Depression

What is it?

Most people feel down, sad or low at some point in their lives. These feelings are normal if felt occasionally and in response to unfortunate life events, and do not constitute depression. However if these feelings persist and begin to interfere with daily activities, this may indicate the onset of a depressive episode. The term depression covers a broad range of symptoms that impact on a person’s emotional, psychological and physical wellbeing, and can vary from relatively moderate to extremely severe (which can be life threatening). It is also common for sufferers to also have a degree of anxiety, since the two conditions often overlap.

How does it affect people?

There are two key symptoms of depression:

Low mood; expressed as sadness, feeling worthless and hopeless, with disturbance of sleeping and eating patterns
Loss of interest in normal activities, reduced energy, fatigue, unable to enjoy anything

How is it treated?

In most cases depression is treated by an individual’s GP and will not require specialist (psychiatric) help. A combination of lifestyle changes (physical activity, reduced alcohol intake), Cognitive Behavioural Therapy (CBT – talking through problems to change ways of thinking) and antidepressant medication may be used depending on severity. Often these take a few weeks to have a beneficial effect, so improvements take time

People with severe depression may be referred to the mental health team which is made up of a team of specialists such as psychologists, psychiatrists, specialist nurses and occupational therapists. They often provide intensive specialist talking treatments, such as psychotherapy

How might it affect work?

You might notice changes in someone’s normal behaviour, as an early sign that all is not well. Typically these changes might include:

Reduced concentration; the quality of work suffers
Difficulty making decisions; the work takes longer
Dealing with large groups of people or the general public; they will avoid this
Lack of energy and tiredness; complaints of fatigue
Inability to cope with tasks that they previously managed; failure to complete, reduced quality

Shift work may also cause symptoms to be worse, in which case adjustments to work hours may be required to help recovery.

Following treatment and recovery, most people with depression will be able to return to their normal roles and will not require permanent adjustments to their duties.

What do I need to do as the Manager?

Firstly and most importantly, if you notice changes in behaviour as outlined above then raise this with the employee and encourage them to take advice from their GP. Early treatment is easier and more effective, but denial is common, so recognition that there is a problem is very valuable.

Discuss how the depression is affecting their work; identify what tasks they can and cannot perform and the length of time that they can perform them. It may be necessary to make some modifications to their work, either to allow them to remain at work or to help them to return. These kinds of conditions resolve relatively slowly, and the employee will have ‘good’ and ‘bad’ days, so review the situation only every week. Make sure that they are able to cope with their work tasks and increase their work in stages to help them to get back to their normal duties.

Examples of modifications that could help include:

Reduce demands of the role
Reduce hours to accommodate tiredness
Modify duties if they are having difficulty with a particular task, such as dealing with the general public
Moving from night shift to day shift temporarily
Focus on supporting the employee; if they are well enough help them to remain at work or to return to work as rapidly as possible
Employees do not need to wait until they are completely better before they return to work
Evidence supports an early return to work or continuing at work as a normalising influence to encourage recovery and a return to normal duties
“Sign post” the employee to internal or external support

Points to Remember

Fit notes

If an employee produces a fit note indicating that they require modified duties, discuss this with them and consider if the modification recommended can be reasonably accommodated.

Job tasks and risk assessments

Review the risk assessment for the employee’s job role and work tasks including the ability to drive safely where required. Take into consideration any temporary modification that may be required to accommodate their reduced ability to undertake certain tasks.

General guidance

If you require further information, refer to the general advice on managing attendance.