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When Depression is Affecting Your Work: Signs to Recognize
Daniel Hageman
When it feels difficult to just get through the day, facing challenging tasks at work can be overwhelming. And the feeling that you're not doing your best on the job may exacerbate your symptoms, especially if you tie your identity to your work.
If depression is affecting your work, it can feel isolating—but it's actually more common than you'd think. According to the Centers for Disease Control and Prevention, in any given year, roughly 10 percent of American adults will experience depression, translating into nearly 200 million days of missed work due to mental health sick days.
However, there is hope. First, it's important to understand how depression is affecting your work specifically, since there's a range of factors with both short- and long-term effects. There are also a number of support and treatment resources you may have access to through your job that can help.
Navigating Depression at Work
Most people are familiar with the emotional symptoms of depression, and it's not difficult to see how they might affect your work performance. Especially in a culture that rewards keeping emotions out of the workplace, putting your head down, and getting things done, emotional symptoms can be challenging to navigate at work.
You may feel sad, empty, or hopeless, wondering what the point of anything is, especially work. Feelings of worthlessness and a lack of confidence may hold you back from accomplishing tasks and projects because you feel like your contributions don't matter. And even if you are typically a self-starting high performer, finding the motivation to get started on a project may feel impossible.
The emotional effects of depression can also impact your relationships with those you work with, from colleagues to clients. You might withdraw from or be short with others, and if you interact with other people frequently, this may start to affect your reputation around the workplace.
Understanding the Physical Symptoms
Physical symptoms of depression sometimes go overlooked, but they're equally liable to present challenges at work.
Depression symptoms can sometimes cause you to feel as though you're trudging through molasses to get the most basic of tasks done. Fatigue is a common symptom, often going hand in hand with either insomnia or hypersomnia (sleeping too little or too much). You may just feel like you want to nap all the time, making it hard to get work done. Frequent dull tension headaches are possible as well and can lead to difficulty concentrating.
You may also experience psychomotor agitation or psychomotor retardation at work. Psychomotor agitation might look like endlessly pacing the room or fidgeting externally; internally, you may be experiencing racing thoughts. Frequent staring off into space, slow walking, and decreased cognitive ability and focus are all signs of psychomotor retardation. Both of these symptoms can make it hard to get work done, either because you are too fidgety to sit down and focus or because your brain is too sluggish to find motivation.
Identifying Stress at Work
As you might expect, sometimes work itself can cause or contribute to depression. You may be feeling spread too thin by an overload of responsibilities and duties, or the sheer pressure of your work may be taking a toll. On the other hand, you may not be feeling challenged enough, and you're bored without a clear path of career advancement.
With many people spending 40 hours a week or more at their jobs, tension and disputes with coworkers can worsen depression and undermine your quality of life. Not only can work thoughts take up mental space after hours, but smartphones and an always-on culture—not to mention the
remote work trend brought on by the COVID-19 pandemic—mean there's a good chance that your work stress is persistent and pervasive. Compensation might also be a point of contention if you feel you're being undervalued or struggling to make ends meet.
Looking to the Future
Depression can mean seeing the future through a gray, foggy filter. You may believe things will never get better, and so your only focus is making it to the weekend so you can have a break. But while depression can make each workday a challenge, it can also take a toll in the longer term.
It can be difficult to set the career goals you're truly capable of when you're struggling with forward thinking and making an accurate assessment of your skills. A lack of faith in yourself may prevent you from engaging in self-advocacy or lobbying for a deserved promotion—and then you may feel guilt because you didn't speak up for yourself when you know you should have. With your confidence rattled, these may be bigger risks than you are ready to take, even though you have the skills and ability.
Finding Treatment—and Hope
The good news is that depression is highly treatable and, more than ever, workplaces recognize the need to focus on their employees' mental health. Many large corporations even offer free or low-cost mental health resources, in addition to health insurance coverage.
If you're navigating depression at work, consider talking to your manager. Certain accommodations, such as a more flexible work schedule or extended deadlines, where feasible, might be a good place to start. Additionally, they may be able to point you to how or where to get help within the company. They can vouch for you and your performance to their higher-ups, if necessary. Or, if your performance has only been minimally affected, perhaps you are just looking for a little empathy and understanding so that you feel less alone.
If your company has a human resources representative, they can also help you navigate your options. Many companies have Employee Assistance Programs that offer short-term counseling, as well as referrals to mental health professionals, such as therapists or psychiatrists. Further, HR can help you demystify your mental health benefits by highlighting what is covered. Your health insurance may cover more of your mental health treatment than you think, thanks to the Mental Health Parity and Addiction Equity Act that requires insurers to provide mental health benefits with equivalent limits and coverage to physical benefits. If you've already tried talk therapy and medications, treatments like transcranial magnetic stimulation may even be covered in full.
Even if depression isn't holding you back from performing at work and advancing your career, you deserve to feel your best. Getting help isn't about getting by—it's about getting the most out of life.
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Starting any medical treatment for the first time can leave you with questions, especially if you’re looking forward to the benefits it may bring. It’s no different when you’re preparing for your nasal esketamine treatment. Your previous mental health treatments may have consisted solely of taking antidepressants at home or visiting a therapist’s office for cognitive behavioral therapy (CBT), so nasal esketamine is probably a new treatment experience for you. If you're wondering what it's like to start nasal esketamine and get ready for your first session, keep reading. Getting Started with the Nasal Esketamine Treatment As with any new treatment, you’ll first talk to your primary care provider or psychiatrist about whether nasal esketamine is a good fit for you. Alternatively, you can schedule your esketamine nasal spray consultation with a treatment center (such as Greenbrook) that has certification by the FDA’s Risk Evaluation and Mitigation Strategy (REMS). At Greenbrook's REMS-certified nasal esketamine treatment centers, our Greenbrook-affiliated psychiatrists and psychiatric nurse practitioners will review your medical history and also conduct our own assessment to help determine whether nasal esketamine treatment is right for you. Certain conditions, including blood vessel disease and a history of psychosis, may make treatment a risk for you. Make sure you discuss all previous and present conditions with your doctor or nasal esketamine provider before beginning treatment. If the medication is deemed a good fit, you’ll receive your prescription from the Greenbrook-affiliated provider. Your Greenbrook Care Team will put together a personalized care plan for the weeks and months to follow. Keep in mind that you will need to take a standard (oral) antidepressant along with your nasal esketamine treatment. There are two important regulations to note when it comes to preparing for treatment: Each treatment is followed by a mandatory two-hour observation period. This means you will need to plan to stay at the center for at least two hours following your self-administration of the esketamine nasal spray. You cannot drive during the rest of the day after treatment and must arrange for transportation. These regulations are mandatory. It may be helpful to sit down and plan out several weeks’ worth of transportation once you know your treatment schedule. In addition, if you’re wondering what to bring for the treatment, we recommend entertainment such as an audiobook or playlist of favorite songs and a pair of headphones. You may want them during the two-hour observation period. What to Expect During Nasal Esketamine Treatment On the day of treatment, you’ll need to stop eating any food two hours before your appointment and stop drinking all fluids 30 minutes before you come in. Your Greenbrook Care Team will confirm that you are prepared for the two-hour observation period and that you have a ride home. You’ll get the opportunity to practice using a “trainer sprayer” that mimics the real nasal esketamine sprayer but does not release any medication. The Care Team will encourage you to use the restroom and set up your preferred environment in your private treatment bay or room. Some patients like reduced lighting, for example, while others don’t request light adjustments. You’ll complete a depression scale before each treatment session. Your Greenbrook provider will confirm that the dose kit is yours, show you how to administer it, and then hand it to you. Each sprayer contained 28mg of Spravato esketamine nasal spray. Patients usually start with two sprayers (56mg) and soon increase to 84mg (three sprayers) per treatment. But, your dosage maybe vary. Should you be left with a metallic taste by the spray, the Care Team will offer suckers to help make the flavor dissipate. After your dose, you’ll be encouraged to lie back in your comfortable recliner. While most patients enjoy a quiet setting, Greenbrook is prepared to accommodate patients with a more animated reaction to the medication. You may feel sleepy, dizzy, mildly dissociated, and/or nauseated during treatment. Greenbrook's Care Team is readily available if you need assistance. How to Prepare for after your Nasal Esketamine Treatment Most side effects begin to wane in the second hour of observation, but if you’re wondering, “Is it safe to drive immediately after nasal esketamine treatment?” the answer is a resounding no. In addition to the mandatory ride home, you will need to block off time to rest and let side effects fully dissipate. This extended rest period is especially important in the first weeks of treatment when you’ll have treatment twice a week. Do not drive or operate machinery of any kind until the day after treatment. Just take it easy, relax, and take care of yourself. If you’re unsure what activities you can do or should avoid during this time, talk to your Care Team for more information. While side effects tend to dissipate completely after a good night’s sleep, many nasal esketamine patients begin feeling relief from depression symptoms within hours of their treatment. Other Tips in Preparing for Your Nasal Esketamine Treatment At Greenbrook, we make every effort to schedule your treatment in the afternoons or whenever it is most convenient for you. We encourage you to see each treatment session as an opportunity to relax and take care of your mental health. If you have any questions or concerns, talk to your doctor or the Greenbrook Care Team. At Greenbrook, we’ll help you feel at ease when preparing for each treatment session. Schedule A Free Consultation To get started with nasal esketamine, schedule your free consultation today.
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