If you ever have the desire to see a perfectly executed eye-roll, or just have a glance at an eloquently blank stare, here’s what to do: Ask another attorney if he or she has been stressed out lately. Pushing the point can escalate the matter from grumbles to outright growls. There’s a good reason for it. Although everyone experiences stress from time to time, attorneys are more likely to suffer from stress more often, and at higher levels, than the general public. The numbers bear it out. Attorneys are 3.6 times more likely to be depressed than people in other occupations, 19 percent suffer from anxiety, and 21 percent have some form of substance misuse disorder.
Stress can negatively affect mental and physical health, cognitive processes such as attention, concentration, and memory. In this article, I want to explain how stress impacts your body, which will enable you to better understand the importance of actively and regularly managing it. I will also discuss several strategies and concepts to consider when planning how you can better address the stress you experience, professionally and personally.
How stress affects the body
One of the most important steps in getting stress under control is understanding how it affects the body. To begin to understand the connection, it helps to understand the difference between the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS).
The SNS is activated in response to a perceived threat, such as encountering a bear while hiking in Wyoming. This is commonly called the “fight, flight, or freeze response.” Stress is the neurological and physical shift that occurs when we detect a threat and is mediated, in part, by the release of certain types of stress hormones (e.g., cortisol). In response to seeing or hearing the bear, the heart rate goes up and blood gets pumped to the muscles. The muscles stiffen and you are ready to respond. Your thinking zeroes in on the here-and-now threat and higher-order thinking (e.g., long-range planning) diminishes. Your body devotes all its resources to the impending threat: digestion slows, the immune response diminishes to save energy, and even sexual responses are diminished.
Once the threat is over, and you have successfully fought off the bear, run away, or frozen (and the bear left), the PNS is more predominant. This is our “rest and digest” response, and this, ideally, should be our baseline condition. Although the SNS prioritizes problem solving, the PNS is more engaged in reflection, a key component of our humanness. The PNS is essential for our health and well-being. It is the state needed for deep thought, connection to others, creativity, sexuality, and digestion.
Our body and mind evolved to respond rapidly to predators, but mostly to be in a state of rest and recharge. However, our modern world, for many of us, has flipped this relationship. Instead, most everything that we experience appears to be a bear.
The relentless nature of modern life and technological stimuli encourage SNS activation regularly. The constant notifications of texts, emails, breaking news, etc. on our phones lead to a stress response and the release of stress hormones. Due to this, consider turning most notifications off on your phone and having phone-free time each day—especially at night. This will help reduce unnecessary stress responses in your body.
At work, deadlines, difficult clients, demanding partners, and billable hours can all trigger the same nervous system response as a predatory threat. When you are in this state, you start to perceive more threats, and this creates a vicious cycle. Further, in this constant state of stress, the part of the brain that manages executive function is less active, and this diminishes self-control and willpower: you might notice that you don’t eat very well or make poor decisions when you are stressed.
When we are in a constant state of stress response, it can lead to anxiety, insomnia, irritable bowel syndrome, muscle tightness, and other chronic physical and mental-health issues (e.g., low mood, lack of motivation, and lower sex drive and energy). Also, of relevance to attorneys, when not properly managed, chronic stress can also contribute to burnout and compassion fatigue.
Managing your stress-doing what works for you
Given all this, it is important to reflect on stress in your life. Which aspects of your stressful life can you eliminate? How can you minimize or lower your levels of stress? Stress reduction will help your body to engage the PNS, bringing you to a baseline of “rest and digest”—the place from which you will be more productive and creative at work.
Stress is something you can learn to actively manage: It doesn’t have to rule your life. Our response to stress, and what helps lower it for us, is personal and individual. When I discuss stress management with my clients, I strongly recommend incorporating strategies that are small, realistic, and doable. What I mean by this is using strategies that you can fit into your life and that are not time-consuming. These activities can be as brief as a two-minute breathing exercise or a 20-minute walk. By being pragmatic, you can figure out what works well for you personally and what you can incorporate in your life daily, weekly, and yearly.
What follows are a variety of strategies, concepts, and options that can help you manage your stress more effectively. Reflect on each one and see if it fits you and your lifestyle. You can do as many or as few of these as you like. Even just one of these tips can be a first step on the path to reducing the impact of stress in your life.
It’s a marathon, not a sprint
I am not crazy (or dedicated) enough to run marathons, but my husband is, and from him I have learned how one needs to approach a marathon. To complete a marathon, you need to determine the running pace that you can sustain steadily for 26.2 miles. This is not the fastest pace at which you can run—it is definitely slower. You also need to figure out when and how you will fuel your body with water and food and when you will rest if needed. The same ideas apply to your life and your career. Like a marathon, go at a sustainable pace, rest and take breaks as needed, and be well-fueled.
Five rules of life
These maxims apply to everyone. You can skimp on them for brief periods of time if necessary, but you cannot ignore these for long. To support your health, mood, and productivity:
1. Eat healthily and enough to fuel you well.
2. Sleep enough and well, for 7-9 hours/night.
3. Drink enough water.
4. Move your body regularly.
5. Relax and recharge.
Exercise is one of the most effective ways to release negative emotions and prevent the risk of burnout. In their book Burnout: The Secret to Unlocking the Stress Cycle, Emily and Amelia Nagoski analogize experiencing our emotions to going through a tunnel. We need to enter the tunnel, move through it, and then come out the other end into the light. It is important that we make our way through the tunnel and do not get stuck. If we get stuck in our emotions and do not complete the stress cycle, we are at greater risk for burnout. Exercise moves us through and out of the tunnel. Additionally, exercise really improves thinking, creativity, and problem-solving—all incredibly important qualities for your work.
You do not need to go crazy with exercising. As I like to say, the best exercise you can do is one in which you will regularly participate. Small periods of exercise are very helpful (e.g. taking a 20-minute walk during lunch, extending your walk to the train or bus after work, taking stairs instead of the elevator). It also is vital to engage in exercise that gets your heart pumping at least four times a week for at least 30-40 minutes.
Breathing is another extremely useful way to engage the PNS. If your exhale is longer than your inhale, it is particularly calming.
One breathing exercise I like to teach my clients is the “4-7-8” breath. It only takes a minute or two and is very effective. To do this exercise, you sit with your arms and legs uncrossed and both feet on the ground. You gently place the tip of your tongue on the tissue right behind your top front teeth. Close your eyes, if you are comfortable doing this. Then, inhale through your nose for a count of four, hold your breath for a count of seven, and exhale slowly through your mouth for a count of eight. You repeat this process either four or eight times, so this takes no more than two minutes.
Other breathing exercises or meditation are very helpful. Guided mediation can be useful if you are new to doing these kinds of exercises or if your mind is very busy. I especially like the app Insight Timer which has over 95,000 guided meditations that can help with calming or with sleep. Some people also like other apps, such as Calm or Headspace.
Mindfulness means paying attention in a particular way: purposefully, in the present moment, and non-judgmentally. “Be here now” is another way to describe being in the present. There are formal ways of being mindful, such as mindfulness meditation, but one can also be mindful in an informal way, paying attention to what you are experiencing right now as you live your life. As I tell my clients, “the present is the most powerful place to be.” If our attention is in the past, we tend towards depression, and when we are thinking about the future, we may experience anxiety.
Being mindful has many benefits, including lower stress, higher happiness, enhanced well-being, lower levels of anxiety and depression, and better physical health. There are many informal ways to be present in your daily life and to bring in the benefits of mindfulness. Options to consider:
· Choose one small activity to do mindfully each day. This could be eating a snack, washing the dinner dishes, brushing your teeth, or any other small thing you do daily. Use post-it notes to remind yourself to do this one activity mindfully.
· Be silent for one or two minutes each day and just be present. Take five or ten breaths and focus on these during this short mindful break. Just focus on your breath, feeling it come in and out. When your mind wanders, just bring it back to the breath. Doing this daily can have a powerful impact.
· Tune into one of your senses when you walk someplace or when you are sitting each day. This helps bring you into the moment and grounds you.
I often speak about the benefits of practicing gratitude. Gratitude decreases stress and increases happiness, improves physical health, and enhances thinking and creativity. Although gratitude is an important part of most religions, you do not need to be religious to benefit from practicing gratitude.
Practicing gratitude can be very short, simple, and pragmatic. I recommend trying to keep a gratitude journal or appreciation log daily for one week and then reflecting on whether this journal or log is beneficial. Keeping a gratitude journal serves a couple good purposes. First, it’s a great way to end the day, by reflecting on specific things we appreciate. Second, it encourages us to pay attention to these small positive things in our life throughout the day.
To start, put a small notebook and pen next to your bed. Each night, just before you turn out the lights, pause and review your day. Write down at least three things that you are grateful for, things that are small and specific to the day. For example, “I had a nice talk with ____,” That tree was beautiful,” “Dinner was great,” or “I was able to work-out today.” Even on the worst day, there are always things to appreciate, such as family and friends, contributing to the profession, having a safe place to live, and so on. The list is endless and it’s just a matter of thinking about it. Once you write, pause for 20 seconds to take in the feelings of gratitude. Research shows that has a positive effect on our brains and neurotransmitters.
Vacations are necessary and non-negotiable. Taking time off is one of the best ways to recharge, refresh, and reinvigorate yourself. It also is a highly effective way to improve your productivity. Many studies show that the more time we take off, the more productive we are at work6. And many Americans, who get less time off than most other developed countries, still do not even manage to use all of their vacation time.
There are so many benefits to taking vacation time. First, the anticipation, planning, and excitement about the upcoming vacation time can be very positive for your mental health. They really lift your mood and give you energy. The idea of an upcoming break can also help us get through our current tasks.
Second, although our culture has created the perception that it is acceptable to work even a little while on vacation, it should be a time when you are truly “off-duty”—meaning not working, not checking work emails, not reading law journals (even this one). We need time not to be working and just to be living. This gives us opportunities to reconnect with ourselves, listen to what we may want to do or enjoy, feel what it’s like to sleep late (or to get up early to spend the day doing what you want to do, not what you have to do), or eat and drink a bit more than usual. It allows us to come back to ourselves, mentally and physically.
Finally, it allows us to reconnect with those important people who we love and with whom we share our lives: partners, friends, children, and relatives. Vacation time is a perfect opportunity to reflect on and remember what we love about these special people. Vacation time makes valued memories, ones that we will look back on in the future with fondness and, hopefully, smiles and laughter. These people and these experiences are what truly matter in life.
Set one goal for yourself
I have just presented you with a wide variety of strategies and concepts which may help you manage your stress more effectively. I did this to provide you a menu of options, not to overwhelm you. As the saying goes, a journey begins with a single step. So, I challenge you: What is one goal you can set for yourself to do this week? Make sure it is small (something you can do in an hour or less), realistic, and doable—and schedule it in your calendar!
 Krill, P. R., Johnson, R. & Albert, L. The Prevalence of Substance Use and Other Mental Health Concerns among American Attorneys, available at J. Addict. Med. Jan-Feb 2016; 10(1): 46-52.
 Skovholt, T. M. & Trotter-Mathison, M. The Resilient Practitioner: Burnout and Compassion Fatigue Prevention and Self-care Strategies for the Helping Professions (3rd ed. 2016).
 Nagoski, E. & Nagoski, A. Burnout: The Secret to Unlocking the Stress Cycle. (2019).
 Southwick, S. M. & Charney, D. S. Resilience:The Science of Mastering Life’s Greatest Challenges. (2012).
 Graham, L. Rewiring your Brain for Maximum Resilience and Well-being. (2013).
HEATHER HERSH, PSYD, is a licensed clinical psychologist, Ivy League professor, and well-being consultant with over 20 years of experience. In her workshops and groups, Heather is an engaging and innovative presenter who brings warmth, compassion, and wisdom to help people move forward in their lives. She specializes in supporting people to improve their stress management, work-life balance, burnout, and mindfulness. After her workshops, participants leave with skills and tools to help them thrive. Heather also supports organizations by doing “deep dives” into an organization’s emotional health and well-being. More information about Heather can be found at thrivewell-being.com.