Down on Being Down
by Ken Nowack

“I feel my best when I’m happy.” Winona Ryder

Emotions do indeed play a role in productivity, morale and customer service.

Any guess what medical condition or health risk is the most costly to employers?  If you guessed stress, smoking, obesity, inactivity or diabetes you are way off the mark.  In fact, the most costly is depression  and can affect 20% of any of us during our lifetime¹.

Depression takes a pretty heavy toll on the U.S. workplace, affecting about 6 percent of employees each year and costing over $30 billion annually in lost productivity and absenteeism.

In a recent study in the Journal of American Medical Association, researchers reported on how a telephone treatment program had a substantial impact on cost savings, return to work and minimizing the length of the depressive symptoms compared to a control group².

The study involved 604  workers at 16 large U.S. companies and included included pilots, lawyers, bankers, truckers and janitors.  The study participants completed an online questionnaire that measured health risk factors including depression. Half of those identified were encouraged to seek a mental health specialist or contact their doctor.  The other group received cognitive behavioral therapy over the phone.

Employees who received the telephone intervention worked, on average, about two weeks more during the yearlong study than those in the control group and more workers in the intervention group were still employed at the end of the study. Finally, the intervention employees were almost 40 percent more likely to recover from depression during the year long study.

Preliminary cost savings from more hours worked averaged about $1,800 per employee compared to the program’s initial $100 to $400 per worker cost.

It would appear that work/life balance benefits, including mental health insurance, would be something that employers would see value given just how prevalent and devastating depression can be in the workplace (Clinical depression affects about 7% - 18% of the population on at least one occasion in their lives, before the age of 40).

Furthermore, recent research with 24,324 employed workers, suggests that increased levels of job strain and a lack of social support at work are associated with higher risk of depression³.  Here are some keys to identifying depression in bosses and co-workers:

SIGNS AND SYMPTOMS OF DEPRESSION

One of the following major elements are typically observed for at least 2 weeks to suggest that an employee is experiencing depression.  These include:

1. Depressed mood (feeling sad, helpless or hopeless etc.)
or
2. Loss of interest in normal daily activities (e.g., having little interest in activities you typically enjoy).

It is sufficient to have either of these symptoms in conjunction with five of a list of other symptoms over a two-week period. These include:

• Feelings of overwhelming sadness or inability to feel emotions.
• A decrease in amount of pleasure or interest in almost all daily activities.
• Intense feelings of guilt, nervousness, helplessness, hopelessness, worthlessness, loneliness and/or anxiety
• Disturbed sleep. Sleeping too much or having problems sleeping can be a sign you’re depressed. Waking in the middle of the night or early in the morning and not being able to get back to sleep are typical.
• Trouble concentrating, maintaining focus or making decisions and have problems with memory.
• Changes in appetite with weight loss or gain.
• Agitation. You may seem restless, agitated, irritable and easily annoyed.
• Fatigue (mental or physical) and loss of energy.
• Low self-esteem. You feel worthless and have excessive guilt.
• Less interest in sex. If you were sexually active before developing depression, you may notice a dramatic decrease in your level of interest in having sexual relations.
• Recurrent thoughts of death, dying or suicide.
• Feeling and/or fear of being abandoned by those close to you.

The good news is that depression is typically treatable and for employees, getting some help would appear to be a direct cost savings for employers.

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1. Goetzl, R. et al. (1988).  The relationship between modifiable health risk and health care expenditures: An analysis of the multi-employer HERO health risk and cost data base. JOEM, 40, 843-854
2. Philip S. Wang, MD, et al.  Telephone Screening, Outreach, and Care Management for Depressed Workers and Impact on Clinicaland Work Productivity Outcomes: A Randomized Controlled Trial.  JAMA, 2007, 298(12), p. 1401-1411
3. Emma K. Robertson Blackmore, Stephen A. Stansfeld, Iris Weller, Sarah Munce, Brandon M. Zagorski, and Donna E. Stewart (2007). Major Depressive Episodes and Work Stress: Results From a National Population Survey. American Journal of Public Health, Sep 2007; doi:10.2105/AJPH.2006.104406