By Lisa Esposito for US News
Chances are, someone at your workplace has depression. It could be a co-worker; it could be you. Not just a case of the blues, not deadline burnout, but chronic, clinical depression that requires ongoing treatment. According to Mental Health America, one in 20 workers is experiencing depression at any given time. And you don't just snap out of it with a little willpower. It's a process that starts by getting the help you need. Here's how people manage at work while dealing head-on with depression.
Recognize the signs.
You're tired all the time. Cooperating with colleagues -- even talking to them -- takes an enormous effort. You keep your office door shut and interact with your computer. Or you visit the employee restroom for another crying jag. It's hard to concentrate and impossible to summon up a positive attitude. Along with morale, your productivity is down the drain. It takes you longer to get things done, and co-workers notice that you seem out of it. Deadlines don't motivate you -- they just pile on more stress. You're calling in sick. Or, you're spending lots of extra time on the job, burying yourself in tasks to avoid your emotions. You're suffering and so is your work. It's time to seek treatment.
Take a mental health break.
Betsy Aimee (who did not use her full name to maintain her privacy), 33, works in public relations in Los Angeles. In her 20s, depression entered her life. "I was really in a little bit of denial about what was happening to me," she says. Aimee describes herself as a "full type-A, very-critical-of-myself individual." It's hard when you can't function as well as you're used to, but slogging on doesn't work when you're in a downward spiral. "When you're at a crossroads in terms of your mental health, you need to really say, 'OK, I'm going to ask for five days off,'" Aimee says. "That might mean the difference between me not having a mental health breakdown, or needing to take additional time off."
If you had a bad case of the flu, you'd take time off to recover, right? And if you developed diabetes, you'd put work aside to find a doctor and get stabilized. "Depression is no different from any other chronic condition," says Paul Gionfriddo, president and CEO of Mental Health America. "To stay with it and maintain an independent and productive life -- it's important to identify it, get the appropriate treatment and then stick with that treatment." When it comes to counseling sessions or tracking medications and their side effects, there's no one-and-done treatment. "People should be going back even as they would with any other doctor and say, 'OK, is this the right med, is this the right course for me?'" he says.
Check into workplace services and insurance.
With chronic conditions -- like depression -- you have workplace protections against discrimination. "'Otherwise qualified' is always the terminology," Gionfriddo says. "If you are otherwise qualified, then a reasonable accommodation has to be made." In practical terms, he says, that might mean "when you need to take a day off and check out, you do that," without fear of jeopardizing your job. Then, he says, you come back to work when you "can give it a 100 percent again." Many workplaces have employee assistance programs that include confidential mental health services. Also, look into your health insurance coverage for treatment including counseling and medication.
Whatever gets you through the day.
Most people don't have the luxury of taking time off until their depression is under perfect control. In a 2012 blog posting about workplace depression, Aimee describes how she managed rough weeks by taking it day by day. She set herself clear goals, created lists and highlighted top priorities so she wouldn't lose sight of her boss' needs. Realizing that her short-term recall was temporarily off kilter, she took plenty of notes during meetings and gave herself extra time to prepare assignments. And she'd ask trusted colleagues to take a second look at her work.
Decide if -- and how -- to tell your boss.
The type of industry in which you work and the relationship you have with supervisors can affect how open you want to be about depression, Aimee says. Before you disclose your diagnosis, it helps to assess your relationship with your boss and to determine how much information you feel comfortable sharing. "In my case, I talked to my boss once I had medical attention and I had a diagnosis," she says. At that point, she was having a hard time focusing on pressing deadlines. "Completing a lengthy research assignment was a challenge for me," Aimee recalls, "and I felt that rather than her thinking I was not engaged in my work, that I would share what was happening to me." For Aimee, opening up that dialogue made her job situation easier.
Take care of your body and mind.
While you're waiting for treatment to take hold, it's important to look after your physical health. "It can help to get enough sleep at night," Gionfriddo says. "It can help not to get too much sleep. It can help to nourish yourself properly – even when it's difficult to put food in your mouth – and to opt for the healthier food choices." Take a walk when you can; a light jog or run can churn up endorphins to ease some depression symptoms. If that walk or run takes you to the nearby park with trees and fountains, so much the better. Meditation helps some people with depression or stress, and it doesn't necessarily require a lot of training or chanting in your cubicle. "Just deep, slow breathing oxygenates us and makes us feel better at the same time," Gionfriddo says.
Office parties -- attend or avoid?
Withdrawal is a symptom of depression, not a solution. That said, when you're depressed, work-social gatherings meant to be fun can feel more like torture. You don't need to choose between two extremes, Gionfriddo says: "It's not either, 'I'm withdrawing to my office and closing the door,' or 'I'm out there with 100 other people who are laughing and joking and having a good time.'" Instead, you might be able to manage five minutes, maybe catch up on a work discussion with a colleague in a quiet corner, then leave. If you've shared your struggle with an office buddy or two, they can help by hanging out with you away from the action.
Tap into peer support -- or provide it.
Humans are social beings, Gionfriddo says, and that's why gathering around the office water cooler used to be so popular. Texting and email have changed that dynamic, though, and it's easier to miss major mood changes in co-workers when you don't communicate face to face. With conditions like depression "people tend to close themselves off from other people," he says. But peers at work can be a great source of support.
If you're not dealing with depression but want to be more attuned to your colleagues, he suggests stepping away from the computer every so often. "Just walk the hall, poke your head in a few offices and say hello," he says. Respect boundaries, though. If someone insists "I'm fine" when he clearly isn't, don't confront him with "Everything is not fine." But, Gionfriddo adds, "It never does more harm than good to ask how somebody's doing: 'You seem a little low today; is everything OK?'"
Reach out to family and friends.
If you're ready to open up to colleagues about depression, it's natural to start with people with whom you already have a comfortable relationship. When they know what's going on, they can have your back during stressful projects and periods -- just like you can have theirs in the future. Friends outside of work and family members can also help you cope. "You never want to replace your professional, your therapist for example, with a peer, but you may want to augment their services with a peer – or start with a peer," Gionfriddo says. Depression can run in families, and some of your relatives may have already been there themselves. They may be further along in managing their condition, and can give you pointers on how to get through the day. If you're in group therapy or a depression self-help group, you can pick up workplace tips and strategies there.
Anticipate job triggers.
As you get a handle on depression, you develop your personal tool kit to manage it. Sometimes you can anticipate depression triggers -- major projects that turn your workplace upside down – and prepare in advance, Gionfriddo says. With your clinical professional, for instance, you might talk about adjusting medication doses or getting more counseling. And with colleagues in your corner, you can say, 'Based on this, I know I'm coming up to a trigger point next week, what can I do? Talk me through this.' Whatever helps -- breathing, stretching -- set yourself reminders. "We all tend to put these things aside until we need them again," he says. "If I'm fortunate enough to recognize my triggers, I'm fortunate enough to recognize what I need to do for self-help."
Know when to seek help ASAP.
Aimee recalls a time when she was still coming to terms with depression at work, and a co-worker basically told her, "We are going to call your health provider right now and get you help, because this isn't just feeling down -- this is something else."
Gionfriddo cautions that even people who are in treatment and have learned how to cope can still return to an acute phase of depression that leaves them totally withdrawn. Whether they're mostly relying on medications or counseling, they may need a "therapeutic reset," he says. "That's the time to call and say, 'Can I get an appointment today?' and explain 'I'm worse off -- and can we head this off at the pass before I'm at point where I'm out of work for two weeks or fail to do my project?'"
Be easy on yourself.
If you think you have depression, and you fear that speaking up might affect your job, it helps to realize "you're not alone – and once you're open to talk about this condition, you'll find that there's more people who are sympathetic to you than those who are critical," Aimee says. "Your fear of the reaction might be worse than the actual reaction." From one who's been there, her advice is, "While you're being proactive about treatment, take it one day at a time and be very gentle with yourself."