Down on the Job

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Volume 4, Number 11

Depression is one of the costliest health problems for employers. There are numerous reasons why this is the case. Depressed workers miss 1 to 4 workdays per month, on average. The symptoms of depression (e.g., low motivation, low energy, and difficulties with attention and concentration) contribute to “presenteeism,” which refers to a pattern of decreased productivity even though an employee is at work. Individuals with depression are at increased risk for a range of physical health problems, including diabetes and heart disease. Problems such as substance abuse and relationship difficulties are more likely when depression is present. Higher rates of job turnover, underemployment, and unemployment are associated with depression. Although depression itself isn’t directly contagious, having a co-worker who is depressed can lower one’s own mood which can in turn detract from one’s own performance. While many health problems have their onset in middle or older age, depression typically has an earlier age of onset. Therefore, it can affect individuals in their prime working years, and may episodically impact individuals throughout their work careers. Depression is also quite prevalent, with all types combined (major depression, bipolar disorder, dysthymic disorder, sub-threshold depression) affecting at least 5-10% of the population each year. Although there is less stigma associated with mood disorders than in the past, a degree of stigma remains. The impact of this is that an individual struggling with depression may be less likely to seek and continue with treatment than a person who has a physical health problem, despite the availability of effective treatments for depression. Furthermore, the stigma can make it more difficult for organizations to conduct screening and intervention programs for depression than for other health problems such as high blood pressure or elevated cholesterol. The April 2008 edition of the Journal of Occupational and Environmental Medicine included a number of articles addressing the problem of depression in the workplace. One common theme was that there is a need for organizations to give more attention to depression in the work setting through prevention, screening, and intervention efforts. Additionally, evidence for the cost-effectiveness of such initiatives is beginning to accrue. Employers can also attempt to reduce job-related stress for their employees, as stress increases vulnerability to depression. What can individuals themselves do? Indeed there are risk factors for depression that one cannot control, such as genetic susceptibility. But there are many steps a person can take to minimize susceptibility to depression and/or the severity of depression. First of all, healthy behaviors, such as getting regular physical activity, not abusing substances, and getting adequate rest, are good for mental health. A healthy lifestyle reduces risk for chronic physical illnesses, which themselves increase risk for depression. Managing stress as effectively as possible, nurturing important relationships in one’s life, and spending time in enjoyable activities contribute to mental health. If depression is present or lurking, seek treatment. There is good evidence for the effectiveness of medication, psychotherapy, or both, in treating depression. Successful treatment contributes to quality of life generally, and to better work performance specifically.

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