Beating the Blues

Wednesday, March 1, 2006 - 08:01

The World Health Organisation (WHO) has predicted that, by 2020, depression will be the world's second biggest health problem behind heart disease. What does this mean for your workplace? Penny Sutcliffe reports.

Depression is shaping up to be one of the most serious challenges confronting the modern workplace. It costs the Australian economy about $4.3 billion in lost productivity each year. Economic studies indicate that an employee's undiagnosed depression can cost the organisation nearly $10,000 a year.

When Jeff Kennett, Chairman of beyondblue, a not-for-profit organisation, spoke about depression at the How to Create a Positive Workplace Forum in Western Australia, he described it as one of the most democratic diseases of all time. The forum was hosted by the Australian Institute of Management (AIM) WA last September.

"One in five will suffer from depression at one point or another in their life," said Kennett. "No one is excluded, it can strike anyone at any time: old, young, fit, unfit, wealthy or poor."

And if that's not enough reason to create awareness in your workplace, the enormous economic impact should be a wake-up call to all managers. Each year, six million working days are lost due to depression, and it accounts for another 12 million days of reduced productivity.

Australia currently has 170,000 new entrants in the workforce annually. The growth in the working age population for the entire decade 2020 to 2030, however, will only be 125,000, according to a study by Access Economics entitled, Population Ageing and the Economy.

What does that mean for your business? It highlights the importance of retaining the employees you want to keep by providing them with a healthy environment to work in.

A recent study by Medibank Private found that employees with poor health and lifestyles have a far higher chance of being unproductive at work. Staff members who are healthy, according to the study, put in more effective working hours - as much as 100 times more - than their colleagues affected by poor health. The study concludes that this is a great incentive to promote a healthy workplace.

The snowball effect of stress, which is often experienced in a workplace setting, can result in the depletion of neurotransmitters (also known as brain fuels). Neurotransmitters are a vital chemical allowing messages to be transmitted from one neurone to the next. When these brain fuels are depleted the brain becomes dysfunctional - the most common result is depression. This brain fuel depletion is a model that explains, in a simple manner, the physiological effects stress can have on employees.

Depression is no longer the hidden disease. Late last year, Woolworths and beyondblue distributed information about depression in all Woolworths and Safeway supermarkets across Australia .

Leonie Young, CEO of beyondblue, said the partnership with Woolworths was a great way of getting information to people as they do their shopping.

Roger Corbett, CEO, Woolworths Limited, says: "It is important for all Australian communities to understand the impact that depression can have on families. Woolworths is pleased to be able to assist with raising awareness so that those affected can seek help and support."

Dr Peter Symons, a Director of the Positive Workplace Foundation, a not-for-profit organisation that provides training in developing positive workplaces, has dealt with depression both professionally and personally. "It would be economic suicide for companies not to stand up and take notice of this condition." He highlights the importance of addressing what is described as "the slippery slope".

"People affected are not psychologically healthy one minute and clinically depressed the next. There is a process that they go through, and signs along the way. If you can identify that slippery slope, find people along it, it is much easier to turn things back and do something about it - rather than wait till they fall."

Treating those affected once they are diagnosed with clinical depression is much more complex and time consuming, Symons points out.

Picking up on the signs

Dr Nicole Highet, Deputy CEO of beyondblue, has a doctorate in clinical psychology, specialising in the treatment of depression. She cites the symptoms of depression as having two or more weeks of persistent low mood and/or a loss of pleasure in life, plus a range of both physical and behavioural symptoms. These include a lack of motivation and satisfaction, changes in appetite, headaches, reduced concentration affecting productivity, increased tiredness, problems sleeping, irritability, relying on drugs and/or alcohol and negative feelings of helplessness and worthlessness.

"It's the cluster of these categories over an extended period of time that defines the diagnosis of depression, and sets it aside from a 'bad day'," advises Dr Highet.

Dr Highet says that diagnosed depression currently ranks as a significant cause of death and disability in Australia. At a time when skill shortages are plaguing the workforce, the effect this illness can have on organisations cannot be underestimated.

"You wouldn't think twice about responding to someone who might be having a heart attack in the workplace, so why not put the same effort into someone who is experiencing depression?" she questions.

Dr Highet advises that when approaching an employee you feel may be affected with depression, there are a number of risks, particularly as they may also have low self-esteem. But there are many strategies around this to achieve the best possible outcome.

"Approaching the person in a non-threatening environment is very important," says Dr Highet. "Asking the employee to enter the manager's office can immediately become quite intimidating."

Speaking at a staff meeting and broaching the topic as a not uncommon malady is a good start. When you are with the employee to discuss the issue, start by hinting that you are worried about their health, and express that this is a concern because the employee is a valued member of the team.

"Show care, concern and empathy, rather than being judging, or acting as if the employee is going to be performance managed," says Dr Highet.

Bringing up specific issues and stating calmly that it is a concern, while ensuring confidentiality and offering ways and means to help, is the most positive approach.

Quite often, the person is not given the support or opportunity to address the problem and seek help; instead they are performance managed from the onset. This has the undesirable effect of making the person feel that trust, support and empathy are lacking.

"This is much more likely to result in absenteeism and reduced productivity," advises Highet.

But for a workplace setting the key target audience, Dr Highet explains, is "not the one in five who are affected, but the other four."

Educating and training employees on how to recognise the symptoms and deal with depression in the workplace is key to effective management.

Dr Highet refers managers - and encourages them to refer employees - to the beyondblue website for a wealth of information, including the relevant types of treatment. She emphasises the benefits of implementing training programs such as the beyondblue workplace program, which not only increases awareness and understanding about depression, but reduces stigma and promotes proactive help-seeking behaviour. Implementing programs of this nature makes it easier to anticipate when a person is predisposed to a condition, empathise effectively with a sufferer and offer constructive support and solutions.

As a general guide, the Black Dog Institute, an educational, research and clinical facility offering specialist expertise in depression, recommends that a manager look out for these key signals:

  • Low self-esteem;
  • Change in mood control;
  • Varying emotions throughout the day;
  • Change in appetite or weight;
  • Reduced ability in enjoying things/tasks;
  • Increased fatigue;
  • Impaired memory and concentration;
  • Late for work/meetings;
  • Withdrawn, does not engage with others; and
  • Out of touch with reality.

Case study

Rising up from the lows

Twenty-seven-year-old Erika was diagnosed and treated with depression as a teenager. But after a move to Sydney, and at the time of accepting a demanding job as an account manager, she felt healthy and ready for the challenge. The trigger for a relapse came in the form of a relationship break-up, combined with dealing with a demanding work client. Things started to spin out of control. "I would come to work and turn on my computer, but just couldn't cope. I was just going through the motions," she says.

Within three months Erika was on the verge of suicide and sought help from a doctor; she was soon on antidepressants. "This helped me stop and think about things in a rational and relaxed way, and enabled me to finally address the problem with my manager.

"I don't blame my employer or employees for not noticing, but if there was more awareness and less stigma in the workplace, it may not have got to the point it did, and perhaps reduced the effect it had on not just me, but my work environment too."

Peter Hosking is a director of marketing communications companies 360, The Glasshouse and Determine. His experiences with employee depression, including Erika, has taught him to take a proactive approach to creating a positive and open workplace for employees - and he is a strong advocate for other organisations to actively create opportunities for people to open up about their difficulties in a safe and comfortable way.

"It is definitely becoming more and more prevalent than in years gone by," says Hoskings.

"Employees who are usually bright, bubbly and intelligent, may suddenly go through increased mood swings, a changed work ethic and find it hard to get through the day."

Hoskings says he is now quicker to respond to such cases and develop ways of moving forward. "In hindsight, with Erika, I was too slow to put the pieces together."

He recommends creating an environment promoting understanding and honesty. "Have a weekly one-on-one session, outline your expectations for the week. Check that your employee feels comfortable with that. Encourage them to let you know if they think it might be too much, or if they are having a bad day."