Companies wishing to offset losses due to workplace depression may be wise to consider expanding efforts to address the problem early and comprehensively.

While the media often focuses on traditional medical problems like heart disease and cancer, depression remains one of the most prevalent and costly illnesses in the world. According to the Centers for Disease Control and Prevention, the lifetime prevalence of depression in the United States is estimated to be about 16.5 percent—greater than diabetes, stroke and HIV combined. According to the World Health Organization’s (WHO) landmark Global Burden of Disease study, depressive disorders are anticipated to rank No. 1 among all causes of disability in the world by 2030.

The WHO reports its findings in disability adjusted life years, or DALYs. DALYs are a measure of the sum of years of potential life lost due to premature death plus productive life lost due to disability. This is an important concept to consider for persons interested not only in disease mortality (deaths), but also in disease morbidity (number of individuals in poor health). For mood disorders like depression, DALYs and morbidity may serve as better representations of the total societal impact because these disorders do not lead directly to death (except for tragic suicide events). Instead, the impact on individuals afflicted with depression, their families and coworkers, tends to manifest as low energy, difficulty engaging, poor concentration and the resulting loss of productivity and erosion of relationships. These factors create workplace and family burdens, pose challenges for human resources and management, and have cumulative negative economic consequences.

Recognizing the Problem
The effect of depression in the workplace is not often easily recognized, especially early on, when treatment may be most useful. The symptoms of depression develop slowly, and many employees with the illness do not themselves identify the problem. Moreover, when they do, the stigma associated with psychiatric illness prevents depressed patients from seeking treatment or reporting it to employers. A 2008 British survey by the Depression Alliance found that an astonishing 79 percent of respondents felt that disclosing depression at work or in college could be detrimental.

Without treatment, depression often worsens to a point that an employee is less productive. The cardinal symptoms of depression—low energy, difficulty concentrating and making decisions, feelings of worthlessness, lack of interest, and more—are the antithesis of qualities employers seek in their best workers.

In the 2001 study, “Comparing the National Economic Burden of Five Chronic Conditions” by researchers with HealthAffairs.org, of more than 6,000 employees at three polled corporations, those with depressive symptoms were seven times more likely to show decreased effectiveness than those without symptoms. Other symptoms of depression, such as anxiety and irritability, may lead to interpersonal difficulties that preclude efficient problem-solving and productivity.

According to another study, Managing workplace depression: an untapped opportunity for occupational health professionals, published by the National Center for Biotechnology Information (NCBI), depressed employees are associated with lower co-worker morale, resulting in higher turnover and general discontent. Administrators may find themselves embroiled in an unproductive, unpleasant atmosphere prior to the depressed employee seeking help, leaving or getting terminated. Most agree that the latter options are less than desirable since an otherwise successful employee can usually be managed with appropriate outpatient mental healthcare.

The Value of Prevention
The most profound negative business effect of depression is absenteeism. As a disorder, depression accounts for more lost work days per year on average than back pain, diabetes, high blood pressure or heart disease, according to the study, The economic impact of depression in a workplace, published by the NCBI. Further, according to a study by Kessler et al., published in The American Journal of Psychiatry, a depressive episode of an otherwise functional worker resulted in an average 27.2 lost work days per year. Considered together—reduced productivity, workplace angst and absenteeism—the collective outcome of depression in the business setting underlies what many experts now recognize as a devastating economic problem.

Kessler et al. state that estimates for the cost of depression have been as high as $83.1 billion per year, the majority of which is attributed to decreased work production. Fortunately, depression is a treatable disorder. Most adept managers recognize the economy of prevention over cure, especially when it comes to human resources, so it is no surprise to learn that many businesses have begun to offer programs to employees that provide early and effective depression treatment.

What may be surprising, however, is that several economic analyses have shown these quality improvement programs benefit not only the employee, but are cost-effective to the company as well. In fact, screening employees for early signs of depression (and other common mental health disorders) may be the most cost-effective method to reduce costs due to mood disorders. One study led by Carolyn Dew at the University of Toronto, found that persons who were prescribed antidepressants were 20 percent less likely to be absent than their counterparts. Other studies have shown that effective mental health treatment also reduces utilization of non-psychiatric services, including a remarkable 85-percent decrease in expensive hospital days.

Depression represents a significant burden on society. It affects individuals and families, but like any other serious chronic medical problem, it also has a negative impact on the business community. Corporations wishing to offset losses due to workplace depression may be wise to consider expanding efforts to address the problem early and comprehensively. Employers interested in learning more about how their companies can help improve the lives of their employees while saving money might start by utilizing a productivity impact model such as that at depressioncalculator.com, one of the many free web-based tools that help illustrate the cost benefits of depression treatment for individual companies. iBi