The Clock Is Ticking . . . .

According to the World Health Organization,
by the year 2020 depression will be the
number two cause of premature death worldwide.

How close are we?


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Without Mental Health!

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What to Do When an Employee is Depressed: A Guide for Supervisors Print E-mail

As a supervisor, you may notice that some employees seem less productive and reliable than usual-- they may often call in sick or arrive late to work, have more accidents, or just seem less interested in work. These individuals may be suffering from a very common illness called clinical depression. While it is not your job to diagnose depression, your understanding may help an employee get needed treatment.

  • Each year, depression affects more than 19 million American adults, often during their most productive years--between the ages of 25 and 44.
  • Untreated clinical depression may become a chronic condition that disrupts work, family, and personal life.
  • Depression results in more days in bed than many other ailments (such as ulcers, diabetes, high blood pressure, and arthritis) according to a recent large-scale study published by the Rand Corporation.

In addition to personal suffering, depression takes its toll at the workplace:

  • At any one time, 1 employee in 20 is experiencing depression.
  • Estimates of the cost of depression to the nation in 1990 range from $30-$44 billion. Of the $44 billion, depression accounts for close to $12 billion in lost work days and an estimated $11 billion in other costs associated with decreased productivity.


"Major depression and bipolar disorder accounted for 11% of all days lost from work in 1987, " reported the medical director of a public utility company.

There is, however good news. More than 80% of depressed people can be treated quickly and effectively. The key is to recognize the symptoms of depression early and to receive appropriate treatment. Unfortunately, nearly two out of three people with depression do not receive the treatment they need.

Many companies are helping employees with depression by providing training on depressive illnesses for supervisors, employee assistance, and occupational health personnel. Employers are also making appropriate treatment available through employee assistance programs and through company-sponsored health benefits. Such efforts are contributing to significant reductions in lost time and job-related accidents as well as marked increases in productivity.


Everyone gets the blues or feels sad from time to time. However, if a person experiences these emotions intensely or for two weeks or longer, it may signal clinical depression, a condition that requires treatment.

Clinical depression affects the total person--body, feelings, thoughts, and behaviors--and comes in various forms. Some people have a single bout of depression; others suffer recurrent episodes. Still others experience the severe mood swings of bipolar disorder--sometimes called manic-depressive illness--with moods alternating between depressive lows and manic highs.

Symptoms of Depression Include

  • Decreased productivity
  • Morale problems
  • Lack of cooperation
  • Safety risks, accidents
  • Absenteeism
  • Frequent statements about being tired all the time
  • Complaints of unexplained aches and pains
  • Alcohol and drug abuse


John had been feeling depressed for weeks though he didn't know why. He had lost his appetite and felt tired all the time. It wasn't until he couldn't get out of bed any more that his wife took him to a mental health professional for treatment. He soon showed improvement and was able to return to work.

Depression can affect your workers' productivity judgment, ability to work with others, and overall job performance. The inability to concentrate fully or make decisions may lead to costly mistakes or accidents. In addition, it has been shown that depressed individuals have high rates of absenteeism and are more likely to abuse alcohol and drugs, resulting in other problems on and off the job.

Unfortunately, many depressed people suffer needlessly because they feel embarrassed, fear being perceived as weak, or do not recognize depression as a treatable illness. 

In the Workplace, Symptoms of Depression Often May Be Recognized by


  • Persistent sad or "empty" mood
  • Loss of interest or pleasure in ordinary activities, including sex
  • Decreased energy, fatigue, being "slowed down"
  • Sleep disturbances (insomnia, early-morning waking or oversleeping)
  • Eating disturbances (loss of appetite and weight, or weight gain)
  • Difficulty concentrating, remembering, making decisions
  • Feelings of hoplessness, pessimism
  • Feelings of guilt, worthlessness, helplessness
  • Thoughts of death or suicide; suicide attempts
  • Irritability
  • Excessive crying


Symptoms of Mania Include

  • Inappropriate elation
  • Irritability
  • Decreased need for sleep
  • Increased energy and activity
  • Increased talking, moving, and sexual activity
  • Racing thoughts
  • Disturbed ability to make decisions
  • Grandiose notions
  • Being easily distracted
  • Chronic aches and pains that don't respond to treatment


Reading this article is a good first step. Familiarize yourself with your company's health benefits. Find out if your company has an employee assistance program (EAP) that can provide on-site consultation or refer employees to local resources.

As a supervisor, you cannot diagnose depression. You can, however, note changes in work performance and listen to employee concerns. If your company does not have an EAP, ask a counselor for suggestions on how best to approach an employee who you suspect is experiencing work problems that may be related to depression.

When a previously productive employee begins to be absent or tardy frequently, or is unusually forgetful and error-prone, he/she may be experiencing a significant health problem.

 As a supervisor, you can:

  • Learn about depression and the sources of help.
  • Recognize when an employee shows signs of a problem affecting performance which may be depression-related and refer employees appropriately.
  • Discuss changes in work performance with the employee. You may suggest that the employee seek consultation if there are personal concerns. Confidentiality of any discussion with the employee is critical.
  • Do not try to diagnose the problem yourself.
  • Recommend that any employee experiencing symptoms of depression seek professional consultation from an EAP counselor or other health or mental health professional.
  • Recognize that a depressed employee may need a flexible work schedule during treatment. Find out about your company's policy by contacting your human resources specialist.
  • Remember that severe depression may be life-threatening to the employee, but rarely to others. If an employee makes comments like "life is not worth living" or "people would be better off without me,'' take the threats seriously. Immediately call an EAP counselor or other specialist and seek advice on how to handle the situation.

Get an Accurate Diagnosis

If five or more of the symptoms of depression or mania persist for more than two weeks, or are interfering with work or family life, a thorough diagnosis is needed. This should include a complete physical checkup and history of family health problems as well as an evaluation of possible symptoms of depression.


Mary couldn't sleep at night and had trouble staying awake and concentrating during the day. After visiting the doctor and being put on medication for depression, she found that her symptoms disappeared and her work and social life improved.

As many as 80% of people with depression can be treated effectively, generally without missing much time from work or needing costly hospitalization.

Effective treatments for depression include medication, psychotherapy, or a combination of both. These treatments usually begin to relieve symptoms in a matter of weeks.


  • Physicians
  • Mental health specialists
  • Employee assistance programs
  • Health maintenance organizations
  • Community mental health centers
  • Hospital departments of psychiatry or outpatient psychiatric clinics
  • University or medical school affiliated programs
  • State hospital outpatient clinics
  • Family service/social agencies
  • Private clinics and facilities

Source: The National Institute of Mental Health, NIH Publication No. 96-3919 (1995, 1996)

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SAMHSA's Resource Center to Promote Acceptance, Dignity and Social Inclusion Associated with Mental Health