Welcome to the Psychiatric Hotline.
If you are obsessive-compulsive, please press 1 repeatedly.
If you have multiple personalities, please press 2, 3, 4, and 5.
If you are paranoid-delusional, we know who you are and what you want. Just stay on the line so we can trace the call.
If you are schizophrenic, listen carefully and a little voice will tell you which number to press.
If you are depressed, it doesn’t matter which number you press. No one will answer.
If you are delusional and occasionally hallucinate, please be aware that the thing you are holding on the side of your head is alive and about to bite off your ear.
One in four adults in the US suffers from some form of mental illness, mostly depression and anxiety disorders. 11% of Americans take an antidepressant. Chances are, someone you work with is depressed.
The cost of depression in lost productivity and health care has been estimated at $83 billion per year. Depression is the primary cause of suicide. More people kill themselves in the US than die in car wrecks.
Yet, depression often is not diagnosed or treated. Men are especially hesitant to get treatment because they perceive it as a sign of weakness.
Employees would rather quit than have the stigma of taking leave for mental illness. (David Mowry has written an excellent essay on attorneys and mental illness in House Rules: A Time Out.)
Many self-medicate with alcohol and other drugs, which just compounds the problem.
So it’s likely that you are dealing with depressed employees at work. It may even be the boss.
Is Depression Covered Under the ADA?
Depression can be a disability covered by the ADA that requries reasonable accommodation, but not always. It must be a mental impairment that substantially limits a major life activity.
Short term or situational depression probably does not rise to the level of a disability. But a long-term or major depressive disorder will. For more information on when depression becomes a disability, see the EEOC Enforcement Guidance on the ADA and Psychiatric Disabilities.
If the person is also addicted to drugs or alcohol, the ADA can be triggered as well. Addiction to illegal drugs is not protected because, well, you can’t have a law that protects illegal behavior. But addiction to prescription drugs and alcohol can be covered. But even if the form of addiction is covered, the only “reasonable accommodation” an employer can make is time off for treatment. The employer doesn’t have to allow someone to drink at work, or come in late because she’s hungover.
Similarly, an accommodation for depression usually involves time off for treatment. It can also involve reduced hours, or responsibilities, or a change of position.
But it is very difficult to know when you are dealing with a depressed employee who needs help, instead of someone who doesn’t want to work there, or is just going through a rough couple weeks.
Is Depression Covered by FMLA?
Depression is a serious health condition that can qualify for Family Medical Leave. Again, it depends on the severity and the need for time off for therapy, medical appointments, or to adjust to medication.
Work with an employee’s physician or therapist to figure out what the employee needs. Then allow time off or intermittent leave.
The rules and procedures for ADA, FMLA, and the corresponding state versions differ. So always check all the procedures and requirements when dealing with leave related to a disability or serious medical condition.
What Does Depression Look Like?
Often someone who is depressed doesn’t even know it. Instead, they think they are coming down with something, or just can’t focus. Not everyone who is depressed goes to bed and doesn’t get out. Often depression shows up as anxiety or panic. Some of the symptoms listed by the Mayo Clinic include:
- Feelings of sadness or unhappiness
- Irritability or frustration, even over small matters
- Insomnia or excessive sleeping
- Changes in appetite — depression often causes decreased appetite and weight loss, but in some people it causes increased cravings for food and weight gain
- Indecisiveness, distractibility and decreased concentration
- Fatigue, tiredness and loss of energy — even small tasks may seem to require a lot of effort
- Feelings of worthlessness or guilt, fixating on past failures or blaming yourself when things aren’t going right
- Trouble thinking, concentrating, making decisions and remembering things
- Unexplained physical problems, such as back pain or headaches
Who doesn’t feel like that sometimes?
So basically, you are dealing with a problem that may require medical help and legal protection, but the symptoms are often confusing and contradictory, and the person may not even know she is depressed.
What to Do.
Look for changes in behavior and performance. When a good employee is suddenly missing deadlines or absent more, look further.
Ask the person if she is depressed. Suggest she see her doctor or a therapist to explore why she’s not feeling or doing well.
Give depressed employees time to get treatment.
Monitor their performance and hold employees accountable for their work within the recommendations of their doctor or therapist.
Maintain the employees’ confidentiality, and ask only for the information you need to comply with the leave policies or law.
The important thing to understand is that HR is not in a position to make the determination as to whether someone is depressed, or whether the depression is potentially protected as a disability. The employee and his therapist or physician are the ones who determine whether the condition is severe enough to require leave. Then HR and the legal department can make sure that the laws get followed.
But next time an employee is having problems at work, consider whether they need help for depression. You may save an employee. You may even save a life.