1. Staying sane in an insane profession.... and maybe enjoying yourself. Christopher R. Nichols Nichols Law Firm 1312 Annapolis Drive, Suite 103 Raleigh, NC 27609 www.NicholsTrialLaw.com Chris@NicholsTrialLaw.com

2. Experts Say... Lawyers suffer from alcoholism, chemical dependency, depression at rates higher than the general population

3. Why? Competing interests to run your law office as a business and to fully devote yourself to practicing law Struggle to meet client needs and still maintain outside interests and family commitments Struggle to maintain objectivity while taking on client’s problems

5. Definitions Alcoholism The Alcoholics Anonymous Model –Definition. Alcoholism is an incurable, progressive, and often fatal disease. Alcohol is a poison to an alcoholic though not to others. An alcoholic is a person whose life has become intolerable through the use of alcohol. AA is a close community of those afflicted with this disease Chemical Dependency Guess what? It is basically the same thing.

6. Depression The inability to experience pleasure (anhedonia) presents as the primary symptom of depression. The illness is all consuming, completely enveloping a person's life. The condition causes one to feel hopeless, helpless, sad, or down during most of the day, almost every day. Depressed people experience feelings of guilt and unworthiness. Sleeping patterns are adversely affected as are eating habits, often resulting in excessive weight loss or gain. People feel hopeless and often believe that they and everyone else would be better off if they were dead. They may be suicidal. Depression is not the result of weakness, moral defect, or deficiency of character. Rather, it is a chronic disease, the nature of which can be organic, psychological, or interpersonal.

7. Results of your “relaxation”… If excessive drinking or drug use continues, it is fatal. Death may result from suicide (25% of all suicides are alcohol related) or in the form of heart failure, liver disease, bleeding ulcers, cirrhosis, gastrointestinal disorders, or any of a number of other ailments. But death will be a direct consequence of the excessive and prolonged intake of alcohol. Not only is substance abuse a physical health problem, it also alters perception and thinking.

9. Take the Depression Test….oh boy! Have you been consistently depressed or down, most of the day, nearly every day, for the past two weeks? In the past two weeks, have you been less interested in most things or less able to enjoy the things you used to enjoy most of the time?

10. During the past two weeks, when you felt depressed or uninterested: Was your appetite decreased or increased nearly every day? Did your weight decrease or increase without trying intentionally? Did you have trouble sleeping nearly every night (difficulty falling asleep, waking up in the middle of the night, early morning wakening or sleeping excessively)? Did you talk or move more slowly than normal or were you fidgety, restless or having trouble sitting still almost every day?

11. Depressed? Find out…. Did you feel tired or without energy almost every day? Did you feel worthless or guilty almost every day? Did you have difficulty concentrating or making decisions almost every day?

12. If you answered yes…. a persistent sad mood and/or loss of interest or pleasure in most activities Changes in appetite or weight Changes in sleep patterns Restlessness or decreased activity that is noticeable to others Loss of energy or feeling tired all the time Difficulty in concentrating or making decisions Feelings of worthlessness or inappropriate guilt Recurrent thoughts of death or suicide … You may be Depressed

14. Impairment affects the lawyer.. Mental ability Physical ability Ability to run office Ability to meet client needs Ability to meet family needs

15. Impairment affects others... Family members Other lawyers Staff

17. Models of Alcoholism SOME COMMON MODELS ABOUT ALCOHOLISM 1. The Impaired Model Definition: An alcoholic is a drunk, souse, toper, tippler, soak, lush. When he/she gets drunk, he/she is plastered, bombed, stoned, tight, oiled. Etiology. Some people are just that way for unknown reasons. Behavior. Drunks are repulsive and dirty; nice people do not like to get close to them. Sometimes they are comical they fall down, talk to lamp posts, try their door key in the wrong house, get their words mixed up, and so forth. But it is wrong to laugh at them and make fun of them because they cannot help it.

18. Models of Alcoholism, continued 2. The "Dry" Moral Model Definition. Alcoholism is a moral failing, not an illness. It is the natural penalty for drinking. Etiology. Alcoholism occurs because drinking occurs. Some strong-willed people can apparently drink without becoming alcoholics. but the social risk in drinking is too great to allow any acceptance. 3. The "Wet" Moral Model Definition. Alcoholics are drinkers who do not obey the rules of the drinking society. They behave badly when drunk, and they cannot hold their liquor. Alcoholism is an unacceptable form of drinking behavior. Etiology. It is a mystery why some people who drink become alcoholics. 4. The Alcoholics Anonymous Model Definition. Alcoholism is an incurable, progressive, and often fatal disease Alcohol is a poison to an alcoholic though not to others. An alcoholic is a person whose life has become intolerable through the use of alcohol AA is a close community of those afflicted with this disease Etiology. Alcoholics are emotionally impaired people who drink to compensate for their inadequacies and then, because of their body chemistry become addicted to alcohol, creating a circular process of further inadequacy and further drinking.

19. Models of Alcoholism, continued 5. The Psychoanalytic Model Definition. Alcoholism is a symptom of a deep, underlying neurosis. Alcoholics are addictive personalities. Etiology. Since the alcoholic is an infantile person, the key to understanding his/her inability to achieve maturity lies in early emotional experiences. 6. The Family Interaction Model Definition. Alcoholism, like drug addiction and schizophrenia, is best seen as a form of family interaction in which one person is assigned the role of the alcoholic while others play the complementary roles, such as the martyred wife, the neglected children, the disgraced parents, and so forth. As this deadly game is played by mutual consent, any attempt to remove the key factor, the alcoholic, is bound to create difficulties for the other family members, who will attempt to restore their former game. Etiology. As these family games are circular and self-reinforcing, it is useless to inquire how it began. In general, the basic personality inadequacies are transferred from generation to generation. The behavior of the alcoholic and other family members is a series of moves in a continuous and long, drawn-out family game.

20. Models of Alcoholism, continued 7. The "Old" Medical Model Definition. Alcoholism is a serious, progressive, and eventually fatal disease which is incurred by the immoral behavior of excessive drinking. Etiology. The etiology of alcoholism is the excessive drinking of alcohol. The reason for the immoderate drinking is unknown. Alcoholics seem to be unable to control themselves. Prognosis. The prognosis is poor because the patient will not care for himself/herself 8. The "New" Medical Model Definition. Alcoholism is a progressive, often fatal disease, possibly hereditary. Alcoholics are ill people whose body chemistry is such that they can become addicted to alcohol. In emergency treatment, alcoholism must be distinguished from schizophrenia depressions, head injuries, and so forth. Etiology. It appears that alcoholics may have a defect in metabolism, possibly involving one of the major amino acids. There are probably also psychological and sociocultural contributing factors. Behavior. Much of the alcoholic's behavior stems from the alcoholic's need to control withdrawal symptoms.

21. My story Promises, promises….. The dog catcher…. Something out of nothing… The engagement party… Oprah… Life again…

22. What Can You Do? Resources NC State Bar NCBA Malpractice Company

24. CONFIDENTIALITY Confidentiality with the Lawyer Assistance Program If you call to seek help for yourself, your inquiry is confidential. If you call as the spouse, child, or friend of a lawyer whom you suspect may have an alcohol, drug or mental health problem, and needs help, your communication is also treated Confidentially and never related to the lawyer for whom you are seeking help without your permission. All inquiries, questions and conferences are privileged and held in the strictest confidence. Under Rule 1.6 of the Rules of Professional Conduct of the North Carolina State Bar, the attorney/client privilege is applied to communications between a lawyer seeking assistance with the Lawyer Assistance Program. In order to assure this high degree of trust and confidence, the Lawyer Assistance Program is, by rule of the State Bar, which has been approved by order of the North Carolina Supreme Court, entirely, separate from any ethics or disciplinary committee of the State Bar

25. Self Help Resources Links: Lawyers Assistance Program: www.nclap.comwww.nclap.com Self Help Fellowships Alcoholics Anonymous http://www.aa.org/http://www.aa.org/ Emotions Anonymous http://emotionsanonymous.org/http://emotionsanonymous.org/ Dual Recovery Anonymous http://www.draonline.org/http://www.draonline.org/ Al-Anon http://www.al-anon-alateen.org/http://www.al-anon-alateen.org/ Co-Dependents Anonymous http://www.codependents.org/http://www.codependents.org/ Narcotics Anonymous http://www.na.org/http://www.na.org/ Gambler's Anonymous http://www.gamblersanonymous.org/http://www.gamblersanonymous.org/ Sex and Love Addicts Anonymous http://www.slaafws.org/http://www.slaafws.org/ Debtor's Anonymous http://www.debtorsanonymous.org/http://www.debtorsanonymous.org/ Understanding the 12-Steps http://www.the12steps.comhttp://www.the12steps.com

26. Mental Health Resources Mental Health Recourses Depression and Bi-polar Support Alliance http://www.dbsalliance.org/ Mental Health Info source http://www.mhsource.com/ http://www.mhsource.com/ Mental Health Depression Publications http://www.nimh.nih.gov/publicat/depression.cfm National Institute of Mental Health http://www.nimh.nih.gov/ http://www.nimh.nih.gov/publicat/depression.cfmhttp://www.nimh.nih.gov/ North Carolina Bar Association BarCares Resource Available in Certain Counties http://www.ncbar.org/legal_prof/barcares/ http://www.ncbar.org/legal_prof/barcares/ Mandarin Health Online http://www.mandarinhealth.org/med_depts/35.shtmlhttp://www.mandarinhealth.org/med_depts/35.shtml Stress at Work http://www.cdc.gov/niosh/stresswk.htmlhttp://www.cdc.gov/niosh/stresswk.html Mental Health Net http://mentalhelp.net/http://mentalhelp.net/ Recovery, Inc. http://www.recovery-inc.com/http://www.recovery-inc.com/

27. Addiction Resources National Clearinghouse on Alcohol and Drug Information http://www.health.org/http://www.health.org/ Sobriety and Recovery Resources http://www.recoveryresources.org/http://www.recoveryresources.org/ Recovery Resources for Professionals http://www.powerfullyrecovered.com/links/professionals.html http://www.powerfullyrecovered.com/links/professionals.html Renewal Center of the South http://www.resouth.org http://www.resouth.org Alcohol Screening http://www.alcoholscreening.org http://www.alcoholscreening.org Dr. Kevin McCauley www.addictiondoctor.comwww.addictiondoctor.com Dr. Omar S. Manejwala www.recoverymd.comwww.recoverymd.com Association of Halfway House Alcoholism Programs of North America, Inc. http://www.ahhap.orghttp://www.ahhap.org http://www.sobersity.com Recovery Renewal Earnie Larsen http://www.earnie.com/http://www.earnie.com/ Hazelden Renewal http://www.hazelden.org/events/events_results.cfm?view=type&type=7 http://www.hazelden.org/events/events_results.cfm?view=type&type=7 Renewal Center for the South http://www.resouth.orghttp://www.resouth.org

28. How to Move Forward Network with others who have been through similar situation Start job search Use the experience as a learning opportunity

29. Conclusion It Can Get Better