Depression affects an estimated one in 10 adults in the U.S., according to the U.S. Centers for Disease Control, and ranks third among workplace problems for employee assistance professionals – behind only family crisis and stress.
When clinical depression is detected, an estimated 80 percent or more of people can be successfully treated, according to Mental Health America. Despite a recent trend among primary care physicians to do a better job of screening for depression, however, many cases still go undiagnosed.
Depression can be difficult to identify in the workplace because of issues related to employee confidentiality as well as employee sensitivities related to the perceived screening for it on the job, according to Mental Health America.
With depression often affecting people in their prime working years, all managers and human resources personnel can and should play a role in early detection, intervention and support.
The toll of depression
A study released last year by noted Boston economist Paul Greenberg found that major depression costs the U.S. economy approximately $210 billion per year, a number that shot up dramatically with the recent recession. These costs are “borne in the workplace in a dramatic way,” Greenberg states, and all employers share the financial burden.
In addition to the medical costs associated with depression, employers experience a negative impact in terms of absenteeism and “presenteeism” (being present but not functioning optimally). The CDC reports that depression leads to an estimated 200 million lost workdays annually, at a financial cost to employers of between $17 billion and $44 billion. In a three-month period, patients with depression miss an average of 4.8 workdays and endure about 11.5 days of reduced productivity.
A recent Yale University study of 6,000 employees found that workers with depressive symptoms were seven times more likely to exhibit decreased performance on the job.
Causes and factors
Depression is often not a singular issue, according to Will Brown, manager of Municipalities and Organization Development at AllOne Health (MIIA’s employee assistance program). It frequently co-exists with other serious medical conditions, such as heart disease, diabetes, HIV and AIDS, and Parkinson’s disease, and can also be connected to anxiety disorders such as post-traumatic stress disorder, obsessive-compulsive disorder, panic disorder, and social phobia. Drug and alcohol abuse can also be a crucial factor that is frequently overlooked.
“We often see multiple diagnoses, which can make it challenging to make progress in terms of helping someone to feel better,” Brown said.
Aside from situations where underlying medical conditions exist, destabilizing events in the workplace can become triggers for depressive symptoms. For example, a co-worker passing away suddenly, a traumatic accident, or a significant change such as retirement of a key figure at work can trigger profound feelings of grief and loss, which can lead to emotional distress and possibly a depressive state.
“People don’t always think about how we can feel the effects of an event months later,” Brown said, “and how this can negatively impact long-term mental health.”
Brown said he sees a pattern with depressive symptoms becoming more prevalent in the digital age, as people are spending more time on their computers and electronic devices, and far less time talking to each other and gaining the benefits of social interaction.
“Although this doesn’t necessarily cause depression, perhaps you have more people predisposed to it by that isolating factor,” he said.
Dysthymia, a long-term condition of low-grade depression, can also be common in the workplace and is difficult to detect, Brown said. A disorder characterized by mild symptoms of depression and a negative view of life, dysthymia can lead to a person suffering from low vitality – functioning on a daily basis, but not optimally, with a low mood that permeates day-to-day life.
Municipal employees, in particular, face a range of situations that can feed into their vulnerabilities, he said. Consider what firefighters and police officers encounter in the line of duty, and the stresses on school personnel and frontline employees at Town Hall in terms of dealing with difficult customers.
Call to action
Municipal managers can be on the lookout for common signs of depression, such as absenteeism, isolating activity like staying behind closed doors throughout the day, sad or anxious moods, difficulty concentrating, fatigue or loss of energy. They can also be aware of traumatic or sudden events that could trigger depressive symptoms among some workers.
When depression is suspected, managers can initiate a formal referral for help through their employee assistance program. After a critical event, the EAP can be called in to lead onsite sessions for employees to talk through their feelings about what happened.
In advance of any particular incident, employers can implement preventative measures, such as holding a general employee training about their EAP and associated benefits, including those related to stress management and mental health. Posted and circulated flyers can serve as a great educational tool on the symptoms of depression.
MIIA offers an anonymous, online mental health screening tool to help employees in member communities to identify mental health conditions that may be affecting their well-being (available at www.emiia.og under Well Aware).
Brown suggests that municipal managers also take steps to build relationships with employees so that they can judge when a sudden change in mood occurs or when they need help.
“This doesn’t mean you have to go out together after work, but just look at bringing more social engagement to the workplace in general, and more face-to-face interaction to ensure that employees are talking through complex issues,” he said.
Wendy Gammons is the Wellness Coordinator for MIIA’s Health Benefits Trust.