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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.
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.
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.
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.
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.
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 www.depression-screening.org.
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.
Reference
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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