Depression common -- but costly -- in workplace

Vanessa McGrady, Contributing Writer, BizJournals.com
From the August 1, 2003 print edition of the Puget Sound Business Journal (Seattle)

A missed day of work here or there because you're feeling out of sorts may just be a drop in the bucket -- but pretty soon, that drop fills the bucket, overflows, wrecks the carpet and rots the floor.

A recent report in the Journal of American Medicine found that missed productivity due to depression costs employers around $44 billion a year. According to Jodi Aronson Prohofsky, the vice president of clinical operations for Cigna Behavioral Health, more than 50 million people in this country will suffer some degree of depression this year.

"Just as in a family, depression affects the whole unit -- not just the individual person," said Mariah Mannia, outgoing executive director for Depression Wellness Network, a Seattle nonprofit that provides alternative, holistic resources for those with depression.

"It affects the depressed person's ability to communicate effectively, make decisions, handle stress and even focus on what the other person is saying. This can be very frustrating for ... people in a workplace," she adds.
Susan Winston, the director for Seattle Mental Health, a nonprofit services provider, says that the problem has only gotten worse in the 25 years that she's been in the field.

"The world is generally more depressed now than it used to be," she said. "People have more stress in their lives in general, and that impacts their life overall, and that includes the workplace."

She cites widespread layoffs, the dot-com bust and a generally poor economy as important factors that contribute to depression and stress. And in a weak job market, many will put up with work situations that make them unhappy -- and employers have less of an incentive to keep workers.

But employers who don't take their workers' depression into account are also hurting themselves.
Prohofsky says that treating depression early saves about $1,500 per worker every year versus letting it go untreated. She also recommends that companies who use different providers for medical and mental health insurance bring everyone to the table.

"We need to integrate these vendors to address these issues. Those players don't often talk to each other."
One benefit is to make sure there aren't any holes in treatment, and that a person who brings in a mental-health concern to his or her primary-care physician can find adequate follow-up care without jumping through too many hoops.

Cigna, for example, just eliminated the requirement that patients call first to be approved for mental-health treatment. "A phone call for some can be a barrier," Prohofsky said.

"Depression does not come in a nice, neat little package. It doesn't present itself like a broken arm," she added.
Symptoms can include prolonged sadness or excessive crying; significant changes in appetite and/or sleep; irritability, anger, agitation and/or anxiety; pessimism and/or indifference; social withdrawal; unexplained aches and pains; loss of energy and persistent fatigue; decreased libido; excessive feelings of guilt and/or worthlessness; loss of pleasure in former interests; inability to concentrate and/or indecisiveness; and recurring thoughts of death or suicide.

Of course, not all of those will show up at work. Winston suggests that when managers and supervisors realize a worker is performing poorly or taking lots of sick days, they try to understand the situation.

"When you notice someone's work has slipped, address that in terms of performance," she said. "It's not the employer's place to diagnose, but to make the resources known." That includes reminding an employee of mental-health benefits, or posting a list of resources.
"Mangers must keep in mind that depression is not a personality flaw -- it's a medical condition that must be treated," Mannia said. "People with depression can no more 'pull themselves up by the bootstraps' than and alcoholic can stop drinking. Mangers can do a great service to their employees by educating themselves about depression and the treatment available for it."

Sometimes, the workplace IS the problem. Workers who feel disrespected, unimportant, undervalued and underpaid won't do as well as happy ones.

"Employers need to be mindful of things (the workers) need," Winston says. "It can be as simple as providing an adequate refrigerator in the lounge."

And if an employer isn't in the position to up salaries or offer an employee assistance program, sometimes things like saying thank you, holding a wellness day and recognizing a person's talents will go a long way.

Mannia says that reducing stress is a huge part of staving off depression. She suggests taking breaks, eating lunch at a reasonable hour, working a reasonable schedule with not a lot of overtime, leaving work at work and finding a symbol on the way home that helps remind people to turn work off for the day.

"Everyone at times could become depressed, it's an illness, but it's a condition that's treatable," Winston said. "You don't have to stay depressed and you don't have to be ashamed you're depressed."

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