
- With Mayo Clinic psychiatrist
David Mrazek, M.D.
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David Mrazek, M.D.
David Mrazek, M.D.
Dr. David A. Mrazek is chair of the Department of Psychiatry and Psychology at Mayo Clinic, Rochester, Minn., and a professor of psychiatry at College of Medicine, Mayo Clinic. Dr. Mrazek has developed a federally funded psychiatric pharmacogenomics research program and implemented clinical psychiatric pharmacogenomics services at Mayo Clinic.
He has received numerous awards including the Award for Creativity in Psychiatric Education from the American College of Psychiatrists and the Agnes Purcell McGavin Award for Distinguished Career Achievement in Child and Adolescent Psychiatry from the American Psychiatric Association. He currently serves as chairman of the board of the American Board of Psychiatry and Neurology.
Dr. Mrazek has focused his current efforts on using pharmacogenomics testing to improve clinical care. One of his specific goals is to decrease the risks of taking psychiatric medications.
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Depression blog
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Nov. 5, 2008
Managing depression in the workplace
By David Mrazek, M.D.
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Work is a big part of our lives. Depression affects you no matter if you are at home or at work. Severe depression can affect your ability to perform your job efficiently.
A buzz word in the literature and press is presenteeism. This means that you are physically at work, but at the same time, are ill. The illness can be medical or psychiatric. The illness can range from mild to severe.
Presenteeism can have a significant negative impact on performance, yet can be difficult to measure.
You continue to go to work despite being severely ill or depressed for many reasons. You may feel you will lose your job. You may want to keep your mind active and have structure in your day. You need your paycheck so you can continue to put food on the table and pay the bills. You do not have paid sick leave and therefore, you have to go to work. You go to work because you feel a duty to your employer and co-workers. You go to work to help your customers.
This is not meant to judge people if they do or do not go to work when ill. The purpose is to provide education and awareness.
How can you manage your depression in the workplace? Make sure you are following up with your health care provider on a regular basis. Follow your treatment plan and take medications exactly as prescribed. Call your provider if you have questions, concerns or are experiencing a worsening in your symptoms.
At work, keep yourself active and challenged. Clearly understand your job description and your employer's expectations of you. Talk with your employer if you need assistance. Use resources available to you in the workplace such as human resources or an employee assistance program. Work can provide a sense of pride and accomplishment and therefore, boosts your self-esteem. Set yourself up for success by treating and managing your depression!
Please share your experiences with depression in the workplace and the issue of presenteeism.
82 comments posted
November 6, 2008 1:35 a.m.
I'm a lifelong depression sufferer. I've taken anti-depressants for 15 years, and have been in and out of therapy for 30 years. I managed my illness, and worked full time. However, 5 years ago I began having back problems, and have had 2 back surgeries (a three-level fusion and a scoliosis correction). Even after the surgeries I still have chronic pain, and am no longer able to manage my depression well enough to work. I did the same job for the same organization for 18 years, but during the last 2 years I couldn't concentrate or remember anything. I was "written up" and eventually retired rather than be fired. I also have severe arthritis in my hip, and another degenerated disk with stenosis. I applied for Disability, but have been denied twice. Work was just too stressful, and sitting all day at a computer only increased the pain in my lumbar spine.
- Paulette
November 5, 2008 11:30 p.m.
Or, you can do what I do. I work my head off for three or four years, get sick, go into the hospital and get fired and have to start all over again.
- j
November 5, 2008 11:21 p.m.
I have had significant family problems for the past several years, I have a disabled daughter, another daugher is a recovering addict, my marriage is awful and we have been married 29 yrs. the stress about 3 1/2 yrs ago when i went back to work began to mount. my daughter spun out of control as did my life. a lack of support from my spouse did not help. in fact he blamed me for all the family problems. I love my work and when I was working a could escape at least for a few hours from the emotional and mental stress. the anxiety at times overwhelmed me and i have had a great difficulty concentrating on the aspects of my job that i don't care for, but the part where i work directly with people is my salvation. at times i felt like i was losing my mind and did have concerns about my ability to handle the demands of my job and four children. If i did not have my work i think my depression would be more severe. although relationally i became more apathetic until i started an antidepressent. my job is not aware of my depression or my struggles.
- Denise
November 5, 2008 10:35 p.m.
"At work, keep yourself active and challenged. Clearly understand your job description and your employer's expectations ...Sorry, but I had to laugh when I read this paragraph. I was so depressed at work that I could barely remember my passwords, not to mention staying challenged! My job as Program Manager for a large government agency required the ability to continually think on ones feet and keep on top of both details and strategic decisions. Unfortunately, like the comments by the others above, my performance declined significantly over a period of years, even with medication and regular contact with my health providers. I was stigmatized as "non-dedicated" since I missed so much work (without pay) due to serious depression and anxiety that caused nausea and aggravated my neurocardiogenic syncope. Now I'm fighting for continued short term disability and hopefully will gain long term (requiring legal support). My performance reviews are in the tank and I've essentially been blackballed in the IT community for "absenteeism." Sitting at work and vomiting throughout the day due to anxiety is not a pleasant experience! Instead of boosting self esteem, the treatment we receive from mgmt is humiliating and has the opposite effect. Just being "present" is not a solution because one is still approached by mgmt to perform (usually under unrealistic timeframes with insufficient data. Many companies outsource their human resource depts so the
- julie
November 5, 2008 3:27 p.m.
Employers have no compassion for those of us with mental illness. After 8 years of outstanding performance, I was overcome with severe depression which I immediately sought treatment for. My employer, which ironically enough is the largest mental health facility in my area, chose to terminate me because of poor performance and increased absenteeism. This of course contributed to deeper depression from which even 14 years later and continued treatment, I have yet to recover. When/if I do recover and am able to get off disability, how do I present my past employment history to a future employer?
- eljay
November 5, 2008 11:18 a.m.
As a fellow depression sufferer, I think what I would do is try to figure out what I needed in a job, and then search for one that supplied that kind of work environment. I completely understand where you’re coming from. I, too, have an extremely difficult job requiring complex, detail-oriented decision-making. I was very ill before I was diagnosed. I had no idea what was happening to me, or why I could no longer to a job I had always been good at. I had trouble remembering how to brush my teeth, let alone manage complex projects. I worked that way for a year before diagnosis. My performance continued to get worse, which worsened the depression. I describe it as “thinking through Jello”. When I came back to work after 3 months disability I was presented with a performance appraisal encompassing the year I was ill. Needless to say it was devastating. The HR department refused to take into consideration the illness, my psychiatrist’s evaluation indicating that I should not be held responsible for the year I was too ill to function. I was put on probation, which did nothing for my continuing recovery. I have recovered but I’m still haunted by that year. Even being told how much I’ve improved is frustrating. I am not working harder than I was then; I’m just capable of working.
- KC
November 5, 2008 2:56 a.m.
I went to HR to let them know I was ill, but I was not allowed to tell them or my boss what was wrong with me. I could not get different duties or assignments, but the work I had to do required intensive thinking which I could not do when severely depressed. My inability to do my job or to let anyone know why I was performing so badly made my illness even worse. I went on short term leave, then went back to work for four months, and then had to go on long-term leave. After 6 months I had the choice of quitting or being fired, so I left. It would have been better financially to be fired so I could get unemployment, but I didn't want to have to tell prospective future employers I had been terminated. I can't decide now if I should tell prospective employers I have disabilty or medical condition that will alter the way I need to work. Does anyone have thoughts on that?
- Lexi
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