Judging Anxiety

We expect the person at the front of the courtroom to exude calm, patience and control in legal proceedings.

Judge Tim Fall, 61, lives up to that expectation, even with a diagnosis of generalized anxiety disorder with depressive episodes.

"Mental health issues do not disqualify," Fall says, and his career is evidence.

For more than 27 years, Fall has been a judge of the Superior Court of the State of California. His courthouse is in Yolo County. He has taught judicial ethics to California judges for twenty years. He is also a presenter at conferences for judges in the state.

The first time Fall was aware of his anxiety was in college. "I had a panic attack in the middle of an algebra final. That was not a good time to have a panic attack. Somehow, I was able to come out of it. I completely bombed the final, but I had a good enough grade to pass the class. So I knew stress was a thing, and I saw it off and on for several years as a thing that got to me sometimes. But I didn't know that it was something that was actually diagnosable."

He adds, "Not everybody who goes through what I went through then has an anxiety disorder. I found out later that I do. And it's a disorder because my brain doesn't work the way that it's designed to."

The National Library of Medicine website lists six symptoms of Generalized Anxiety Disorder:

1. Restlessness or feeling keyed up or on edge
2. Being easily fatigued
3. Difficulty concentrating or mind going blank
4. Irritability
5. Muscle tension
6. Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)

Fall explained his place on the anxiety spectrum. "If you have two of these six symptoms, you can be diagnosed legitimately with generalized anxiety disorder. I have five of the six," he said.

For people like Fall, the disorder is not connected with a particular trigger, as is the case with post-traumatic stress disorder.

"There isn't some trauma in your experience," Fall said. "It's that your brain doesn't work right. That's just how your brain was made."

A chemical called serotonin is key in Fall's diagnosis. "People's brains are designed to have electrical impulses flowing and chemicals flowing. That's how the brain cells talk to each other and pass information along. These chemicals and electrical impulses have to move along smoothly. My brain does not transmit the chemicals appropriately."

Mental illness affects 20% to 25% of adults in the United States, although the Centers for Disease Control reported cases of anxiety or depressive disorders as high as 41.5% during the height of the COVID pandemic.

Fall's diagnosis includes anxiety which is sometimes concurrent with depressive episodes. For those, like Fall, who have chemical causes for their anxiety, a doctor may prescribe a range of treatments. Cleveland Clinic and Mayo Clinic websites suggest possibilities from diet and exercise to prescription medications, including several different classes of anti-depressants.  

From the bench, Fall, like other judges and court professionals, encounter situations that add to anxiety. They are categorized as secondary, or lower-level, bystander trauma.

"Judges and others in the court system hear details of violent events in people's lives," Fall explained. "Even though the events did not occur to them, they hear from many people over the course of years, and those impressions add up."

Time away from the courtroom does not fully relieve the effects. "You never reset to zero," he said.

Renee Branson is a Charlottesville, Virginia- based consultant who leads organizations toward resilience, which she describes as the ability to not merely bounce back, but to bounce forward.  

"What I have discovered is that while we each may have a certain, pre-determined level of resistance – much like the color of our eyes or how tall we are – there are factors fully within our control that will allow us to stretch and grow our resilience."

In her foreword to Fall's book, "Running for Judge," Branson commented on the prevalence of specific mental health issues in the legal community.

"Lawyers are nearly four times more likely to suffer from depression, anxiety and substance abuse than other professions," she wrote.

Of Fall's experience, Branson said, "He illustrates how he not only survives with anxiety, but thrives with it, using the lessons it has taught him to expand his compassion, empathy and ability to serve justice."

Fall said he has always felt compassion for people in his courtroom, recognizing that he is dealing with people, not cases. His understanding of his diagnosis helps him to see when they are experiencing stress. He can suggest a recess as needed.

He pointed out that part of the canon of ethics is that a judge has to display control – not in a dictatorial way, but as a leader in court. The canon also says a judge "shall be patient."

"Because I picked up some tools along the way, I am able to maintain the control of myself and the courtroom," he said.

Fall gives his wife a lot of credit for her support on his journey. He also said he counts on his spiritual belief.

"It's not 'let go and it's out of my hands, God is the one who is going to get everything done.' For me, it was more recognizing I am not in this alone," said Fall.

He said he believes in fellowship with God and with others.

"There is a passage where it's the God of all compassion who provides compassion to us so we can provide compassion to others," he said. "That also translates as coming alongside. We have a God who is alongside us so that we can come alongside others."

Judge Fall has received mixed responses to his book from his colleagues. Many are supportive, while others are concerned that his revelation will affect his career.

"It's this stigma thing," Fall said. "We're talking about your brain, which is an organ in your body. And if there's something wrong with an organ in your body, then you can address it with good health care. And that's what I want people to start to understand.

"I speak out about this because I want to remove the stigma on mental health issues."