Working Through It
How to cope when you're on the job
Stephanie Stephens
esperanza Fall 2008 Issue
If only you could, as rock legend Neil Young suggests, "leave your troubles at the door," then depression would be neatly deposited on the office doormat. The reality is that people who are depressed at home most likely will be depressed at work.
If that's you, your not alone.
The World Health Organization reports that depression affects some 121 million of us worldwide and is the leading cause of years lost to disability. In America, The National Institutes of Mental Health classifies major depression as a serious medical illness affecting 15 million American adults or approximately 5 to 8 percent of the adult population in a given year. The Journal of Occupational and Environmental Medicine reports that depression affects more than 6 percent of the U.S. working population. Approximately half a million Canadian workers experience depression, and most say the symptoms interfere with their ability to work.
Look around your office and you may formulate your own statistic. You'll find depression at the water cooler, in the adjacent employee cubicle, and in the penthouse suite. Depression strikes the mailroom attendant or the top executive—like Tom Johnson, the former chairman and CEO of CNN Newsgroup. Johnson was diagnosed in 1988 while working as publisher and chief executive of the Los Angeles Times and simultaneously overseeing The Denver Post and The Dallas Times Herald.
Now retired, Johnson remembers that at the time of his diagnosis, no programs existed at his workplace to help. Rather, it was left to him—an employee of one in charge of some 12,000 others.
"My work was often affected," he admits. "Schedules were changed to enable me to come to work late when I could not drag myself out of bed." It took patience and time to determine the appropriate medication dosage, he recalls. "Soon, I was back to my 'old self.' I have been in terrific shape with few, short, less severe bouts of depression since then."
Johnson now immerses himself in philanthropic work while helping others with depression. One who knows you can't fix what you don't know is broken, he advises that if you think you have depression and you're taking it to work, "Go to a professional to get a diagnosis."
He's developed his own no-nonsense "take care" list, including exercise, solitary quiet time, and perhaps a hot tub or massage. "Having very good trusted friends and family helps. I'm trying to be the best granddaddy," he says, to youngsters who bring him "more laughter, joy, and pure love" than he can describe—testimony that happiness may be closer than you think.
His other tips for compassionate recovery? "Get rid of every possible stressor in your life that isn't needed. Do not drink too much alcohol. Do not ingest illegal drugs. Do not hold stuff inside of you. Find joys in your life—old joys and new joys. Have fun. Do not become a workaholic, as I did."
HELP IS BREWING
Employees in small business experience depression, too—a fact not lost on Mary Allen Lindemann. The walls of her office are covered with prestigious awards telling the story of Coffee by Design in Portland, Maine, a specialty coffee company with four locations. Lindemann’s 40 employees know they’ve got a friend in their boss, who tunes in to them on the job and off. As someone who has depression and undergoes counseling, Lindemann believes she has a responsibility to her employees’ emotional well-being, and she doesn’t shirk it.
“You learn a lot about yourself when you see what other people are going through,” she says, and so remains dedicated to roasting good beans and fostering workplace mental health. Lindemann remembers being inspired by a television report about a European village that took responsibility for the mental health needs of its residents.
“One person at a time, we can make a difference,” she says, and she does. Lindemann instituted employee training that addresses mental health and mental illnesses. She offers flexible shifts and support for employees recovering from mental health problems, and a benefits package with mental health coverage and short-term disability.
Last year a Coffee by Design employee suffered a psychotic episode and was hospitalized. “It was terrifying for the staff, for we all feel at times that we’re on the edge, too,” Lindemann says. Policies on paper materialized into real help: the employee received needed treatment and, in a fairytale ending, returned to work and eventually married a customer.
Depression may still accompany Lindemann to work. “The pressure of small business ownership is unlike anything anyone can prepare you for,” she says. “There are many rewards but many challenges as well. For someone who has had difficulty in asking for help, I have learned the need to ask for it and surround myself with good people.”
One is veteran social worker Claire Harrison, who initially counseled shop employees on how to deescalate potentially volatile situations when customers are angry, upset, or distracted, or exhibiting possible signs of mental illness.
“It’s OK to say something, to ask them to leave, if they’re not respecting the parameters of behaviors you expect from others. It’s more stigmatizing if you treat someone differently because they have a mental illness,” Harrison says. At Coffee by Design, an open exchange exists in which disorders, including anxiety and depression, are dealt with instead of being swept under the tables.
MOB RULE
Employees working through depression and anxiety struggle with the obvious question: Do I tell or not? Both choices carry far-reaching implications, as Donna Hardaker knows too well.
About eight years ago her depression surfaced, damaging her image as a rising star at work. Once known as a team builder she was recast as “a weak, bad person, and a troublemaker” she says. Her uncharacteristic outbursts of anger, frustration, and agitation caused her coworkers “great distress,” she adds.
They retaliated with “mobbing,” a subtle and insidious workplace dynamic. As her mental health deteriorated, fellow employees responded by avoiding her, banding together and shutting her out of discussions and projects. Their behavior “greatly affected my recovery,” she says. “I was suicidal. It could have ended really badly. They didn’t know that they were hurting me, but they just didn’t know what to do.”
For Hardaker, getting well meant leaving the toxic workplace, receiving treatment, and ultimately finding her dream job as a mental health works specialist for a branch of the Canadian Mental Health Association (CMHA) in Newmarket, Ontario. The unpleasant memories from that time now serve a positive purpose for employers and employees who meet Hardaker. She tells them that she bravely disclosed her depression in the initial job interview at CMHA, where she says she receives “tremendous support.” Managers and employees who hear her tell her story say it lends valuable insights about acceptance, she notes.
“It is still a risk to tell because some people see mental illness as a defect, a weakness, a liability,” Hardaker adds.
To tell was the right thing—the only thing—for Bob Smith, chief of appeals for Canada Revenue Agency’s Vancouver tax services office. “I think you need to know I’m on antidepressant medication,” he initially told his current employer.
Thanks to employment benefits that provided comprehensive mental health treatment, he’s now working “full force,” says Smith, who encourages employees with depression to balance their needs with employer resources.
“Know your benefits and know your rights,” urges Smith, a graduate of Mental Health Works training, which teaches managers how to resolve conflicts more effectively, discuss sensitive issues with employees, and separate performance issues from mental health issues. “Know what type of coverage you have” because every worker and every workplace is different, he says.
Smith advises employees to ask questions freely about subjects like sick leave: Is it paid or not? If not, what supplemental plans are available? Do you qualify for disability or early retirement? Are back-to-work, part-time arrangements possible? Do Employee Assistance Programs (EAPs) exist? If you don’t ask, you can’t know.
Case in point: A 2007 survey of American workers found that 40 percent weren’t even aware of the mental/behavioral health benefits offered by their employer. More than one-third said they would be more likely to use those benefits if their employer did a better job of promoting them.
Is that you? If so, do your homework. Smith says Canadian employees should familiarize themselves with the country’s Employment Equity Act, “which requires…the accommodation of differences.”
“You can’t discriminate against an individual for health issues,” he says. “Plus, treating mental illness saves money, because human rights complaints are very expensive, as is releasing an employee, then recruiting someone else, then retraining them,” he adds. “People who return to the workplace after successful treatment contribute to diversity.”
9-TO-5 REWARDS
Depression doesn’t deserve a raise. Its combination of missed workdays, decreased productivity, and other related issues are estimated to cost the U.S. economy approximately $80 billion a year and in Canada as much as $30 billion.
Studies show that depression also affects “presenteeism”—being there, but not being productive—and is associated with limitations in time management, interpersonal/mental functioning, and overall output. Other research indicates depression is associated with a more than two-fold increase in the probability of missing work because of illness and a 50 percent increase in lost work time.
“I don’t wanna go,” the depressed person groans. When the sun comes up, their mood spirals down. “As a physician, I encounter this regularly,” notes Gregory Simon, MD, MPH, a physician and researcher in Seattle, Washington, and chairman of the Scientific Advisory Board of the Depression and Bipolar Support Alliance.
“When people want to call in sick from work, we have a serious discussion about why they shouldn’t,” he adds. Employees also don’t tend to call in and say they’re depressed, but will feign another illness.
“People who are depressed do generally have more difficulty going to work or attending other activities,” Simon says. “When they’re at work, they don’t function as well, their energy is low, they don’t converse as much, and they’re easily distracted.”
When depression is severe, Simon recommends fighting that tugging tendency to rest, even though one of its core symptoms is fatigue.
“The fundamental basis of most psychotherapy is to be engaged in meaningful, regular, positive activities. Not doing so worsens depression and is not healthy,” he says. “The self-reinforcing nature of depression leads people to withdraw from doing things that tend to be rewarding or positive when, for most people, work really is just that: a major source of structure and reward.”
That nine-to-five commitment enforces helpful principles of “verticality,” says Simon. “Feet need to be on the floor with head higher than feet. Now you’re ready to maintain a schedule and a regular sleeping and eating pattern.” Establishing and maintaining a routine is critical to recovery.
Work is also a main source of social support and contact, Simon adds, so try to be with people—people who value and care for you and enjoy your company. Yes, that likely includes many of your coworkers.
“Those with depression have misperceptions that others don’t want them around. Negative, exaggerated perceptions are often part of depression,” Simon says.
Clarity, honesty, and fairness, are often difficult to achieve at work, yet they’re all critical to managing depression, adds Hardaker. So be clear, honest, and fair with yourself and your employer. If you have depression, your health is job one. e
Stephanie Stephens is an award-winning journalist, specializing in health, who lives in California and New Zealand
How to cope when you're on the job
Stephanie Stephens
esperanza Fall 2008 Issue
If only you could, as rock legend Neil Young suggests, "leave your troubles at the door," then depression would be neatly deposited on the office doormat. The reality is that people who are depressed at home most likely will be depressed at work.
If that's you, your not alone.
The World Health Organization reports that depression affects some 121 million of us worldwide and is the leading cause of years lost to disability. In America, The National Institutes of Mental Health classifies major depression as a serious medical illness affecting 15 million American adults or approximately 5 to 8 percent of the adult population in a given year. The Journal of Occupational and Environmental Medicine reports that depression affects more than 6 percent of the U.S. working population. Approximately half a million Canadian workers experience depression, and most say the symptoms interfere with their ability to work.
Look around your office and you may formulate your own statistic. You'll find depression at the water cooler, in the adjacent employee cubicle, and in the penthouse suite. Depression strikes the mailroom attendant or the top executive—like Tom Johnson, the former chairman and CEO of CNN Newsgroup. Johnson was diagnosed in 1988 while working as publisher and chief executive of the Los Angeles Times and simultaneously overseeing The Denver Post and The Dallas Times Herald.
Now retired, Johnson remembers that at the time of his diagnosis, no programs existed at his workplace to help. Rather, it was left to him—an employee of one in charge of some 12,000 others.
"My work was often affected," he admits. "Schedules were changed to enable me to come to work late when I could not drag myself out of bed." It took patience and time to determine the appropriate medication dosage, he recalls. "Soon, I was back to my 'old self.' I have been in terrific shape with few, short, less severe bouts of depression since then."
Johnson now immerses himself in philanthropic work while helping others with depression. One who knows you can't fix what you don't know is broken, he advises that if you think you have depression and you're taking it to work, "Go to a professional to get a diagnosis."
He's developed his own no-nonsense "take care" list, including exercise, solitary quiet time, and perhaps a hot tub or massage. "Having very good trusted friends and family helps. I'm trying to be the best granddaddy," he says, to youngsters who bring him "more laughter, joy, and pure love" than he can describe—testimony that happiness may be closer than you think.
His other tips for compassionate recovery? "Get rid of every possible stressor in your life that isn't needed. Do not drink too much alcohol. Do not ingest illegal drugs. Do not hold stuff inside of you. Find joys in your life—old joys and new joys. Have fun. Do not become a workaholic, as I did."
HELP IS BREWING
Employees in small business experience depression, too—a fact not lost on Mary Allen Lindemann. The walls of her office are covered with prestigious awards telling the story of Coffee by Design in Portland, Maine, a specialty coffee company with four locations. Lindemann’s 40 employees know they’ve got a friend in their boss, who tunes in to them on the job and off. As someone who has depression and undergoes counseling, Lindemann believes she has a responsibility to her employees’ emotional well-being, and she doesn’t shirk it.
“You learn a lot about yourself when you see what other people are going through,” she says, and so remains dedicated to roasting good beans and fostering workplace mental health. Lindemann remembers being inspired by a television report about a European village that took responsibility for the mental health needs of its residents.
“One person at a time, we can make a difference,” she says, and she does. Lindemann instituted employee training that addresses mental health and mental illnesses. She offers flexible shifts and support for employees recovering from mental health problems, and a benefits package with mental health coverage and short-term disability.
Last year a Coffee by Design employee suffered a psychotic episode and was hospitalized. “It was terrifying for the staff, for we all feel at times that we’re on the edge, too,” Lindemann says. Policies on paper materialized into real help: the employee received needed treatment and, in a fairytale ending, returned to work and eventually married a customer.
Depression may still accompany Lindemann to work. “The pressure of small business ownership is unlike anything anyone can prepare you for,” she says. “There are many rewards but many challenges as well. For someone who has had difficulty in asking for help, I have learned the need to ask for it and surround myself with good people.”
One is veteran social worker Claire Harrison, who initially counseled shop employees on how to deescalate potentially volatile situations when customers are angry, upset, or distracted, or exhibiting possible signs of mental illness.
“It’s OK to say something, to ask them to leave, if they’re not respecting the parameters of behaviors you expect from others. It’s more stigmatizing if you treat someone differently because they have a mental illness,” Harrison says. At Coffee by Design, an open exchange exists in which disorders, including anxiety and depression, are dealt with instead of being swept under the tables.
MOB RULE
Employees working through depression and anxiety struggle with the obvious question: Do I tell or not? Both choices carry far-reaching implications, as Donna Hardaker knows too well.
About eight years ago her depression surfaced, damaging her image as a rising star at work. Once known as a team builder she was recast as “a weak, bad person, and a troublemaker” she says. Her uncharacteristic outbursts of anger, frustration, and agitation caused her coworkers “great distress,” she adds.
They retaliated with “mobbing,” a subtle and insidious workplace dynamic. As her mental health deteriorated, fellow employees responded by avoiding her, banding together and shutting her out of discussions and projects. Their behavior “greatly affected my recovery,” she says. “I was suicidal. It could have ended really badly. They didn’t know that they were hurting me, but they just didn’t know what to do.”
For Hardaker, getting well meant leaving the toxic workplace, receiving treatment, and ultimately finding her dream job as a mental health works specialist for a branch of the Canadian Mental Health Association (CMHA) in Newmarket, Ontario. The unpleasant memories from that time now serve a positive purpose for employers and employees who meet Hardaker. She tells them that she bravely disclosed her depression in the initial job interview at CMHA, where she says she receives “tremendous support.” Managers and employees who hear her tell her story say it lends valuable insights about acceptance, she notes.
“It is still a risk to tell because some people see mental illness as a defect, a weakness, a liability,” Hardaker adds.
To tell was the right thing—the only thing—for Bob Smith, chief of appeals for Canada Revenue Agency’s Vancouver tax services office. “I think you need to know I’m on antidepressant medication,” he initially told his current employer.
Thanks to employment benefits that provided comprehensive mental health treatment, he’s now working “full force,” says Smith, who encourages employees with depression to balance their needs with employer resources.
“Know your benefits and know your rights,” urges Smith, a graduate of Mental Health Works training, which teaches managers how to resolve conflicts more effectively, discuss sensitive issues with employees, and separate performance issues from mental health issues. “Know what type of coverage you have” because every worker and every workplace is different, he says.
Smith advises employees to ask questions freely about subjects like sick leave: Is it paid or not? If not, what supplemental plans are available? Do you qualify for disability or early retirement? Are back-to-work, part-time arrangements possible? Do Employee Assistance Programs (EAPs) exist? If you don’t ask, you can’t know.
Case in point: A 2007 survey of American workers found that 40 percent weren’t even aware of the mental/behavioral health benefits offered by their employer. More than one-third said they would be more likely to use those benefits if their employer did a better job of promoting them.
Is that you? If so, do your homework. Smith says Canadian employees should familiarize themselves with the country’s Employment Equity Act, “which requires…the accommodation of differences.”
“You can’t discriminate against an individual for health issues,” he says. “Plus, treating mental illness saves money, because human rights complaints are very expensive, as is releasing an employee, then recruiting someone else, then retraining them,” he adds. “People who return to the workplace after successful treatment contribute to diversity.”
9-TO-5 REWARDS
Depression doesn’t deserve a raise. Its combination of missed workdays, decreased productivity, and other related issues are estimated to cost the U.S. economy approximately $80 billion a year and in Canada as much as $30 billion.
Studies show that depression also affects “presenteeism”—being there, but not being productive—and is associated with limitations in time management, interpersonal/mental functioning, and overall output. Other research indicates depression is associated with a more than two-fold increase in the probability of missing work because of illness and a 50 percent increase in lost work time.
“I don’t wanna go,” the depressed person groans. When the sun comes up, their mood spirals down. “As a physician, I encounter this regularly,” notes Gregory Simon, MD, MPH, a physician and researcher in Seattle, Washington, and chairman of the Scientific Advisory Board of the Depression and Bipolar Support Alliance.
“When people want to call in sick from work, we have a serious discussion about why they shouldn’t,” he adds. Employees also don’t tend to call in and say they’re depressed, but will feign another illness.
“People who are depressed do generally have more difficulty going to work or attending other activities,” Simon says. “When they’re at work, they don’t function as well, their energy is low, they don’t converse as much, and they’re easily distracted.”
When depression is severe, Simon recommends fighting that tugging tendency to rest, even though one of its core symptoms is fatigue.
“The fundamental basis of most psychotherapy is to be engaged in meaningful, regular, positive activities. Not doing so worsens depression and is not healthy,” he says. “The self-reinforcing nature of depression leads people to withdraw from doing things that tend to be rewarding or positive when, for most people, work really is just that: a major source of structure and reward.”
That nine-to-five commitment enforces helpful principles of “verticality,” says Simon. “Feet need to be on the floor with head higher than feet. Now you’re ready to maintain a schedule and a regular sleeping and eating pattern.” Establishing and maintaining a routine is critical to recovery.
Work is also a main source of social support and contact, Simon adds, so try to be with people—people who value and care for you and enjoy your company. Yes, that likely includes many of your coworkers.
“Those with depression have misperceptions that others don’t want them around. Negative, exaggerated perceptions are often part of depression,” Simon says.
Clarity, honesty, and fairness, are often difficult to achieve at work, yet they’re all critical to managing depression, adds Hardaker. So be clear, honest, and fair with yourself and your employer. If you have depression, your health is job one. e
Stephanie Stephens is an award-winning journalist, specializing in health, who lives in California and New Zealand
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