychological, and occupational consequences, burnout is a syndrome resulting from chronic stress. When it comes to doctors and lawyers, chronic stress is typically associated with work. It is characterized by overwhelming exhaustion, negative attitudes or a lack of commitment to clients, and dissatisfaction with job performance.

Why is this all happening?

In an attempt to appeal to the natural curiosity that permeates your profession, and without overwhelming you with science, this is the pathophysiology. And most importantly, once you understand the why, you can work toward the “how” to fix it.

What Does Burnout Mean and What Does It Do to Your Body?

Burnout, adrenal fatigue, and high cortisol are essentially the same thing. Cortisol is a hormone that has gotten a bad rap. Although it is known as the body's stress hormone, cortisol is also responsible for keeping our ancestors alive when they either had to fight or flee from the prehistoric tiger. Cortisol in short bursts is good. It helps mount an immune response and keeps you safe from germs, tigers, and even yourself. However, like all good things—too much, too often is maladaptive, and long-term cortisol exposure can drastically affect your health.

“Burnout is a significant predictor of the following physical consequences: hypercholesterolemia, type 2 diabetes, coronary heart disease, hospitalization due to cardiovascular disorder, musculoskeletal pain, changes in pain experiences, prolonged fatigue, headaches, gastrointestinal issues, respiratory problems, severe injuries and mortality below the age of 45 years.” (Salvagioni DAJ, Melanda FN, Mesas AE, González AD,Gabani FL, Andrade SM. “Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies.”) These are compounded by the psychological effects of burnout: insomnia, depressive symptoms, use of psychotropic and antidepressant medications, hospitalization for mental disorders, and psychological ill-health symptoms.

Studies, even as early as 2001, have shown that lifestyle choices, including substances,nutrition, exercise, and sleep, can affect your cortisol levels, for better or worse, just as much as mental stress. Most people would acknowledge this is true, so what are we missing?

The Legal Profession Demands Performance Beyond What Your Body Can Support

We are called to choose between our health and our careers in professions that demand far above the expectation of normal performance. Training and decades inundated with the culture of law and medical practice have led us to this point. Law and medical students hustle for limited resources, scant As, and internships. Then we graduate. Now, the stress of job acquisition, finding a mentor, billable hours, and meaningful work begin and slowly eclipse family and social life. Cortisol continues to rise.

Almost inconspicuously, we are encouraged to sacrifice ourselves. We do what we must do for the good of our clients/patients/firms and don’t understand why we feel so overwhelmed when everyone else seems to be executing just fine. The culture is the problem. We must do more and be more at all times, in all situations, and for all people. It is impossible to keep up the facade that imposter syndrome demands.

Fortunately, things are slowly getting better in our noble professions. New generations of doctors and lawyers are starting to recognize the toll these sacrifices have taken on their older and more seasoned superiors—and they are deciding that maybe it isn’t worth it. However, until the culture changes the practice and the practice changes the training, we must adapt.

As highly driven individuals, we are unlikely to radically jump the ship we have spent a better part of a decade creating. The only option is to optimize the things you already do in life; just do them better.


Focus on How You Want to Feel Instead of What You Want to Achieve

Is this where you thought you would be after all this work? How do you feel? Are you stuck in an endless to-do list that you never seem to be able to gain traction with? In her book The Desire Map, Danielle Laporte outlines the importance of emphasizing the feelings that we want to invoke in our daily lives to create fulfillment rather than what objectives we want to achieve. Laporte subdivides our lives into six key areas: personal, professional,health/wellness, relationships, spiritual, and financial. Most to-do lists will fall into one of these categories.

Instead of focusing on the doing—focus on the feeling. How do you want to feel at the end of the day? Accomplished? Happy? Fulfilled? Then what are the actions that will make you FEEL that feeling? Create a list under each category of your core desired feelings. You can use feelings in multiple categories, so don’t think about it too much. can provide you with more specific feelings than just happiness. Happy has different connotations for different people or in different circumstances. Happy can include aroused, curious, confident, and inspired, to name a few. Once you have created your list, go back through each and highlight the feelings that appear most frequently. Pick the top five; those are your core feelings, and all actions should focus on attaining the FEELING.

For instance, I want to feel healthy and accomplished. As a result, I get up early to exercise and eat a healthy breakfast. I want to be a person who exercises before work. As a result, I found a way to fulfill those goals. Make your list, acknowledge that there is a problem,encourage your colleagues (maybe show them this article), and then stay tuned. You are worth taking care of.

During the next six months, I will provide you with small, actionable steps that affect every aspect of your life. These pillars will address nutrition, exercise, sleep, social connections,stress, substances, and spirituality. Mindfulness is the first step. Let’s go!


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