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Depression Awareness

By Dorothy Blum and Mike Kirchner1
U.S. Customs Service Employee Assistance Program

Depression is the most frequent mental health concern of the American population. Each year 10 to 20 percent, or about 17 million people, suffer from it. Unfortunately, only about one-third are diagnosed and treated.

Not only does depression take a toll on its victims, but it costs society more than $43 billion a year, of which $17 billion is the cost of job absenteeism alone. The workplace is affected in terms of lowered productivity, decreased quality of work, poor decision making, accidents and health care costs.

Do you or someone you know suffer from depression? Many people use the term "depression" loosely for sadness or "the blues" caused by any unhappy event. However, in this article, we are talking about the medical illness of clinical depression which affects a person's mood, thoughts, body and functioning.

Does this sound familiar?

"For weeks, I was always on the verge of tears. I thought I had fallen into a black hole that I couldn't get out of. Was I going to feel this way forever?"

"Even though I was always tired, I kept waking up early in the morning and I completely lost my appetite. Everyone irritated me: people at work, my spouse and kids."

"My family and friends noticed that I just wasn't myself anymore. I didn't enjoy the things I used to.... It became so difficult to concentrate at work that I felt worthless, like I couldn't do anything well."

No two people experience clinical depression in the same manner. Symptoms vary in severity and duration among different people.

Typically depression is the result of a combination of the person's biochemistry, genetic heredity, psychological factors such as pessimism and low self-esteem, or stressful life events. The root cause of depression is a chemical imbalance in the brain of neurotransmitters that regulate emotions, energy level, eating, and sleeping.

Know the Signs of Depressive Illness

The blues are a normal reaction to unhappy or stressful life situations. Clinical depression, however, is a serious medical illness.

Irritability, chronic physical problems and trouble concentrating affect people on the job. In the workplace, depression may reveal itself in absenteeism, fatigue, irritability, decreased productivity, and withdrawal, to name a few.

Use the following checklist to determine if you or a loved one or a co-worker may be suffering from a depressive illness. (Note: This list is an aid to understanding, not a basis for conclusive diagnosis.)

  • I feel extremely sad all or most of the time.
  • I have no energy.
  • I cry a lot when I'm alone.
  • I've lost interest in most of the activities I used to enjoy.
  • I sleep much more (or much less) than usual.
  • I have suddenly gained (or lost) a lot of weight.
  • I have trouble concentrating, remembering and making decisions.
  • I feel hopeless about the future.
  • I feel worthless.
  • I feel anxious.
  • I'm often irritable, and I never used to be that way.
  • I think about death and suicide.

If two or more of these apply, and if symptoms persist for at least two weeks, you should consult a psychiatrist, psychologist or your physician, or you should encourage your family member, friend, or co-worker to do so.

If a depressed person makes comments such as "life is not worth living" or "people would be better off without me," see Suicide Crisis Intervention.

Depression Can Be Treated Successfully

Clinical depression is one of the most treatable of all medical illnesses. In fact, more than 80 percent of people with depression can be treated successfully with medication, psychotherapy or a combination of both. Talking to a friend, family members, or clergy can often give people the support needed when going through life's difficult times. but only a qualified health professional can diagnose and treat clinical depression.

As with many illnesses, the earlier the treatment begins, the more effective it can be. If untreated, clinical depression can makes one's life miserable and lead to risk of suicide.

How You Can Help

If you are trying to help someone who has clinical depression, you must avoid sermonizing. Don't say, "Just cheer up and snap out of it!" or "Come on, just pick yourself up!" It's not that easy.

What you should do is:

  • Respectfully encourage the person to get professional help.
  • Encourage the person to continue treatment and take his/her medication as prescribed.
  • Maintain as normal a relationship as possible.
  • Show respect and make the person aware of his/her value to others.
  • Urge the person to stay involved and not isolate themself.
  • Counter pessimism and avoid criticism.
  • Ask your Employee Assistance Program, counseling service, or doctor for a free brochure on depression.

Contact your Employee Assistance Program, local counseling service, or doctor if you or a family member suffers from depression or if you wish to learn more about how to help a co-worker who suffers from depression. Supervisors and managers wanting information about helping an employee seek help for depressive illness are also encouraged to obtain professional advice.

Usually Not a Security Issue

As a general rule, depression alone is treated as a medical or performance problem, not a security issue. Depression can generally be controlled by medication or professional counseling, and depression alone is not the type of illness that is likely to trigger impulsive or high-risk behavior. The depressed person generally lacks the energy and confidence to embark on new initiatives, especially a high-risk activity such as espionage. Depressed individuals are more likely to do nothing, for fear that whatever they do will be wrong and cause even more problems.

Counseling or treatment for depression will not affect a person's security clearance. Executive Order 12968, dated August 4, 1995 states that no negative inference concerning eligibility for access to classified information may be made solely on the basis of mental health counseling. Counseling may be a positive factor if it facilitates an individual’s ability to cope with or adapt to stressful circumstances.

Depression could become a security issue if the individual fails to take prescribed medication, or if the depression affects judgment or is accompanied by other problems that cause insecure, unsafe, irresponsible or unreliable behavior. For example, depression is sometimes accompanied by periods of mania, in which case it is a different illness called bipolar II disorder. Mania, or extreme excitability or irritability, may cause impulsiveness, poor judgment, and increased talkativeness, all of which are security concerns.

Sources for More Information

Doctors, counselors, and Employee Assistance Programs have a lot of experience dealing with depression, as it is such a common problem.  Self-screening for depression via the Internet is available at For other relevant Internet sites, search for Depression and Mental Health.

Your local library and bookstore have a number of books on depression, usually filed under Health or Self-Help. Here are some of the more popular titles:

  • Breaking the Patterns of Depression, by Michael D. Lapko. Main Stream Books, 1998.
  • Self-Coaching: How to Heal Anxiety and Depression, by Joseph J. Luciani. Wiley, 2001.
  • Undoing Depression: What Therapy Doesn't Teach You and Medication Can't Give You, by Richard O'Connor. Berkley Publishing Group, 1999.
  • What to Do When Someone You Love Is Depressed, by Mitch Golant, Susan K. Golant. Owl Books, 1998.
  • A Woman Doctor's Guide to Depression: Essential Facts and Up-to-the-Minute Information on Diagnosis, Treatment and Recovery, by Jane S. Ferber & Suzanne Levert, 1997.
  • I Don't Want to Talk About It: Overcoming the Secret Legacy of Male Depression, by Terrence Real. Fireside, 1998.

Related Topics:  Coping with Stress, Suicide Crisis Intervention.

1. D. Blum & M. Kirchner (1997). Depression at work. Customs Today, Winter issue. Quotes used with permission of the National Mental Health Association. The Blum & Kirchner article is used with the authors' permission. It has been edited slightly to adapt it to this format and context, and the sections on relevance to security and sources of additional information have been added.




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