Working with depression: Tips for employers and employees

During Canada's Healthy Workplace Week, take the time to learn more about Depression and commit to creating a psychologically healthy workplace.

• About depression
• Who it affects
• Causes & effective treatment of depression
• Detecting depression
• Creating a psychologically healthy workplace what you can do (Tips & Checklist for Managers & Employees)

About depression

• Depression is one of the most prevalent mental health disorders, which impacts individuals in their prime working years.
• The nature of depression is such that it affects people's thinking skills, their motivation and their ability to interact with others, thus having a tremendous impact on the ability to work effectively.
• We don't know what causes a particular episode of depression for a particular person but we do know that workplace factors do play a significant role in providing them with support and maintaining their functioning or in creating a situation that may bring on depression and worsen functional decline.
• Depression is the fastest rising source of disability in Canada, as it is in the rest of the Western world. It has been estimated that depression costs the Canadian economy approximately $15 billion per year. About 1/3 of this reflects public costs such as health care, medications and unemployment, the other 2/3 are born directly by employers.
• Depression is often associated with other forms of physical or psychological illness and raises the risk workplace accidents, injuries or incidents. Dealing with depression at work is therefore a critical issue for the individual, the organization and society as a whole.
• Although there are a number of effective treatments for depression, at best only 50% of depressed individuals get a proper diagnosis and less than 50% of them get evidence based treatment.

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Who it affects

Estimates of the amount of depression vary, however a conservative estimate would suggest that about 5% of individual will have a clinically diagnosable episode of depression at some point in their life. This number is at least twice as high if we consider minor depression that may not meet the criteria for diagnosis but nevertheless leads to suffering and impaired functioning. Depression cuts across class, culture, ethnicity and age, although the first episode of depression often occurs during the teen or young adult years (at the point when they are entering the work force!). Women appear to have higher rates of depression than men, likely because of biological factors (e.g. post partum depression) and because men are less likely to acknowledge psychological problems.

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Causes & effective treatment of depression

Although we do not know definitively what causes depression, for many individuals it is likely a combination of biogenetic and psychosocial factors. The following diagram illustrates the complex relationship between life circumstances, our cognitive interpretations, emotional reactions, physical state or predisposition, and behaviour, as they can interact in a vicious circle that can result in low mood or depression.

The most effective forms of treatment address key aspects of this cycle, typically involving antidepressant medication or a form of psychotherapy called cognitive behaviour therapy.

• Both are equally effective and the combination may be optimal.
• Cognitive behaviour therapy may be particularly relevant for working persons as it focuses explicitly on problem-solving, becoming more active and increasing functioning.

Antidepressant medications are prescribed by physicians while cognitive behaviour therapy is available from qualified psychologists, employee assistance providers and mental health professionals.

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Detecting depression

• As with any health condition, the earlier it is detected and effective action is taken, the more likely it is that a positive outcome will be achieved and unnecessary suffering, impairment and loss of productivity will be avoided.
• Unfortunately, fewer than half of individuals with depression receive a proper diagnosis and fewer than half of those receive proper treatment.
• Depression recurs for about half of those who recover from an initial episode, and one recurrence raises the likelihood of subsequent episodes. As a result depression is increasingly being addressed within a 'chronic disease model', which has an emphasis on minimizing suffering and decline in functioning and maximizing optimal treatment and self-care.
• For these reasons alone, it is imperative that organizations provide accurate, timely and effective attention to the psychological health of the workplace and the workforce. This requires a comprehensive effort amongst all concerned.
• Two critical players are:
  • Front-line managers who are typically in the position to notice workplace behaviours and performance concerns that may indicate mental health issues such as depression;
  • Employees themselves who have a vested interest and responsibility to care for their mental health (and those of their colleagues).

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Creating a psychologically healthy workplace what you can do

There are a number of effective psychological and pharmacological treatments for depression. A key ingredient that may be used on it's own or can complement professional treatment is good self care. A new, on-line, confidential, free and effective program for helping working adults who may be dealing with depression is "Antidepressant skills in the workplace: Dealing with mood problems in the workplace" (Bilsker, Gilbert & Samra, 2007). The guide is intended for:

• Working people with low mood, who may be at risk for developing depression
• Working people who have developed mild or major depression
• Depressed individuals who have been off work and are returning
• Partners, family members, friends or workmates who are concerned about someone they care about
• Employers, supervisors, human resources professionals or union personnel who are concerned about staff well-being
• Medical, mental health or rehabilitation providers who would like a tool to enhance their care or services

This guide is meant to provide accurate information about depression. It is not a psychological or medical treatment and is intended to complement treatment, where it is needed. This online resource will be available at www.carmha.ca/publications after June 20th. This may be accessed, downloaded and printed from the web. If organizations are interested in doing a print run or providing training on how to use the guide, contact the Centre for Applied Research in Mental Health and Addiction at info@carmha.ca.

For a description of this guide, how it was developed and how it may be used, click here.

Provided by:
Merv Gilbert PhD
Registered Psychologist
Gilbert Acton Ltd
Occupational Health Consultants
Phone: 604 872 0172
Web: www.gilbertacton.com

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