The ethics of pursuing mental health care

Imagine receiving a mental health diagnosis.

Scratch that.

Imagine receiving a mental illness diagnosis.

Imagine anxiety that weighs you down. Skin crawling, breath-stealing, blood pressure spiking anxiety that makes your brain race with all the what-ifs, what-do-I-do-now, how-do-I-get-out-of-this scenarios that wake you up at midnight and keep you staring at the ceiling as you try to argue yourself back to sleep, knowing it's in vain and you'll crawl out of bed in the morning more tired than you crawled into it the night before. And the night before that. And the night before that.

Imagine you go to your law office anyway and you open that file, or make that phone call, or draft that letter and do it all in a way that serves your clients' interests competently and more than just competently.

Or imagine you go to your courthouse and sit at your desk in chambers and open those emails that proliferate overnight, read those briefs and declarations that land on your desk moments before the calendar begins, and then take the bench and give due process to every person coming before you that day.

And you do it all with an anxiety disorder like mine. (Or depression. Or another mental health condition like bipolar disorder or schizophrenia.)

Getting the job done well with a diagnosis is possible. The answer though, contrary to what some may insist, is not to suck it up, grow a thicker skin, and for crying out loud stop stressing out so much. In fact, that (as I'm about to show) is possibly an unethical response to a colleague with a health issue, mental or physical.

Managing this health problem is no more a matter of willpower than diabetes or cancer is. My disorder, while listed in the Diagnostic and Statistical Manual of Mental Disorders, is a brain issue, not a thought issue. The chemistry in my brain, that is, how my cells transfer substances to one another, doesn't work like other brains without this disorder work. It's physical.

I received my diagnosis of Generalized Anxiety Disorder (which my doctor said could have as easily been a depression diagnosis) in 2008 in the middle of a mental health crisis. That diagnosis didn't signal the beginning of the disorder. I'd had the condition for years, if not decades. It was at times overwhelming, like many health problems are.

And I'd already been on the bench for thirteen years by then.

One of the best things about receiving the diagnosis is that by identifying it as a medical condition, I was able to work with my doctor to pursue better health. That's important when you're a judge. It's important when you're a lawyer, too. It's important for anyone regardless of whether you have a connection to the legal field, of course, but for lawyers and judges the importance takes on an ethical dimension.

Canon 3 of the California Code of Judicial Ethics states "A judge shall perform the duties of judicial office impartially, competently, and diligently." Canon 3B(4) goes on to say, "A judge shall be patient, dignified, and courteous to litigants, jurors, witnesses, lawyers, and others with whom the judge deals in an official capacity...."

For attorneys, the competence required in the California Rules of Professional Conduct, rule 1.1(a), includes the "mental, emotional, and physical ability reasonably necessary for the performance of" service to the client.

I'd be surprised if other jurisdictions didn't have similar standards.

Experiencing overwhelming anxiety, depression, or any other serious illness can interfere with the judges' ethical obligations of diligence, patience, dignity, and courtesy, as well as the mental, emotional, and physical competence required of attorneys.

Seeking care and making it possible for people in the legal field to seek care are both ethically required by the spirit of the canons and rules, if not the explicit words of those government regulations. As a profession, the legal field must support and accommodate those in need of proper health care. Stigmatizing mental health care thus runs counter to the ethical obligations of judges and attorneys who may not themselves have mental health conditions. It may be that stigmatization itself becomes an ethical violation for interfering with an attorney's or judge's ability to pursue mental health care so they can do their jobs well.

As an ethical issue, one thing about mental health is certain: Pursuing proper care to address, treat, and manage your health is an ethical pursuit. Talking to your doctor about your health, getting good care, and taking proper steps to be as healthy as possible - all enhance your ability as an attorney to maintain your mental, emotional, and physical competence, and for you as a judge to be diligent, patient, dignified, and courteous.

I've served longer now after my diagnosis than I did before receiving it. My experience proves that having a mental illness is not a disqualification.

If you've read this far and are still of the opinion that mental illness is all in your head (suck it up, grow a thicker skin, and for crying out loud stop stressing out so much), I'd respond by saying that a heart attack is all in your chest. Go see a doctor either way.

You can have a fulfilling and successful career. I've enjoyed mine, and I hope you enjoy yours, too.