Depression
Overview
General Considerations
Depression is a term commonly used to describe everything from transient sadness to a serious health disorder that encompasses both emotional and physical symptoms. While everyone experiences feelings of sadness from time to time, a depressive disorder may be present when these feelings of sadness are prolonged and interfere with daily functioning. Depression is a real medical condition and there are many proven treatments. These treatments are often more effective if implemented in the early stages of depression.
Recognizing the Symptoms Associated with Depression
Depression is a prolonged and persistent negative mood, which usually affects an individual's work performance and interpersonal relationships.
While sadness is key sign of depression, it is sometimes not readily apparent (i.e., people can hide their moods). It is therefore important to recognize that people who are depressed often show several other signs, including a significant change in behavior. A talkative person, for example, may suddenly become silent and detached from others. The following signs have been associated with depression:
- Persistent feelings of sadness.
- Loss of interest in pleasurable activities.
- Apathy at the workplace/decline in work performance.
- Difficulty sleeping.
- Change in appetite or weight.
- Poor focus and concentration.
- Feeling fatigued (lack of energy).
- Statements of excessive guilt.
- Hopelessness.
- Restlessness, irritability or easily agitated.
- Thoughts of suicide.
- Engaging in unsafe behaviors (reckless driving, driving while intoxicated, and decreased safety practices).
Additional Information about Depression
- Depressed workers may be more prone to accidents since the symptoms of depression may affect the unit member's safety.
- Not all depressed people are suicidal; however depression does increase the risk of suicidal thoughts and behaviors.
- For people who are depressed, normal activities may become overwhelming.
- People with depression may deny there is a problem.
- People with depression may withdraw from social support networks at the time when they need them the most.
- Symptoms such as lack of sleep and poor concentration may lead to additional life stressors, such as difficulty with job performance.
- Relationship loss or threatened loss is a frequent precipitant of depression.
- Alcohol, sometimes used as a coping mechanism, can make depression worse.
The Impact of Depression on Work
Depression may have a significant impact on overall work performance. Members may come to work late and appear tired from lack of sleep. Poor concentration and focus may reduce productivity or accuracy. In addition, depression can lead to irritability that may foster conflict with peers and supervisors. Low morale, lack of cooperation, and unintentional injuries may also be observed on the job.
Understanding Barriers to Seeking Help
Depression can often interfere with a person’s desire to seek help. People may feel a sense of helplessness or hopelessness and become convinced that nothing can help. Some members may be afraid of medications, while other may have reservations about therapy. Other times, the stigma associated with having depression or getting help for depression may prevent people from getting the help they actually need. Knowledge that depression is a real medical condition and that effective treatments are available can be vital in getting people help…and the earlier the better! Most people with depression can be successfully treated on an outpatient basis.
Depression is most often treated on an outpatient basis. Many people with depression are helped by therapy alone. Others have better success with medication or a combination of medication and therapy. Someone who is reluctant to go t may be more open to seeing their primary care provider. Most importantly, encourage them to get help soon.
What Leaders Can Do to Help
The role of commanders, watch commanders, and front line supervisors is to assist the person in getting help. Leaders should encourage use of helping agencies to resolve problems such as depression. Leaders who recognize the presence of depressive symptoms are not expected to act as counselors or therapists. Emphasize that you are looking forward to the individual returning to prior functioning and offer encouragement that effective treatments are available. Leaders can take the following steps to help members with depression:
- Know the warning signs of depression--for example, changes in the member's performance may be a sign that emotional problems are interfering with work.
- Communicate to the person with depression that asking for help is a sign of strength not weakness.
- Ask the person directly about depressed mood or loss of interest in pleasurable activities. Consider information you may receive from coworkers and/or family members who express concerns about the emotional state of the individual.
- Barriers to seeking help may need to be addressed with the member. Discussions should address concerns the member may have about the negative career impact from seeking help. Leaders may also need to remind members about the possible consequences of not seeking help, such as the condition worsening with greater impact on job performance.
- Ask directly about thoughts or feelings of suicide. Refer to emergency services immediately if you suspect suicidal behavior.
- Ask directly about how you can be supportive.
Community Resources Available to Help Depressed Personnel
- Behavioral health providers are available. The behavioral health provider i can conduct an initial assessment, provide intervention, or offer an appropriate referral. Encourage personnel to seek care with their primary care manager for depression.
- Chaplains and Health and Wellness Centers provide services that build protective factors. Many of these can decrease the risk for depression.
- In many communities, free support groups are available for people struggling with a variety of emotional problems including depression.
II. Relevant Policy
Consult local policy directive and operating instructions specifi to mental health.
II. Suggested Resources
National Institute of Mental Health website: www.nimh.nih.gov
IV. References
Diagnostic and statistical manual of mental disorders; DSM-IV-TR. (2000). Washington DC: American Psychiatric Association.
Harold, K., & Benjamin, S. (1995). Comprehensive Textbook of Psychiatry VI eds. Baltimore: Williams and Wilkins.
Hoge, C. W., & Lesikar S. E. (2002). Mental disorders among US military personnel in the 1990's: association with high levels of health care utilization and early military attrition. American Journal of Psychiatry, 159, 1576-1583
Levenson, J. (2000). Depression. Philadelphia: American College of Physicians.
