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Why do depressed and anxious professionals develop substance abuse disorders Life and style



B.The appearance of a civil lawsuit was stressful in the best of times, but during the pandemic, that stress became insurmountable for Russell, a young lawyer in Minnesota. When the blockade began, Russell was already facing a crushing workload and multiple deadlines. In mid-March, he was also isolated, working from home without the support of colleagues or the office structure.

Russell, who did not use his real name and spoke on condition of anonymity, was sober for nearly four years after battling heroin addiction, but when the blockade began, he felt the need to “take the edge”. . He began using kratom, an herbal extract made from the leaves of an evergreen tree that grows in Southeast Asia. Kratom, which is legal, has an opioid-like effect on the brain, causing pleasure and sedation; in small amounts acts as a stimulant. Kratom was useful for a few days, and then it was not. I just thought, why am I wasting my time with this? He remembers. So Russell bought some heroin and overdosed in his home office. His girlfriend found him. “The bottom line is that I have a disease that justifies everything I need, and Kovid gave me that excuse,” he said.

Witness the clash of two epidemics. The new one, Covid-19, with its deadly consequences, worsens the already existing epidemic – the drug epidemic. And many of its victims include those we often think are the least vulnerable in society: white-collar professionals.

Employment in a wide range of occupations – including finance, law, insurance, media, technology, sales and advertising – has declined. According to the Bureau of Labor Statistics, business and professional services alone have lost 1.5 million jobs since February; leisure and hospitality have lost 4.1 million; education and health, 1.2 m.

Lawyers are particularly vulnerable to substance abuse; they already have high levels of depression, anxiety and alcoholism and many are struggling. The New York Attorneys Support Program recently held a webinar discussing substance use and mental health. Typically, such a webinar will attract about 100 lawyers, says Eileen Travis, the program’s executive director. There were about 700 in attendance.

At the end of May, the Kentucky Bar Assistance Program held a webinar entitled “Managing Your Anxiety and Well-Being in the Transition to the New Normality” and allowed attorneys to ask questions anonymously. Before Covid, about 50 lawyers would show up; more than 500 were in attendance, “this is insane for us,” said Yvette Hurrigan, who runs the program. The country’s legal community is populated mostly by smaller companies and solo practitioners who are losing business and struggling to survive.

Nina Vasan, a clinical assistant in psychiatry at Stanford University School of Medicine and a psychiatrist concierge at the Silicon Valley Executive Psychiatry, says her professional clients are “people with the highest percentage of 1%” who include technical contractors, entrepreneurs, at-risk capitalists, lawyers and investment bankers – they fight in ways she has never seen before. Isolation, insecurity and lack of control are the perfect setting for depression, anxiety, drug use and excessive drinking.

Part of the problem seems to be the lack of consequences. Few professionals drive to and from the office now or travel for business. They should look good from the neck up for just 8am Zoom appointments, so it’s easier to hide intoxication or a hangover. Vasan said that for the first time in her career, two of her executive clients appeared at their therapy session. Other clinicians I’ve talked to say the same thing happened to them. “I had two different clients who told me in the middle of the session that they had news and it was around 11 in the morning,” said Ashley Anested, a psychotherapist who sees clients from a distance. “I would unpack it pre-pandemic, but now I’m like, yes, you have four children under 10 years old. I sympathize, but I don’t want that for you in the long run. “

New real-time data from ODMAP, the University of Baltimore’s Overdose Detection Program, shows that drug overdoses have risen during the pandemic, rising by about 18 percent since home orders were carried out. mid-March. This is partly due to illegal (and illegally purchased) drugs, which are more dangerous than ever. Although the number of opioid prescriptions is steadily declining, the overdose is increasing. This is because illicit opioids and other drugs (including cocaine, methamphetamine and benzodiazepines) are reduced by the synthetic opioid fentanyl, of which only a small amount – 2 mg – can be fatal.

For professionals trying to stay sober and recover, the pandemic has been particularly severe. Isolation and lack of connection are triggers for use and often cause overdose. When my ex-husband Peter – a partner in a prominent law firm with hidden drug addiction IV – died five years ago, just when he was isolated. Peter used it for at least a year, but when he finally alienated his children, friends, and colleagues, when he stopped showing up at the office, he stopped answering calls, emails, and text — that was the end of it. Peter fenced himself in his beautiful home, supposedly working from there, but really on a drug-powered bender, injecting himself with opioids and amphetamines continuously for days until he died.

The connection and community are usually found in meetings like AA and NA, which have largely moved online. For many people this works, but for many others it does not. Michael Waxlax, a licensed addiction counselor supporting male patients in the Hazelden Betty Ford Professionals Program, says face-to-face meetings make many participants feel unable to convene virtually. “They know the feeling when they enter an AA meeting room, the smelly smell of the church basement, this energy, the communication, this immediate sense of belonging. These types of connections may be unconscious, but we associate them with recovery. “

For professionals who have studied for years to earn MBAs, MDs, PhDs and JDs who have had very specific career paths, identity is often inextricably linked to their careers. The loss of office and support staff, which is not needed by clients who retire due to their own financial problems, the reduction of income – all this can cause an existential crisis for professionals, as they question their place in the world and their goal. . And this can also be a reason for self-medication.

Nathan, who also wished to remain anonymous, for example, deeply identifies with his work as a dentist serving low-income patients in Ohio. He was used to seeing about 20-25 patients every day at the clinic where he worked, and he loved it. But once he stopped taking Covid, he was only allowed to do emergency or palliative dental treatment. It was usually just him and an assistant. All the positive results of his work were gone – he would no longer teach children how to floss and avoid sugar, but simply patients who had neglected their teeth and now had pain and infections. “I started drinking every day. I also took Xanax for a few weeks to help me sleep. My wife was pregnant and I kept wondering, do I bring anything home with me? I was suffering from anxiety and boredom, “he told me. Nathan’s drinking kept escalating, but he promised himself that when the baby arrived, it would be over. On the way home from the hospital, his wife and new baby in the back seat, he stopped at a liquor store. “That was it,” Nathan told me. “I went straight for treatment.”

Addicted psychiatrists and counselors who treat professionals have repeatedly told me that as the pandemic continues and we are heading for winter, they are preparing for an “attack” on mental health and addiction problems. And not only among lawyers and traders and investment bankers, but also health professionals – doctors and assistants and nurses.

Jessica Sellar, field director at The Ridge Ohio, a medical facility in Milford, Ohio, says The Ridge has admitted twice as many health professionals as usual in the past three months. “I think we just scratched the surface or we didn’t even scratch it,” says Selars. “There will be a huge amount of additional damage from this.”


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