In the sporting world, athletes often “play hurt” through a variety of physical injuries. Competing now is their focal point, and long-term health risks the afterthought.

The practice of law is similar in many respects. Many lawyers often find it difficult, no matter what else they may be going through, to call for a substitute. So, they put on their game faces and push through stress, anxiety, depression, and much else.

But left untreated, lingering injuries can lead to massive damage.

“If I break my leg [in a sporting event] everyone understands that I need to be carted off the field and get an X-ray and have a cast applied and take time to get better and do rehab,” said Douglas Ey, deputy general counsel at McGuireWoods. “It’s the same thing if I’m suffering from depression—I need to be evaluated and treated by professionals and then I can come back on the field, ready to go.”

In Charlotte, a group of general counsel for law firms in the Carolinas, including Ey, meets quarterly to discuss issues affecting law practice everywhere. Kate Maynard, general counsel for Robinson Bradshaw, said that lawyer well-being is a perennial topic of those meetings.

“Our group is a place where we share ideas and concerns about what we’re dealing with to kind of be resources for each other,” Maynard said.

Just as football players are more likely than golfers to be injured, studies show that lawyers are more at-risk than other populations of developing behavioral health issues, from severe anxiety to drug and alcohol abuse. Practicing law consistently ranks as one of the most stressful jobs in America. There always seem to be looming deadlines, demanding clients, and excessive work.

But athletes have a number of advantages that lawyers don’t. In the law, for instance, there are few breaks and no off-season. But the most important differences boil down to one key concept: Teammates and coaches.

Encourage help-seeking behavior

In sports, those teammates and coaches can often spot signs of physical injury and help an athlete get prompt treatment. The signs of mental health challenges are more easily concealed from colleagues and supervisors, however. In a firm, who pays attention to the agitated colleague or the one who frequently works behind closed doors? The consensus is that everyone should be aware.

“If you see something, say something,” Ey said. “We do want everyone to have their antenna up and hope that supervising lawyers and mentors will really pay attention, but we also hope that those being supervised will pay attention, too. Absolutely no one is immune.”

If no one knows there’s a problem, no one can help. Discussing mental health recently has become less taboo than it once was, but many people are still hesitant to disclose their diagnosed or undiagnosed issues for many reasons. For lawyers, the added fear may be that they will be incorrectly perceived as incompetent or unstable, and that they will develop a reputation that negatively affects their ability to practice. In short, they’re afraid of the stigma they believe is attached to mental illness.

Robynn Moraites, the executive director of the North Carolina Lawyers Assistance Program, said that the adversarial nature of law practice can create a “winner-take-all” framework. But it’s not any actual stigma, but rather the fear of stigma, that discourages individuals from discussing their struggles.

“Most lawyers will tell you once they actually ask for help and tell their stories at CLEs and things like that … they are well-received with open arms and have people … say ‘you know, I’ve actually had a problem with this,’” Moraites said.

She offered a suggestion for making the profession “less toxic”: creating structural change to encourage help-seeking behavior.

Culture takes root early

Lawyers and athletes differ in other ways. Younger attorneys—those in their first decade of practice—are up to three times as likely to suffer from psychological issues as their older counterparts, according to a survey of nearly 13,000 attorneys conducted in 2016 by the American Bar Association Commission on Lawyer Assistance Programs and the Hazelden Betty Ford Foundation.

Those struggles often arise not from the practice of law, but the study of it. A 2014 ABA study cites significant data showing that mental and chemical illness begins in law school and can carry into practice. The transition from college to law school presents myriad potential stresses, from adapting to new teaching and testing styles to learning to balance class and life.

According to another study, by Yale University, 44 percent of law students face significant psychological distress. The ABA study showed that 43 percent reported binge drinking.

Law schools are taking the issues seriously.

“It takes everybody,” said Susan Kuo, a professor at the University of South Carolina School of Law. “Here, our faculty will call or email when they think something’s wrong. We have an amazing professional staff, and they are always alert.”

Some students report to law school already dealing with certain difficulties, said Heather Beatty, USC’s director of student affairs, adding that some are to be expected.

“I do think that we do our very best to catch those things and nip them in the bud so if it’s bad, it doesn’t become ugly,” Beatty said.

You’ll never walk alone

Where cortisone shots may help athletes deal with the pain of a physical injury, they do little to treat the underlying problem. The same is true for managing mental afflictions. Ey said that firms must create a culture and safe places in which lawyers are comfortable telling their stories.

“I have a clip of Steph Curry twisting his ankle, and that is just like somebody being debilitated by mental health issues,” Ey said. “He needed to be carried off the floor by his teammates. [Lawyers] need to be taken home by our colleagues.”

Whether someone is a first-year law student or a senior partner, professional help is often paramount to winning psychological battles. For firms, the imperative to help lawyers get the help they need, when they need it, is both moral and professional.

“Running a law firm, you’re running a human capital business and you’ve got to think clearly because it’s at the heart of what we do,” Ey said. “The smart firms are paying attention … there’s so much pain and so much stress that we have to deal with.”