Dealing with worker depression

Help keep a common condition from putting your employees and workplace at risk

Everybody feels sad or unhappy sometimes. But for many people, such feelings are more than temporary – they are symptoms of depression, a common yet serious mental illness.

According to the National Institute of Mental Health, 6 million American men and more than twice as many women suffer from depression. The condition most often strikes people during their prime working years.

Studies have repeatedly shown that depression impacts employers in the form of medical costs, diminished productivity, and increases in absenteeism and presenteeism. Alexandria, VA-based Mental Health America reports that depression is one of the top three workplace problems recognized by employee assistance professionals, after a family crisis and stress.

The link to safety

Some studies indicate that in addition to affecting the bottom line, depression can have a significant impact on workplace safety. A 2008 study published in the Journal of Occupational and Environmental Medicine found that depression, as well as medications used to treat the illness, negatively impacted the overall safety of a workplace.

According to a 1995 study from the British Medical Journal, many symptoms of depression – including anxiety, agitation, fatigue, lack of concentration and weakness – can contribute to workplace incidents. At its extreme, depression can cause workers to become suicidal or act with little regard for consequences.

“If somebody’s feeling weak, they could hurt themselves. If somebody’s feeling nervous, they could hurt themselves or somebody else,” said Michael Topf, president and CEO of Topf Initiatives, a Philadelphia-based safety training organization. “So that’s one of the challenges that we’re dealing with with depression.”

Although employers are becoming more aware of the financial impact depression has on the workplace, fewer recognize the toll the condition takes in terms of safety, said Clare Miller, director of the Partnership for Workplace Mental Health in Arlington, VA. “I don’t know that as many employers have made the connection with safety,” Miller said.

The drug impact

All drugs – even those legally prescribed – have side effects that could impact worker behavior, Topf said. “Everybody reacts differently. Drugs affect different people in different ways,” he said.

In addition, depression can coexist with substance abuse problems, as individuals seek to ease their symptoms through self-medication. “A lot of workers are coming to work depressed. And they’re either using a legal, prescribed drug from their physician, or an illegal or self-prescribed medication from themselves,” Topf said. “Just about any medication that people are taking for depression – legal or illegal, prescribed or self-prescribed – impacts people in a way that may cause a risk to their safety, to their health, to their well-being, or that of other people.”

Miller acknowledged that even legally prescribed drugs can have negative side effects, but said receiving those medications while under a doctor’s care can significantly reduce the risk. 

“In general, if someone is being treated for a mental health disorder, they are going to be more effective at work and they’re going to be safer employees,” she said. “Some medications do have side effects, but I would say, on balance, when they are being taken properly through the supervision of a physician, they’re going to be a safer employee.”

Recognizing warning signs

How can employers identify a worker who may be suffering from depression? The biggest warning sign is significant negative change of any kind. Be alert for major alterations in the worker’s behavior, conduct or appearance.

“Look for the signs,” Topf said. “Usually the person was high-toned, and now they’re apathetic and low-energy. Or they performed at a certain level and there’s a decline in their job performance. Or they were neat and now they’re sloppy. You can see changes in physical condition, changes in their housekeeping; they become irritable and quarrelsome, frequently distracted.”

Miller pointed out that depression can affect men differently than women. Depressed men frequently become angry or irritable, while depressed women are more likely to become emotional or experience episodes of unexplained crying.

According to Mental Health America, some of the more common indicators of depression include:

• A persistent sad, empty or anxious mood
• Sleeping too little or too much
• Reduced appetite and weight loss, or increased appetite and weight gain
• Loss of interest in activities once enjoyed
• Difficulty concentrating, remembering or making decisions

On the job, MHA recommends employers specifically look for:

• Missed deadlines
• Frequent absences
• Overworking
• Forgetting directives, procedures and requests
• Difficulty with work transitions or changes in routine

How can employers intervene?

Identifying signs of depression in an employee is only the first step to a safer and more productive workforce. The second, more difficult step is convincing the employee that he or she should seek help. “I think awareness of the problem is more often recognized,” Miller said. “But I think employers are struggling with how to respond.”

Experts caution that managers cannot diagnose a worker’s mental health condition. “You have to be careful here because supervisors and managers are not trained psychologists or psychiatrists or mental health practitioners,” Topf said. “What I recommend they approach [workers] on is their job performance.”

Perhaps the best tool at the employer’s disposal is an employee assistance program. “It’s a really good resource for the person who is experiencing a mental health condition or just mental health concerns, but it’s also a resource for the supervisor,” Miller said. “So if a supervisor is noticing something and isn’t quite sure how to have that discussion or intervention – particularly if you’re a small company without a large HR staff – the employee assistance program can be very useful.”

Miller said that if a worker is resistant to seeking help, supervisors can require the employee to consult an EAP. “If you have a supervisor referral to the employee assistance program, that’s a required thing,” she said. “You might broach it initially as a suggestion, but really that can be made a requirement.”

Although the Americans with Disabilities Act includes protection for people suffering from depression, immediate safety concerns take precedence.

Topf suggested presenting the worker with an ultimatum on receiving treatment, but also discussing the subject in a compassionate manner. “Say, ‘Look, I know you don’t want to get help or treatment, but you must correct your behavior that’s affecting your job,’” he said. “‘I can’t allow you to continue to be so distracted because you’re a danger to yourself and people around you, and I’m doing this out of my concern for you.’”

Topf also recommended that supervisors be fully trained on company policy regarding such matters, including what type of recourse they are permitted to take and who needs to be involved in the discussion, whether it be a human resources professional or a union representative.

MHA cautions employers to keep their own emotions in check when confronting a worker who exhibits signs of depression. A supervisor may feel angry about a worker’s declining performance or worry about the worker’s well-being. Also, a confronted worker may respond with anger, shock or defensiveness.

In extreme cases, mental illness may pose an immediate safety risk, MHA cautions. When an employee makes statements such as “I wish I were dead” or “Life’s not worth living,” take these statements seriously. Take the worker to a mental health professional immediately, or call 911 if the threat seems imminent.