Like many people in your workplace you might be stressed, but these symptoms are signs of something more serious: Depression, a condition that is unpleasant, often disabling and even fatal if left untreated. It badly hurts everyone: the sufferers, their families and their employers.
We’re not talking about a passing mood or a personal weakness. This is a major, but treatable illness that can strike anyone from the loading dock to the boardroom, and outstanding performers with no apparent worries are not immune.
Depression is more than normal sadness after a loss, it’s a physical condition in which low levels of chemicals, such as serotonin and norepinephrine, interfere with the function of the ‘mood centre’ of the brain. Severe depression is like a grey fog blanketing one’s life, sapping energy, taking away joy, and making it very difficult to function normally for any length of time. You can’t just ‘pull yourself together’ or ‘snap out of it’.
Depression is common, affecting 17 per cent of people at least once. It’s sneaky too, as only 50 per cent of it is detected, even less is treated, and it often recurs. It’s twice as common in women and peaks at age 25 to 34 years old.
A well-known sign of depression is sadness and crying. But often, sufferers don’t seem particularly sad. Common symptoms, which for proper diagnosis must be present for more than two weeks, include:
• Fatigue • Loss of interest or pleasure in ordinary activities • Difficulty concentrating, remembering, making decisions • Hopelessness • Insomnia, anxiety and irritability • Feeling guilty, worthless, helpless • Weight or appetite changes • Low sex drive • Thoughts of death and suicide • Chronic aches and pains, especially back pain
Effects and costs
Employers ought to be thinking and talking about depression. Left untreated, the costs are three times as high as the treatment costs: absenteeism, reduced job performance and lost earnings due to suicide.
Depression threatens the very skills needed in today’s rapidly changing workplace, where most jobs don’t need brawn but knowledge, concentration, the ability to learn, work with other people and cope with frequent change. Depression, more than most illnesses, severely impairs these kinds of skills.
One large company found that short-term disability costs from depression (average of 40 days) are almost as high as heart disease and low back pain (average of 37 days each) and far more than high blood pressure.
Employees with depression were among the most likely to go back on disability, and over a three-year period, pharmacy inpatient and outpatient costs for depression were highest by far, three times more than for hypertension.
Recognizing the signs
The causes of depression vary and are often combined. There may be a family history of depression or just chronic dissatisfaction and pessimism. Deeply buried, painful emotions such as anger, fear, guilt, and childhood abuse or neglect may set the stage.
Can poor working conditions directly cause depressive illness? It’s uncertain, but excessive pressure, lack of control and feedback, major changes and the threat of layoffs can combine with other stresses, such as financial, marital and children’s problems, to make depression more likely.
People are at risk if work is boring and repetitive, if skills are unused, if they have an incompetent or bullying boss and they are subjected to ‘office politics’.
It’s more common among the poor, and those with chronic illness. Women suffer depression more than men, possibly because of hormones and brain chemistry, burning out from a constant ‘caregiver’ role in life, or holding anger inside.
Once diagnosed, 80 per cent of depression responds well to treatment, but the big hurdle is getting it diagnosed, because of the sneaky ways depression can show itself. If you have an employee who is increasingly: underperforming, ‘not themselves’ or taking more time off work, then someone in management should take the time to ask some general questions about how things are going for them. They will not likely come right out and say they’re depressed, but they may have enough symptoms for you to suggest a doctor’s appointment.
The big danger in depression is suicide. It’s vital that your employees know to get urgent, expert help if they are experiencing feelings of isolation, loss of hope for the future, or intense, recurrent suicidal thoughts. Remember, depression is not a sign of weakness or insanity — in fact, taking the steps needed to recover may well give us an opportunity to grow stronger and eventually have a happier, more fulfilling life.
What can employers do?
In times of intense competition, no business or institution will be successful if it ignores the physical and mental health of its employees. Key actions that employers can take are:
1. Promote and maintain awareness of depression as a common, destructive but treatable illness.
2. Attempt to provide meaningful work, feedback, praise and rewards, and eliminate bullying or unfair management styles.
3. Put physical and mental wellness high on the list of priorities, with regular assessments of worker’s stress levels and sources of stress, and provision of the means for them to take action to stay in balance with them.
4. Have a good EAP in place so that depression can be diagnosed sooner, and more effectively treated without unnecessary delay.
Dr. David Rainham is the founder of Optimum Health Centre in Waterloo, ON, specializing in stress, weight/nutrition and pain management. You can contact Dr. Rainham by calling 519-897-3670 or you can visit the company web sites at www.stresswinner.com or www.optimumhealth.ca.
Mari-Len De Guzman is the former editor of Canadian Occupational Safety magazine and www.cos-mag.com.