Friday, October 10, 2008

Depression and Work

Kelly wrote to ask what to do about work since she's feeling so depressed and her performance is suffering. This is a difficult question to answer. Initially I said that by the time my depressions were truly debilitating, I was already a freelance grant writer so it wasn't a problem.

The value of freelance work is that you can do it whenever you feel like it. Even though I had deadlines I couldn't miss, if I was feeling a bit under the weather, I could work later in the day or even at night, and for most of my career I didn't miss a deadline. Later, when the medication caused havoc, it destroyed my career. And while it was salvageable, I no longer was interested in grant writing. These days I'm semi-retired so it's not a problem.

At first I didn't think I could offer Kelley any advice about how to handle depression in an organizational setting. But the more I thought about it, the more I realized that I do have some suggestions. The problem as she stated it is that she's feeling so hopeless that it's difficult to motivate herself.

First of all, I'm wondering if you're taking antidepressants and why they're not helping you get rid of the "hopeless" feeling. In the best of times, it usually took 14 days for the antidepressants to kick in--that is when they worked. And once they worked, I felt 100 percent better and could motivate myself. (Later, they didn't work at all, but I'm an unusual case.)

I've read a lot about work and depression and many of the books suggest you should discuss your condition with your boss to see if there can't be some accommodations made, which will help you in the short term.

Given my own experience, I've got to say I disagree. About five years ago I took a part-time director of development job for a nonprofit organization, and did tell the boss about my illness (primarily because the salary was way below my usual fee and I needed to explain why I wanted to be paid more).

My disclosure initially enabled me to get the salary I wanted and to work the hours I wanted. But, about a month into the job, I learned that my boss was a real "nut-job" and had a history of taking advantage of the people who worked for her. When I tried to see if I could report to someone else within the organization, she used my illness against me by suggesting the problem was mine rather than hers. It's a long story, but it was very unpleasant. Ultimately, I had to resign because my health is my most important priority.

A few years later, I accepted a book editing position, and once again disclosed the illness because the author/client wanted me to work side-by-side with her for five days a week and I felt I could could only stand to be with someone for three days a week since I was only recently feeling well.

Although I did a terrific job editing the book, I had numerous difficulties dealing with this client. Again, she tried to blame my illness for our problems rather than her behavior (which I learned had been problematic with a lot of former employees). Since I'd already been through this once, and knew that my own behavior was very professional, and hers wasn't, I didn't allow her to take advantage of me. But, I felt that if I'd never mentioned the illness, I would have been better off.

So...having said this, my own experience suggests that disclosing the illness is fraught with problems. If other people have other experience with this, please let Kelly know.

Back to your original questions, which is how to motivate yourself when you're not feeling well, I guess I would suggest the following: 1. Talk to your doctor to see why your medication isn't working. 2. If you're not exercising, try to start. Aerobic exercise, which is truly difficult to start when you're feeling depressed, can ultimately make you feel better if medication can't.

3. Whether or not you're feeling motivated, there must be things you need to accomplish each day. While I don't know what kind of job you have, I do know that as a writer and grant writer, it was critically important that I make progress every day. So I wrote myself a detailed daily list of what I needed to accomplish. Whether I felt well or not, I slowly worked through my list. While I may not have been enthusiastic, that was less important than getting the job done.

4. The worst feeling in the world is letting things slide and hoping no one will notice. Ultimately they will, and the last thing you want to have happen is to have a less than stellar performance appraisal or be fired (in this economy). So, even if you decide not to disclose your depression to your boss, is there a colleague (or a therapist outside the work environment) who can help you figure out what you need to do to be productive until you feel better?

5. Also, I'm not sure if your work environment is helping to cause your depressive episode. If it is, you need to make sure you're talking to a therapist or counselor about the problems caused at work and see if you can figure out ways to improve things.

Since I don't know enough about your specific situation to give better advice, these are my top five ideas for now. If anyone else has suggestions, I'm hoping you'll provide them. Kelly, if we need more info to help you, let us know. All my best!



P.J. said...

When it comes to telling the boss, that is a tough one. I think that every case is different. It depends a lot of what kind of job you have, and what type of relationship you have with your boss. I worked at my job for 5 years before being diagnosed, I have a great relationship with my boss, and it still took me a month after my diagnosis to tell him. He's made a smart remark about it here or there, but he's also shown me grace when I need to go to appointments or take a few hours off for some "mental health day" (which I think EVERYONE needs sometimes!!)

Susan, you've outlined great steps. For me, stress makes me depressed. Getting that to-do list done helps me feel better. I know I've accomplished something, and I don't have to have that hanging over my head. Definitely get the meds checked out. Taking to a friend or counsellor will be a for sure help. Start your day with a 10 minute walk outside - that gets the good juices flowing and the fresh air will awaken your mind as you enjoy the beautiful outdoors.

When I'm depressed, I write. It makes me feel good when I can express myself on my blog and have others comment on it with some kind of encouragement - even if it's just a simple "I've been there".

okay, enough talking for me. Kelly, I agree with Susan, that if you have some specific questions, please ask!!

Andrea said...

Kelly, I wish I could help - having been through this myself, I have a feeling what you much be going through.

I agree that you absolutely should NOT tell your supervisor/employer. Like Susan's examples, some people will blame their problems on someone else, given the chance. However, if your company has an EAP program, you can take advantage of that without fear of the information getting out. People use EAP for all sorts of mental health reasons, like a death in the family; so even if someone in HR knows you're using it, they don't know why.

I wish you a speedy solution. You can get through it, I found a way through and you can too.

KJ said...

I can tell you this. Everytime Joe has disclosed his illness a boss they have found a way to terminate his employment. It was suggested to Joe by his therapist that he not tell his boss he is bipolar because of the stigma that still exists.

I know that if you don't do the work required of you even in a depressive episode there may be consequences to your employment that may make the despression worse. So try to get the help you need before the situation gets worse.

I am so sorry for Kelly's struggles and my thoughts are with her during this time of struggle for her.

Wellness Writer said...

Dear P.J., Andrea, and KJ,
Thanks for your empathic responses to Kelly and your great advice. Sometimes, I think we feel better about a situation just because others have "been there" and know what we're experiencing.

I find it interesting that P.J.'s boss has "shown her grace," that Andrea can recommend a EAP program (something I know nothing about), and that Joe's therapist has recommended he not disclose his illness because of discrimination.

Kelly, hopefully you will find some level of solace, and help in the disclosures of my wonderful readers and friends.


Gianna said...

something funky happened when I sent this the first time...delete it if this is the second time you got it.

Later, they (antidepressants) didn't work at all, but I'm an unusual case.

antidepressants not working is not best they only work 30% of the time and that's in the psychiatric literature...

30% is also approximately the same as how often placebos work so we can legitimately wonder if the active ingredients in AD's are ever doing anything.

other wellness activities and lifestyle changes really need to be pursued.

Many of those are talked about on this site and in this post.

Wellness Writer said...

Dear Gianna,
Thanks for the information on the lack of efficacy of antidepressants. I had no idea it was such a high percentage!


Kelly said...

Well, it appears that telling my boss about my depression is not a good idea. I had the sneaking suspicion this was the case.

Susan, I've been on Wellbutrin for years, and it has kept me out of the depths of depression for the most part. Now I'm taking lamictal for bipolar, which has antidepressant properties. My doctor recommended increasing lamictal to deal with the depression. I'm seeing him in a few days to discuss everything. It's very frustrating taking medicine that might not be working anymore, like Wellbutrin, and having to find a new antidepressant -- dealing with the side effects.

I am getting regular activity, walking and lifting weights. I've looked at it as part of my therapy. They're tangible things I can do for myself. Still, much of the time I just want to sleep. I'm happiest getting in bed by 9 every night, or earlier is even better. Like right now it's 7:38 and I'm counting the minutes when I can get in bed.

Some of my work can be done at home, and I can arrange to work at home sometimes. That might help some. But I'm afraid all I'd do is sleep. We'll have to see.

Thanks to you all for your suggestions. There's no easy way out of this, but I have some good tips, and it's nice to hear from people who've been through the same thing.

Bradley said...

I think you made a great list, Susan. I've decided that I am going into freelance web design full time because I couldn't imagine working in a typical office environment. Maybe there's a lot more entrepenuers with mental health problems than we know.

Wellness Writer said...

Dear Kelly,
It sounds like you're very disciplined and that you're doing the best that's possible under the circumstances.

I do have a few things to say about antidepressants. First, was the Wellbutrin working before you started taking the Lamictal?

Although every psychiatrist I ever saw said that a mood stabilizer won't diminish the effect of antidepressants, for me that wasn't the case.

Second: I personally never received any antidepressant effect from Lamictal although I know it works for others.

Third: Antidepressants do poop out, but Wellbutrin is quite different than some of the others. It's supposed to be the one medication--as far as I am aware--that won't cause heightened hypomanias. So, before searching for something else, I'd make sure that Lamictal hasn't diminished its effect.

Obviously you know that an increased desire to sleep is the sign of depression. I've been there so many times that I do want you to know I have great empathy for you.

Let us know what your doctor says.


Wellness Writer said...

Dear Bradley,
That's great news about your decision to go into WEB design as a freelance career. Who knows? Maybe you can get hired by mental health organizations?

And yes, I wouldn't be surprised if freelancers and entrepreneurs have issues!


Gianna said...

wellbutrin can indeed cause mania...I've seen lots of people get manic on it and it made me sleepless which can lead to mania in some...I stopped taking it because it messed with my head so bad...made me really twisted.

it also gives a lot of people a sort of caffeine buzz.

as far as I know, and I've seen clients on just about every antidepressant, any AD can potentially cause mania...

Wellness Writer said...

Thanks for the info. Kelly's evidently taken it for years and it works for her. As we know, medication affects people differently.


naturalgal said...

I have to ditto what people said about telling your boss or co workers...DON'T!

Also ditto to both of Gianna's statements on Sue NOT being unusual and the on the effectiveness of antidepressants.

Wellness Writer said...

Naturalgal, thanks for weighing in on this topic.


Andrea said...

Susan -
EAP = Employee Assistance Program. A lot of companies offer this now. It provides 12 counseling sessions per year for whatever reason. You go through the EAP provider, not your company. It's for so many different issues (including "stress") that it doesn't set off any red flags.

Some companies also have/instead have Employee Wellness Programs. These vary in benefits.

Hope this helps. Andrea

Wellness Writer said...

Thanks very much for the info. I think it's very helpful, and I appreciate it.