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  • Nov. 5, 2008

    Managing depression in the workplace

    By Gabrielle J. Melin, M.D.

55 comments posted

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Work is a big part of our lives. Depression affects you no matter if you are at home or at work. Severe depression can affect your ability to perform your job efficiently.

A buzz word in the literature and press is presenteeism. This means that you are physically at work, but at the same time, are ill. The illness can be medical or psychiatric. The illness can range from mild to severe.

Presenteeism can have a significant negative impact on performance, yet can be difficult to measure.

You continue to go to work despite being severely ill or depressed for many reasons. You may feel you will lose your job. You may want to keep your mind active and have structure in your day. You need your paycheck so you can continue to put food on the table and pay the bills. You do not have paid sick leave and therefore, you have to go to work. You go to work because you feel a duty to your employer and co-workers. You go to work to help your customers.

This is not meant to judge people if they do or do not go to work when ill. The purpose is to provide education and awareness.

How can you manage your depression in the workplace? Make sure you are following up with your health care provider on a regular basis. Follow your treatment plan and take medications exactly as prescribed. Call your provider if you have questions, concerns or are experiencing a worsening in your symptoms.

At work, keep yourself active and challenged. Clearly understand your job description and your employer's expectations of you. Talk with your employer if you need assistance. Use resources available to you in the workplace such as human resources or an employee assistance program. Work can provide a sense of pride and accomplishment and therefore, boosts your self-esteem. Set yourself up for success by treating and managing your depression!

Please share your experiences with depression in the workplace and the issue of presenteeism.

55 comments posted

blog index
  • November 17, 2008 10:11 p.m.

    How sad that we still are not willing to take care of ourselves. In my opinion there is no job worth ones physical or mental health. If it comes to that then that's what our legislators are for, to write legislation to make the changes so that we can take care of ourselves and those we love.

    - Katherine

  • November 17, 2008 10:01 p.m.

    This is so bogus! We live in a society where it's all about performance and we go to work sick because we don't have the courage to say enough! It's not okay to take care of ourselves because we've allowed it to be that way. We don't demand changes in work situations that will allow us to take care of ourselves, our kids, our relatives, to stay home with pay until we're healthy enough to go back to work. Until we, the people, make the changes, decide to pull together and work together to devise a system that works and not cave to the corporate guilt/performance machine it's not going to change. We choose to be brainwashed little automatons who are waiting for someone else to make it happen. What's so sad is that we have the power to make the changes happen. People are just so apathetic and unwilling to do the work necessary to make our jobs a better place to be. We do what we're told. Now that is something to get sick over.

    - Janice

  • November 15, 2008 5:31 p.m.

    I've been through many personal challenges that have left me severly depressed for many years. I've been on many kinds of medication, and noe of them really have seemed to work. I have PTSD. Being at work is sometimes more than others, very difficult. My mind is so fogged sometimes I cannot rember anything. It just goes blank. right in the middle of a project. I cannot sleep, therefore I am perscribed sleeping pills, sure they worked for a while till my head was so fogged in the mornings that I did not want to get up. People who have a mental disorder are the only ones who understand. not the boss, or friends, or even family members. I find that keeping it to myself is the safest thing to do. Mike

    - Mike

  • November 12, 2008 10:56 a.m.

    I am 46, I lost my mother to cancer when I was 13, my father was a alcohlic and told me he did not want the responsibility of raising a 13yr. old, he told me I needed to find a place to go. I did not realize at the time that was the beginning of my depression and PTSD. I went to college and became a LPN, I was able to work for 13 yrs. I was married 23 yrs. We have 2 wonderful sons. My husband in his early 40's was diagnosed with malignant hypertension, he also was an alcoholic, in time, at his check up, the doctor told us he was in chronic renal failure. My husband had no idea what this meant, it was only weeks later that he had to have a shunt and began hemodialysis 3x weekly. He suffered greatly, after 2 1/2 yrs he shot himself in the head in our front yard. our son's were 10 and 16 and they both thought they were the cause of their dad shooting himself. By the grace of God, we made it through, and my oldest son is married with 2 beautiful daughters, and my youngest is about to graduate high school this May. I worked as a nurse review specialist for a federal gov. agency. This job was staffed with doctor's and nurses. I had and have severe mood swings, and now have been diag. with bipolar illness, I have attempted suicide many times, before my husbands illness began. I have been disabled now for over 10yrs. When I was in the psych. hospital, my manager came to the hospital and while I was in the shower left layoff papers on my bed. I struggle every day. God bless you all.

    - Catherine

  • November 12, 2008 10:10 a.m.

    There is still very much a stigma about depression. Revealing this to your employer or immediate supervisor is a big mistake. While there is legal protection for firing some one for a medical condition, there is no protection for the change in regard by supervisors and employers. They will profess the legally correct concern; but in reality you are toast as an employee especially if you aspire to any sort of career goals.

    - Mary

  • November 11, 2008 8:37 p.m.

    Even though my depression is generally on the mild side, when it's active, it's difficult to focus on my work, as it must be for others, too. I've found that IF I can talk myself into diving into a project and sticking with it for, say, an hour, and then longer, the day passes quickly and I have actually accomplished something! Sometimes, though, it is an hour-by-hour goal/deal with myself, but for the most part, this "game" has helped me through, and I hope it can assist someone else as well. Luckily, my immediate supervisor suffers from depression, too, so he knows the ups and downs of it. I feel great sorrow for those who cannot reveal this at work if only for the support aspect. I don't know what I would do without my supervisor's empathy. Best wishes to all as we travel this path together - Maggie's mom.

    - Maggie's mom

  • November 11, 2008 7:53 p.m.

    I can relate to this subject. I changed jobs many times due to depression and had to take time to get over clinical d. several times. Many years ago I had to realize that I cannot pursue the level of job activity that I would have had I not suffer from depression/anxiety. This was very hard for me to accept and it has been very difficult for my family, especially when my children were growing up. For the past 8 years, I worked in a sales compacity and worked like a manic crazed lunatic that finally took a toll that I simply couldn't ignore any longer. I am lucky that my family is now more understanding. But I had to make the decision of what I can do and cannot do. In my opinion, it is in our best interest to try to keep our illness as private as possible due to the ignorance that is still shown. I have found, even in my close friends and family, that everyone has an idea of what depression is, but it is not the same for each of us. Best wishes,

    - Kathy

  • November 11, 2008 7:42 p.m.

    Krissy, I was especially moved by your comments. There are support groups for depression. I have been suffering and changing meds for a long time. There are a lot more people with these problems that you'd think. You can also find some online support groups too. www.nami.org, dbsa.org.....Sincerely, Kathy

    - Kathy

  • November 11, 2008 6:57 p.m.

    I have suffered from PTSD for many years, I have had trouble in most of my jobs, because of this. I have been on antidepressants for years, gone to psychiatrists, etc. nothing has helped. My last boss, found out what had happened to me (dumb me, confided in her) and used this against me, she made my life miserable, she kept telling me to "just get over it and think positive thoughts" what a crock of crap. I also have fibromalgia and arthritis, when I was hurting badly, she would say "we ALL hurt!" Many times she indicated that it was "all in my head". I finally quit this job, and she told all sorts of lies about me to her boss, which was a very good friend of hers and the "big-wig" of the hospital, I had to get a lawyer to get my last paycheck etc. from this hospital. This was a Major setback for me and I once again do not, nor will I ever trust people again.People who have never been through abuse do not realize the struggle we have and should not be allowed to give advice or guidance, as they have no idea what they're talking about. I now feel trapped in my home, as I am afraid of trying to ever get a job again, for fear or being taken advantage of once more in my life. My psychiatrist said this woman abused me in the same way my adopted mom had abused me which brought back a mountain of bad memories. Can I or how do I apply for disability?

    - Sharon

  • November 11, 2008 2:42 p.m.

    I'm suffering from PTSD for the past 5+ years. My career is gone, just hanging in till retirement. I am a burden to my family and don't have any friends left. I am ashamed (you know your supposed to just get over it...they say) and depressed. Doesn't anyone have any answers for us? I didn't bring this on myself and it is a very lonely road to travel.

    - krissy

  • November 11, 2008 12:37 p.m.

    I, too, was diagnosed and have been dealing with major/sever depression, and post-traumatic stress disorder for the last 16 years. I had the boss from hell at that time, I was also dealing with two seriously ill parents at the time. I was treated horribly by the boss, and people that told me "Snap out if it! Well, it is impossible to snap out of it. Luckily, after three tries, I found a great Psychiatrist (the others were just HORRIBLE). I see him every three months now, and take medication regularly. My problem is that because I was hospitalized for depression, I get turned down by EVERY insurance company for everything. They don't give you credit for going to therapy, and taking your medication and continuing to do well.

    - Nancy

  • November 9, 2008 9:16 p.m.

    I had severe clinical depression and had to take a short term leave. I didn't tell my employer what my condition was, only that I had a serious illness. I'm glad I didn't tell them because I think there is still a big stigma in the workplace and in general relative to depression. My FMLA leave was approved, but my ST disability coverage was denied. I'm in the process of appealing. I was shocked it was denied. Anyone who has ever experienced depression knows how hard it is just to even get out of bed and do minor tasks, much less perform like you need to in the workplace. I'd like to see more legislation protecting people in the workplace with mental illness. I've always been an excellent performer at work, but now I'm worried about getting fired due to my performance before leave and the fact that I'm still recovering from my illness and it is still very difficult to work, but I don't feel like I can take any more leave without becoming a strong candidate for being laid off or fired. I only took about 5 wks. I've found lowering my expectations of myself at work is helping me get through. My goal right now is just to survive there while I recover. It's taking all my energy and effort just to accomplish that. I'd like to see more guidance on how to establish a case for disability when you have depression. Maybe I'll write a blog or post something here if I'm successful. This whole thing makes me want to help those and advocate for those with this condition.

    - Sue

  • November 8, 2008 5:08 p.m.

    I was forced to resign from a job at which I was promoted and recognized many times. After two FMLA leaves, I was "welcomed" back to the workplace with a plan of correction for my work performance during the time I was most ill. This sent me into another tailspin-- and medical leave. The day I was to return from that leave I submitted my resignation and hired an attorney. I filed a wrongful discharge and ADA violation suit against my former employer. Three years later a settlement was agreed upon. Know your rights under ADA as clinical depression is a qualified disability. My former employer would not even consider the accommodations my physicians requested which had always been granted while I was recovering from surgery.

    - No Name

  • November 8, 2008 9:53 a.m.

    The person who wrote this article obviously has no idea what it is really like to deal with having depression and needing to work. I sincerely hope the attitude in this article isn't the same attitude she gives her therapy clients! I would walk out of the office of anyone who treated my issues so simplistically! How helpful is it to be saying "just try harder and it will be fine"? I would really like to see information on REAL coping techniques, written by people who have actually suffered these issues. Why are employers getting away with treating employees the way these people have commented on??

    - Anonymous

  • November 7, 2008 9:02 a.m.

    After the death of my mother and brother, the loss of our family home, and my deployment to Iraq I had adjustment disorder with depression and anxiety, along with an undiagnosed minor organic brain disorder. I was an active duty military nurse. They can't fire you. They just mess with your head and make you worse until you get bad enough to warrant being discharged. It's almost policy. It messed me up so bad, I don't think I'll ever be able to work as a clinical nurse again. I get near a medication cart and start shaking inside and can't think at all. Fortunately I've found a non-clinical job where, even though I have my ups and downs, I can pretty much keep up with things.

    - Kelly

  • November 7, 2008 2:08 a.m.

    I've lived with depression and bipolar disorder for 25 years. Going through the changes in effectiveness of drugs and changes in drs due to insurance coverage. the pit of depression is a vivid memory but it was long ago. luckily i have a good fit with anti depressants and therapy. i wish people would try and compare their lot in life with this neurological brain disorder as just one of many conditions a person could have. Sure it's a tough one but I feel I live a normal life and love my support group friends and family. Reading the Bible and positive mental attitude books helps. Surround yourself with positive-type people and I'm much more content since lowering my perfectionistic expectatons of myself. I'm human with good points and bad like anyone else! I'me very proud to have worked one-on-one with my children to learn well in school and they are professionals now. it's a crowning achievement and I look forward to helping others get the most out of living life even WITH a mental illness diagnosis. Keep the faith, there are a lot of us needing encouragement and suport. heart. May

    - May

  • November 6, 2008 9:39 p.m.

    I sought help for my depression because I was terrified I would lose my job, and then my marriage, family, friends, etc. I was showing up at work every day, but felt confused and overwhelmed and enveloped in a black cloud. Antidepressants gave me a little more energy, but therapy helped the most. My therapist helped me realize that most of the people at my work weren't really focused on me, which calmed me down. She helped me see that I was setting unrealistically high standards for myself, and suggested that I make it my goal to be an "average" employee. She gave me an exercise to do every morning at work when I felt the most paralyzed, and this helped more than anything: to write down three things I was grateful for, and three things I had accomplished. They didn't have to be things I had accomplished at work. Sometimes my accomplishments included getting out of bed and getting to work. That little exercise, repeated every day, helped me to recognize that there were still bright spots in my life, and that I was still able to do some worthwhile things. Over time, I was able to build on that beginning and crawl out from under the black cloud. One note: even while I was depressed, I received occasional praise from my employers, and I still receive praise from them now despite my new goal of being an "average" employee. Depression really warped my view of what I was able to accomplish at work, and how others viewed me. Now that I feel better, I love my job a

    - No name given

  • November 6, 2008 2:20 p.m.

    I had major depression in a job and ended up quitting because of it. We had huge workloads. It was a toxic workplace environment. You were "written up" if you were standing by a co-worker's cubicle. You were forced to attend work holiday potlucks whether you wished to or not- and attendance was taken at these events. Actions were punitive in nature, and militant. All employees were carefully monitored. The managers were almost all toxic, and could care less about employee morale. This happened to be a governmental department in a large city, and the new Mayor recently did a huge overhaul of the place- most of the people who worked there are gone now. Wish that was the case when I was there. My point is this. Often, in my experiences, the workplace culture CAUSES the depression. The lack of leadership from management. The "do-nothing" attitude when it's clear there is low morale. As employees and job applicants, you DO have a choice. Perhaps it may mean sacrificing higher pay or prestige. But in my opinion, it's worth it. You can always find ways to supplement your income outside of work. Be choosier about where you work, and you'll find the depression subsiding. I was somewhat annoyed when the counselor had told me that the environment wasn't the employer's responsibility. I beg to differ. However, now I realize that I am the one that needs to be proactive and be much choosier about where I work. And this realization has definitely empowered

    - Been There

  • November 6, 2008 2:18 p.m.

    My current HSA health insurance premium, even with a deductible of about $3,000 I'll never reach, just jumped from $285 to $306, so I've been hunting for a less expensive policy. My policy doesn't cover Mental Health. I was just denied coverage by another company to which I applied. I have to investigate why, but I believe my mental health care over the past fifteen-or-so years is to blame. It's unfair and ironic that a history of mental health issues and their care can result in denial of a whole policy when mental health hasn't and won't even be covered. Maybe it would be better not to seek care or take medication, from their viewpoint. Aren't there enough people out there we wish WOULD seek treatment? Thanks for punishing those of us who do.

    - Ellen

  • November 6, 2008 11:36 a.m.

    I have to laugh when you say "keep yourself active and challenged. Clearly understand your job description and your employer's expectations of you." I wonder if whoever wrote that has ever been depressed? This is an impossible thing to do when each day is a struggle just to keep living. There is no compassion in the workplace for mental illness. My work colleagues laugh about the 'wackos' who have disclosed their illness. They think that depression is the same thing as a physical illness. They are wrong.

    - Andrea

  • November 6, 2008 11:30 a.m.

    I've had an awful experience with depression in the workplace. My manager appears to have recognized that I was struggling but chose to bully me. I struggled every day to come to work and do a good job but with major depression and generalized anxiety it was impossible. My career still has not recovered and I am treated like a 'whack job' at work because I disclosed my illness to my manager.

    - R

  • November 6, 2008 3:04 a.m.

    I think mental illness is one of the last "stigmas" to be actively discriminated against in the workplace. People treat you differently, assume you will be less prouctive, and tend to shy away from you, like they might catch it. At least that has been my experience.

    - Lily

  • November 6, 2008 2:49 a.m.

    What do you do when you had to leave your job because you were too sick to go, were hospitalized, haven't worked for 7 years because you can't sleep and therefore can't remember things, and then employers want to know why you left a mid-level management job but now just want to work part time for close to minimum wage? I can't blame it on my family because I don't have one. I also don't qualify for disability because I can get out of bed and do daily chores, I just can't take the stress of high-intensity work. And how do you fight the system when ou're too depressed to even take a shower?

    - Cassandra

  • November 6, 2008 1:35 a.m.

    I'm a lifelong depression sufferer. I've taken anti-depressants for 15 years, and have been in and out of therapy for 30 years. I managed my illness, and worked full time. However, 5 years ago I began having back problems, and have had 2 back surgeries (a three-level fusion and a scoliosis correction). Even after the surgeries I still have chronic pain, and am no longer able to manage my depression well enough to work. I did the same job for the same organization for 18 years, but during the last 2 years I couldn't concentrate or remember anything. I was "written up" and eventually retired rather than be fired. I also have severe arthritis in my hip, and another degenerated disk with stenosis. I applied for Disability, but have been denied twice. Work was just too stressful, and sitting all day at a computer only increased the pain in my lumbar spine.

    - Paulette

  • November 5, 2008 11:30 p.m.

    Or, you can do what I do. I work my head off for three or four years, get sick, go into the hospital and get fired and have to start all over again.

    - j

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