Treating Depression Without Antidepressants

There may be hope for hard-to-treat depression as scientists explore novel ways to help people who have the often crippling condition.

Recently, a number of studies have suggested the benefits of Botox, ketamine, and certain sometimes-unexpected means of treating depression.

“I’m excited in general, and I’m curious,” says Peter D. Kramer, MD, author of Listening to Prozac and Against Depression.

Each year, around 16 million U.S. adults battle major depression. Many of them benefit from antidepressants. But as many as a third get depressive symptoms despite medication. And side effects, which can include weight gain, nausea, and insomnia, are troublesome for some patients. That leaves many people with depression searching for alternatives.

But if Kramer is hopeful about the newer, novel ways to treat the condition, he’s also cautious. The studies backing those treatments aren't conclusive, and none of the approaches have been approved by the FDA to treat depression (though some, such as ketamine, have been approved for other uses).

“Things are merely hopeful until they are demonstrated [safe and effective],” Kramer says. “It’s always hard to tell what’s going on, but it’s a very interesting time, and I think some of them will come through.”

Here’s a closer look at what might be used to help treat depression in years to come.

Ketamine. Already in use in certain clinics and in some emergency departments around the country, ketamine is an anesthetic most often used during surgery. It's given through an IV, and it quickly eases symptoms of depression, often in a matter of hours. The benefit is temporary, though.

One recent study found it to be very good at helping curb suicidal thoughts in severely depressed people. But it's expensive, still experimental as a depression treatment, and can cause hallucinations and other side effects.

“Some people are very uncomfortable with the side effects,” says Alan Manevitz, MD, a psychiatrist who specializes in treatment-resistant depression at Lenox Hill Hospital in New York City.

Nitrous oxide, or laughing gas. This is an anesthetic commonly used by dentists. A small study published last December reports that nitrous oxide improved depression symptoms within less than 2.5 hours.

Unlike ketamine, though, nitrous oxide had few side effects. The benefits lasted from 24 hours to a full week in some of the 10 people in the study. Much more research needs to be done on the safety and effectiveness of nitrous oxide, but Manevitz says it’s promising.

“For people who are in suicidal despair or crisis, it may, like ketamine, temporarily relieve that person and act as a bridge until other treatments start working,” he says.

Botox. Best known for temporarily erasing frown lines and crow's feet, onabotulinumtoxinA (Botox) has recently attracted interest as a novel means of lifting major depression. The theory is simple: If you can’t frown, you won’t be sad. And some research has borne this out.

A single Botox injection into the facial "frown muscles" provided lasting relief from depression symptoms, according to a study published last spring in the Journal of Psychiatric Research. Another study found similar effects following Botox injections into frown lines around the eyebrows. Many questions remain, though.

“The Botox is very interesting, and the best evidence [it helps] is as an add-on to antidepressants, but what’s going on?” asks Kramer. “Is it really feedback to the brain, that if you can’t frown, do you feel more resilient? Or is it that people respond to you differently?”

Anti-inflammatory medications. Inflammation has been linked to depression for several years now, says Brown. A recent review of studies, published in JAMA Psychiatry, further backs up the connection. The researchers found that painkillers such as celecoxib, ibuprofen, and naproxen reduced depression symptoms. Another class of anti-inflammatory drugs, called cytokine inhibitors, also showed some benefit.

The authors of the review call their findings "proof of concept," meaning that their results are strong enough to encourage further research. Another recent study reports that omega-3 fatty acids, which have anti-inflammatory properties, helped treat depression linked to chronic hepatitis C.

“If you could actually treat depression symptoms along these lines, that would be interesting,” Kramer says. “Some of the antidepressants are also anti-inflammatories, and some people have thought that maybe it’s just coincidence that they work on [the brain chemicals] serotonin and norepinephrine, and that the real effect is anti-inflammatory.”

Uncertain Future

The treatments listed above aren't the only ones being tested.

Nasal sprays that have protein peptides or small molecules have shown some promise, Kramer and Manevitz say. A method called transcranial direct current stimulation, which uses electricity to change brain activity, is also being tested.

Mindfulness meditation is another promising addition to depression treatment, and exercise is known to help relieve symptoms, too.

If some of the newer treatments seem far-fetched, Manevitz points out that the same was said just a few years ago about transcranial magnetic stimulation (TMS), a non-invasive therapy that uses magnets to affect parts of the brain linked to mood.

“People looked at me cross-eyed and thought it sounded wacky,” he says. “Now, it’s an FDA-approved treatment for depression, and it’s used around the world.”

Which, if any, of these treatments prove effective is anybody’s guess at this point. Researchers have a lot of work ahead of them before any make it to patients in the clinic.

“So many medicines get lost in the pipeline,” Kramer says. “Either it’s hard to engineer them in ways that are not going to harm the kidneys or the liver, or the actual principle under which they are working turns out not to be right. It’s hard to give your heart to any one of them because they tend to disappoint.”

Source: http://www.webmd.com/depression/news/20150225/depression-treat-without-antidepressions

Coping at Work

An important aspect of recovering from depression is continuing to participate in as many of your regular daily activities as possible during treatment.  For many people, work is high on that list.  Employment is about much more than making a living. The satisfaction and security of work contribute to positive self-esteem, and being part of a work team can help foster a sense of belonging.
But it can be challenging to function at your best in the work world while dealing with depression.  That’s true whether you currently have a job, or you’re just entering or returning to the job market.   Strategies to help you make the most of your job situation are found below. Note that many of these strategies can be put into action before you ever set foot in your workplace or schedule your first job interview.  When you are playing an active role in your own treatment plan and maintaining the proper perspective on your situation, you will find it easier to bring out your very best in the work world.

On-the-Job Strategies

Consider adopting the following strategies to improve your outlook and performance on the job:
Don’t let work take precedence over recovery.  Work is important, but it is only one aspect of your life.  Even on the busiest of days, remember that recovery is your top priority. Your treatment plan and the self-care strategies you employ each day should not take a back seat to the immediate concerns and demands of the workday. 
Remember what’s important about work.  It is rare to find a job that doesn’t involve challenging people, deadlines, difficult assignments and other stressors.  At times when work feels overwhelming, try to focus on the positive reasons why you work, including financial independence and security, personal satisfaction and the sense of community or belonging that comes from contributing to a team effort.
Don’t set yourself up by expecting perfection.  You will face disappointments, make mistakes, and encounter obstacles at work – everyone does.  Adjust your attitude and expectations about yourself and your work, knowing that problems are inevitable in any job.
Don’t let the past define today or tomorrow.  Realize that problems caused by your symptoms in the past will not necessarily repeat themselves, especially if you have a working treatment plan in place. Just because a lack of energy once caused you to miss a crucial deadline doesn’t mean you are unreliable.  Give yourself credit for the progress you are making, and permission to start over.
Develop symptom-specific strategies.  To help you keep focused on the future instead of the past, make sure to learn all you can about your illness and your specific symptoms. Take a close look at the symptoms that have tripped you up in the past, and develop specific strategies for countering each of them.  For example, if your depression can make it hard to concentrate or if you feel overwhelmed when beginning a project, it might be helpful to break work assignments into smaller, more manageable steps that can be completed in shorter timeframes.
Keep in mind that politics and personalities are part of working.  When you work with other people (and most of us do!), differing agendas, conflicting priorities and interpersonal conflict can’t be avoided. They do not need to derail your efforts to recover from depression. 
Don’t go it alone.  It is difficult to juggle a full work schedule while also meeting everyone’s expectations at home.  When you also need to find time and energy to devote to managing your depression, it can be overwhelming.  Examine your daily or weekly schedule and look for activities, both at home and at work, that could be delegated to others.  Involving coworkers in shared responsibilities, asking family members to help with chores, or reaching out to a friend to provide a “sounding board” for your ideas and concerns are all good strategies for accomplishing your goals without sacrificing your emotional health and recovery.
Source:  http://www.depressiontoolkit.org/takecare/coping_at_work.asp

5 Quick Ways to Calm Anxiety at Work

If you struggle with anxiety, you may find it especially tough to get things done at work. “Anxiety can be debilitating on its own, but in the workplace, it can be magnified immensely,” said Jenifer Hope, LCPC, a therapist who specializes in treating anxiety.
With its often-fast pace and mounting demands, work can spike stress. One of Hope’s clients, who has generalized anxiety disorder (GAD), feels anxious most of the time and in most situations. When her anxiety is severe, she has a hard time completing any task. She’ll reread the same line in an email because she can’t focus on anything else except her anxiety.
Whether you struggle with severe or occasional anxiety at work, you can practice certain strategies to feel better. Hope shared these five tips.
1. Slow down your breathing.
As Hope said, the reason patients get oxygen at the dentist’s office is because it calms you down. To practice deep breathing, “sit back in your chair and place your hand on your abdomen. When you take a deep breath in, your hand should rise up. When you breathe out slowly, your hand should lower.”
She suggested breathing in deeply for five seconds, and breathing out until you don’t have any breath left. “Repeat this several times until your chest feels less tight and your mind has stopped racing.”
2. Practice reassuring self-talk.
Regularly ruminating about how anxious you are and that you can’t handle the situation amplifies your anxiety and paralyzes you. “If you change your thinking, you can change your behavior,” said Hope, who practices at Urban Balance, which provides comprehensive counseling services in the Chicago area.
For instance, she suggested reminding yourself that anxiety is a feeling that will change and go away. You might say to yourself: “This is temporary. It will pass,” and “I will be OK. I am OK. I will get through this.”
You also can talk yourself through work tasks, such as: “I will work on this project for 20 minutes and then reevaluate how I am feeling.”
3. Get moving.
If you’re able to get outside, take a brisk 10- to 15-minute walk, Hope said. Or find a quiet spot in your building to do several sets of jumping jacks, she said. “This will release endorphins that will help calm your mind and your body.”
Another option is to practice muscle tension and relaxation, which shifts your focus from anxiety to the exercise, and releases the tension your body holds onto from the anxiety, Hope said.
Start with your face. “First, scrunch all the muscles in your face as tightly as you can. Hold this for about 20 seconds. Then release and relax all the muscles in your face.” Do the same with your neck and other parts of your body, moving down to your toes.
Hope’s client finds it helpful to take breaks in the office gym throughout the day.
4. Separate tasks into smaller time periods.
Most people who struggle with anxiety at work are counting down the minutes until they can go home, Hope said. They also may look at their entire schedule, instantly become overwhelmed and feel like fleeing, she said.
Breaking down tasks into shorter time increments shrinks them to a size you can manage and helps you realize that you’re capable of working, she said.
For instance, prioritize your projects, and start with the most important one. Go hour-by-hour, and then re-evaluate. “Tell yourself ‘I just need to get through this hour; then I can think about going home.’”
After that hour, set another goal, she said. “Work on another project for an hour; when that hour is over, take a break and praise yourself for making it through two hours of work.”
“Your day will slowly feel less overwhelming and you can be proud for making it through the day.”
5. Reach out.
When Hope’s client feels extreme anxiety, she emails or calls Hope or a close friend. “If you have someone you can talk to, you can explain your feelings and receive validation, comfort and reassurance, which can help remind you that you are capable of getting through this; you are already doing it.”
If you’re still struggling with persistent anxiety at work, get help. “Do not feel embarrassed. You would be surprised how many other people are suffering just like you.”
Source: http://psychcentral.com/blog/archives/2014/07/24/5-quick-ways-to-calm-anxiety-at-work/

Major Depression Is a Chronic Disorder

Some people with major depression experience the symptoms of depression only once in their life. Others experience frequent relapses and recurrences. Once treated, it's important to pay attention to your feelings in order to catch possible signs of a relapse. Seeking help and responding promptly to the warning signs may help you prevent a full return of major depression.

 Depressed Mood

How can you tell depression from simple sadness? If you're feeling down because of a specific event, such as losing a job or the breakup of a relationship, it could be normal and temporary sadness. If you feel sad, despairing, teary, or "empty" every day for more than two weeks and it's interfering with other aspects of your life, it may be clinical depression.

 Breaking Plans, Withdrawing Socially
Do you avoid leaving the house? Does making conversation feel like too much effort? Do you retreat to your bed when family members try to draw you out? Maintaining a strong social network is important. Losing pleasure in activities can indicate feelings of depression. It may help to join a support group of people who understand what you're going through.

 Sleeping Too Much or Too Little
A change in your sleeping habit such as insomnia -- trouble falling or staying asleep -- could be a sign of depression. It can cause or aggravate other symptoms that may also indicate depression, such as fatigue. If you regularly lie awake at night with your mind racing or sleep too much to avoid getting out of bed, speak to your doctor. If your sleep problems are a symptom of depression relapse, medication and talk therapy may help.

Irritability
Lately you've found it difficult to handle everyday stresses. Small things make you snap. You constantly bicker with friends and family. Where you used to be easygoing, you now have violent outbursts. Depression can show itself in irritability and anger. Men are more likely than women to behave recklessly and, sometimes, violently when they are depressed.

Loss of Interest in Sex and Other Pleasures
This is one of the most common signs of depression. Activities you used to enjoy may now feel like a burden. If you've had depression in the past and have lost feelings for your spouse or children, or lost interest in work, hobbies, or other favorite activities for more than two weeks, could you be relapsing? Ask your doctor for help. Symptoms recurring within a year put you at risk of a depression relapse.

Feeling Worthless

Old feelings of self-loathing and guilt may come creeping back. Or you may be unable to "turn off" self-criticism, preoccupied with your failures. You may feel responsible for events that are out of your control. Psychotherapy may help you with low self-esteem and learn to build on your strengths. If you are living with depression and have attempted suicide, you may have a higher risk of relapse.

Chronic Aches and Pains
Do you have back pain even though you haven’t strained your back? Chronic headaches and stomachaches?  Unexplained chest pain or achy legs and arms? You may not think of physical pain as a sign of depression, but it can be. If you have aches and pains that don't get better with treatment, ask your doctor whether depression may be contributing to your condition.

Sudden Weight Gain or Loss
Many people who are depressed lose interest in food and eating. They may forget to eat or even have to force themselves to eat. Other people overeat or binge eat when they're depressed. If you've had depression and experience a strong change in your appetite, or gain or lose weight without a change in dieting or exercise it may be a sign of relapse.

Fatigue
Do you drag through your day? Depression can make you feel too tired or weak to do anything. Daily activities such as getting dressed and doing dishes can seem overwhelming and exhausting. Not eating or eating an unhealthy diet can contribute to fatigue. Good nutrition, exercise, and sleep can help you fight it.

Slowed-Down Thinking
Sometimes people feel as if their thinking processes have slowed down when they're depressed. You may be easily distracted or find it difficult to concentrate. You may suddenly have trouble remembering things. You may have problems making decisions -- as minor as what to wear in the morning or as major as problem-solving at work. The sudden onset of symptoms may be a warning of a relapse.

Suicidal Thoughts
 Suicidal thoughts are a very serious warning sign and could signify severe depression and be a risk factor for relapse. Some people think about suicide regularly. Others may start planning out suicide or how to harm themselves. People who feel hopeless and have lost interest in pleasurable activities are particularly at risk. If you or someone you know has suicidal thoughts or talks about suicide, seek immediate help from a doctor or psychiatrist.

Relapse
Everyone experiences depression differently. If you have any of these warning signs or symptoms that concern you, talk to your doctor or psychiatrist. They may recommend therapy or increasing medication to prevent a relapse. Adopt strategies to reduce stress. It may help to add activities that make you feel good into your daily routine. Long-term treatment may be needed after three or more depression episodes.

Source:  http://www.webmd.com/depression/ss/slideshow-relapse

17 Ways to Avoid Depression Relapse

Recovering from depression is a long and difficult journey.

Unfortunately, 50% of people who have one major episode of depression will relapse, and the likelihood goes up if you’ve had more than one episode, says Eve A. Wood, MD, medical director of the Eating Disorder Center of Denver and author of 10 Steps to Take Charge of Your Emotional Life.
Your relapse risk can vary, depending on the severity of your symptoms and family history.
The good news is that there are some steps that may help you avoid depression relapse.

Don’t take on too much

While staying busy isn’t a problem, doing too much, too soon could be.
Feeling overwhelmed creates stress, and stress is a risk factor for depression, says Nancy Irwin, PsyD, author of You-Turn: Changing Direction in Midlife. What’s more, stressful experiences can make the symptoms of anxiety and depression additionally severe.
“Thwart stress by creating balance and knowing your limits,” Irwin says. “If you are prone to depression, this is your responsibility—just like brushing your teeth or obeying the speed limits.”

Exercise regularly

One of the best ways to prevent depression? Exercise.
“Exercise appears to be an antidepressant in its own right and may act like an antidote to stress,” says Gerard Sanacora, MD, PhD, professor of psychiatry at Yale University and director of the Yale Depression Research Program, in New Haven, Conn.
A 2009 analysis found that exercise lightens depression as well as cognitive behavioral therapy (CBT) or antidepressants.
A resistance and aerobic combo seems better than aerobic exercise alone. Workouts with a meditative focus, such as tai chi and yoga, also help, according to a 2008 study.

Work on a positive attitude

Is your glass half empty? It can help to try to have a more positive attitude.
In fact, certain depression treatments, such as CBT, can help you develop a more upbeat outlook—although this treatment doesn’t work for everyone.
“Not all respond to CBT interventions,” says Dr. Wood. “The underlying philosophy of CBT is that the thoughts are what cause the distress and if you change the thoughts you can change the depression, but that’s true for only a subset of people.”

Take care of your health

Now is the time to focus on both your mental and physical health, because the mind-body connection plays a role in depression and relapse.
“The more we take care of ourselves, the less vulnerable we might become to depression, as well as to a recurrence,” says Dr. Wood.
Depression is associated with a greater risk of heart disease and diabetes.
“There’s very good evidence that people with depression have higher rates of medical illnesses than people without depression, and the more medical illnesses you have, the more likely you are to have depression and to relapse,” explains Dr. Sanacora.

Put off big decisions

You may feel like a new person, but it's not the time to make major changes—even ones that you think will make you happier.
“Both good and bad ‘big decisions’ are stressful," says Susan L. Marusak, MD, research physician and clinical faculty at the Mood Disorder Research Program at UCLA Medical Center and a private practitioner, in Santa Monica, Calif. "I often advise patients to wait, if they can, until they are feeling stable and euthymic before making a major life-changing decision.”
Irwin recommends putting off big decisions until you're at least a six on a happiness scale of one to ten (where zero is misery and ten is elation).

Stop blaming yourself

If you’re prone to depression, you may mentally berate yourself for missteps, either real or imagined.
But a constant barrage of “I should have done this differently” or “If only I would have done that” is counterproductive, and could send you spiraling downward into depression.
You need to learn to accept what you can’t change and focus on changing what you can, says Dr. Sanacora, who recommends seeing a therapist with expertise in techniques like cognitive behavioral therapy to help change your thought patterns.

Watch your diet

Diet and exercise go hand in hand when it comes to maintaining mental and physical well-being.
“A low-fat diet, rich in fish, especially omega-3s, and folic acid can be helpful for mood. And avoiding alcohol and minimizing caffeine use is also helpful,” says Dr. Marusak.
A Mediterranean-style diet, rich in veggies, fruits, nuts, whole grains, and fish, is linked to a lower risk of developing depression, according to a 2009 study in the Archives of General Psychiatry.

Don’t stop treatment

Doctors recommend taking medication for six to nine months after symptoms lift and you start to feel stable, says Dr. Marusak.
The decision to end therapy or medication should be made with your doctor's help. “Some drugs, if you go off them, may not work for you again when you go back on them—(there’s no) guarantee that if it worked once, it will work next time,” says Dr. Sanacora.
For some people, the best way to prevent a relapse is to continue treatment.

Volunteer

Reaching out to others may help you too.
One 2005 study in the Journal of Health and Social Behavior found that volunteering had a beneficial effect on depression among older adults, and preliminary findings conducted at the Institute of Psychiatry at King’s College, London, suggest a “strong link” between volunteering and recovery from mental health problems, with about 85% of participants reporting positive outcomes after volunteering.
“Usually when we can get out of ourselves in some way, we can feel a lot better,” says Dr. Wood.

 Avoid alcohol and drugs

Steer clear of alcohol and especially illegal drugs, which can interfere with depression medications and alter your mood—and not in a good way.
“Alcohol is a depressant, and many street drugs deplete serotonin and dopamine, which are important neurotransmitters in relation to mood,” says Dr. Marusak. “We usually recommend patients abstain from alcohol, even socially.”
Irwin says that you can be setting yourself up for a relapse if you take unprescribed drugs. “Alcohol gives depressives ‘permission’ to slip into that abyss, because it underscores or verifies your negative mood state,” she says.

Manage stress

Chronic stress can actually cause physical changes in the brain, which can affect moods and emotions.
In fact, a number of studies have led researchers to suspect that stress produces changes in the brain similar to those caused by depression.
“Stress might have a large effect on some of the brain regions that control emotion and memory,” says Dr. Sanacora. "If it is chronic and uncontrollable, stress might actually cause physical damage to the brain."
Develop stress-busting strategies, such as exercise, yoga, pilates, meditation, acupuncture, hypnosis, talk therapy, or turning to friends and family for support.

Have an attitude of gratitude

Although it sounds simplistic, research suggests that for many, gratitude is a road to greater happiness.
In fact, a 2005 study published in the journal American Psychologist found that people who performed daily gratitude exercises, such as making a list of three good things in their life, had lower levels of depression.

Join a support group

“Support groups are particularly helpful, because there will be people there who have learned how to manage their depression and can provide excellent advice,” says Anne Sheffield, author of Depression Fallout: The Impact of Depression on Couples and What You Can Do to Preserve the Bond.
To find one near you, check out the National Alliance on Mental Illness or the Depression and Bipolar Support Alliance.
“Being with people who share your problem forces you to realize that you’re not alone and that others have battled the same problems and can help you find solutions,” says Sheffield.

Reconnect

Depression can make you feel alone, so it’s important to reconnect with friends and family.
“We know that for all aspects of wellness, community has a healing and protective effect,” says Dr. Wood.
In fact, a 2009 study published in The American Journal of Psychiatry found that people 65 and older with a history of depression were at greatest risk of developing major depression if they believed they had poor social support.

Talk to people you trust

Many people don’t want to talk about depression because they think they should be able to handle it on their own, or don’t want to burden others.
But confiding in close friends, a spouse, or family member can give you the social support you need to stay on the path to recovery.
“Health, purpose, and love are your weapons against depression,” says Irwin. Just remember, your friends or spouse aren’t licensed therapists and may not know how to help you, warns Sheffield. So if you start having depression symptoms again, you should reach out to your doctor or therapist as well.

Get your rest

It's important to get sufficient rest as you recover, since sleep helps regulate moods and is necessary for both mental and physical health.
Insomniacs are almost 10 times as likely to have depression compared to their well-rested counterparts, according to a 2005 study in the journal Sleep.
“Sleep is a cornerstone of health, like food,” says Irwin. “If it goes unattended, the body and mind cannot function properly. Regulating sleep can really help prevent depression and relapse.” 

Source:  http://www.health.com/health/gallery/0,,20431660,00.html

How to create a happy, healthy, stress-  free career...

It’s up to each and every one of us to make sure our own career is in good shape and that we have a work-life balance that keeps us happy and healthy.

If your work and career are causing you stress then it’s time to do a proper sound check and really get to the root of what is going on.

Where is your career-stress coming from?

Answer questions 1 to 10 to identify where your career is out of shape and causing you stress:

1.Are your day to day activities in the work you do, activities that you’d choose to do even if you weren’t at work? Are they activities that you enjoy that make you come alive?

2.Are the subjects you work with ones that you’d choose to be involved in even if they weren’t part of your work.

3.Are you using your natural strengths in the work that you do? Do you feel like your work is effortless,are you confident in what you do, do you get good results easily?

4.Do you get a healthy sense of challenge and stimulation to keep you engaged in the work that you do?

 5.Do you love the environment that you work in? Do you feel you can be yourself? Do    you feel energised by your work environment?

6. Does your work-style work for you? Do you feel you have the security and the freedom that you needto be happy in your career?

7.Do you have the money that you need to live in the style that makes you happy?

8.Do you feel that the work you do is important, that it is worthwhile and make a positive contributionin the world?

9.Do youknow what your values are? What qualities are most important to you in life? And are they reflected in your career?

10.Do you have a healthy work life balance? Are you able to switch off after work and spend quality timeon the other areas of your life–relationships, hobbies, friends & family?

Once you’ve identified which areas of your career are out of shape and causing your stress, the next step is tofigure outwhat shifts in your career you can make to get your career back in shape.

Source:  http://www.stress.org.uk/files/stress-free-career.pdf

31 Secrets of People Who Live With Anxiety

Anxiety disorders are the most common form of mental illness in America, according to the Anxiety and Depression Association of America. The condition affects 40 million adults in the United States. That’s 18 percent of the U.S. population.
Despite this, people with anxiety disorders still live with a stigma often associated with invisible conditions. So we asked our readers with anxiety what they wished the world could understand about it. This is what they had to say.
1. “I do realize the things I worry about are ridiculous. Even though I’m aware, I can’t just stop it.” — Erika Strojny Myers
2. “I might look like I’m doing nothing, but in my head I’m quite busy.” — Diane Kim
3. “I don’t always know why I’m anxious.” — Teri-Marie Harrison
4. “It’s paralyzing.” — Marlene Pickering

5. “I don’t just ‘get nervous.’ Heck, half the time I’m not even nervous when I’m having a panic attack — I’m anxious. Sometimes it’s for no reason I can identify. When I’m anxious and nervous I recognize some of it is irrational, but I can’t just snap out of it. My mind and body aren’t cooperating with reason.” — Alex Wickham
6. “I’m not being ridiculous or dramatic.” — Melissa Kapuszcak
7. “We don’t need someone to look at us like we’re crazy. We need someone to be compassionate.” — Kristen Cunningham
8. “I don’t want to feel this way.” — Jenny Genoway

9. “After a hectic day, especially after being in crowds or dealing directly with multiple people, I have a ‘people hangover’ the next day. I need alone time to reboot from all the energy used. I have to rest and reset my mind. If I don’t, I will become bone-tired, overwhelmed and moody.” — Lisa Shuey
10. “It’s totally possible to have social anxiety and be a raging extrovert.” — May Daonna

11. “You can’t just stop worrying. There is no ‘on’ or ‘off’ switch.” — Kim Derrick-Bené
12. “Even though we look OK on the outside, our anxiety is wreaking havoc on our insides.” — Cynthia Adams McGrath
13.  “I’m being attacked by something I can’t escape from.” –  Sherri Paricio Bornhoft

14. “No matter how irrational I may sound, it’s real to me.” — Lorri Smith
15. “Saying, ‘you will be fine’ doesn’t help.” — Thea Baker
16. “It’s not a choice. You don’t choose to have anxiety. It chooses you.” — Patricia Lynn

17. “It’s sometimes so exhausting and distracting that I may be forgetful or unproductive, but it’s not me trying to be thoughtless, lazy or make excuses.” — Anna Powers
18. “It’s real. I’m not overreacting.” — Kimberly Warren

19. “Anxiety [is] an illness. You can’t just get over mental illness.” — Heather Morello
20. “Anxiety and worrying are not the same things.” — Amy Hrynyk
21. “Prayer doesn’t make it disappear.” — Kayla Gosse
22. “Just because I can’t explain the feelings causing my anxiety, doesn’t make them less valid.” — Lauren Elizabeth

23. “I’m not crazy.” — Peggy Hess
24. “All the logic in the world won’t keep my heart from hammering in my chest.” — Rebecca V Cowcill
25. “Even the simplest tasks can be overwhelming at times.” — Rhonda Bodfield

26. “It’s uncontrollable.” — Asia Pope
27. “Just because you don’t understand doesn’t mean my fears aren’t real.” — Vicki Happ

28. “It feels as if the weight of the world is on your shoulders. You feel suffocated.” — Danielle Nicole Box
29. “I’m not doing it for attention.” — Georgia Tsaganis Johnson

30. “The smallest things can set me off. The more trapped I feel, the worse off I am. Personal space will always make me feel better.” — Manda Ree
31. “My mind is my enemy, so I need you on my side. Sometimes I even need you to fight alongside me.” — Erin Farmer-Perrine

Source: http://themighty.com/2015/05/31-secrets-of-people-who-live-with-anxiety/#ixzz3oRQyaiaC

How top European employers are targeting depression at work

An alliance of European employers is calling on HR and occupational health (OH) professionals to push mental health, and depression in particular, further up the corporate agenda. Sarah Silcox investigates why this is necessary.
The “Target Depression in the Workplace” initiative, run by the HR Leadership Forum, brings together some of the largest businesses in Europe. Occupational Health spoke to three of them – Barclays, Deutsche Post DHL and Ogilvy & Mather – about reducing stigma, changing culture and the best ways to give line managers the confidence to support individuals with mental health problems.
Depression, along with stress and anxiety, is a major contributor to long-term sickness absence in the UK, affecting the lives of significant numbers of employees, their families and the organisations in which they work. A group of big-name European employers has formed an alliance to target depression in the workplace, and has recently published a report as an early first step in its campaign, setting out why employers must act, the challenges they face and the steps they can take to reduce the workplace impact of this serious condition (HR Leadership Forum, 2014).

Depression and impaired work

Depression accounts for 7.2% of the overall disease burden in Europe, affecting 30 million EU citizens at any one time, according to an analysis published on PLOS One in March 2014 (Evans-Lacko and Knapp, 2014). The alliance’s report points out that people with depression lose an average 5.6 more hours a week of productive time than those without the condition. A joint study by the London School of Economics and King’s College London quoted in the “Depression in the workplace in Europe” report estimates that depression costs European business £77 billion a year.

XpertHR resources

Good practice manual: Stress management
Good practice manual: Wellbeing

This loss in productivity is, by far, the greatest contributor to the overall economic impact of depression and the evidence for an association between depression and impaired work performance is strong. During an episode, workers with depression experience a range of cognitive symptoms, including trouble concentrating, indecisiveness or forgetfulness for up to 94% of the time.
However, many line managers believe that employees with mental ill health, including depression, are able to carry on working as normal and that their organisation’s mental wellbeing policies and practices are primarily designed to help the employer avoid litigation, the PLOS One study suggests.
An organisation’s workplace culture and environment strongly influences whether an employee with depression decides to disclose their illness. The support and openness of managers, and, in particular, their willingness to talk about the issues around working with an ongoing condition, such as depression, are crucial in enabling a person to stay in work, and also in building a social acceptance of the illness.

Supporting mental health at DHL

Organisational culture underpins German company Deutsche Post DHL’s (DPDHL) approach to depression at work. DPDHL launched a corporate guiding principle, “Respect and Results”, in 2008: “This means we are always striving for good results, but in ways that show respect for the individual,” according to Andreas Tautz, chief medical officer at the company. The launch of the principle was an important milestone for DPDHL, acting as a starting point for a range of initiatives around building a culture that supports mental health.

Deutsche Post DHL: health strategy

DPDHL believes you can promote workforce wellbeing on four levels, all of which are influenced by health management:

• Health-promoting workplace design – favourable workplace set-up, working conditions, working hours and working atmosphere.
• Qualification/development of decision-making competence – foster capability to take responsibility and improve stress resilience.
• Individual health promotion – support a healthy lifestyle.
• Respectful company culture and social interaction – open, transparent communication; culture of respectful feedback; creation of social networks; and sympathetic interaction.

Its health strategy is guided by one main principle: “Respect and Results”.

DPDHL manages mental wellbeing at four levels, one of which is described as “respectful culture and social interaction”. Employment is good for health, and the company uses this inherent advantage to promote healthy working environments: “Once we’ve focused on this we can then move on to look at developing a health-promoting company culture by focusing on relationships between executives and employees, and strengthening relationships in teams,” Tautz adds.
The role of DPDHL’s OH team of 70 physicians is: to identify therapeutic needs through referrals; work, if appropriate, with external specialists to provide immediate help with acute needs; and develop rehabilitation plans for those returning to work after time off due to mental ill health.

Barclays’ “This is Me” campaign

Barclays launched a “This is Me” campaign in May 2014 as the central plank of a year-long initiative on mental health at work. “This is Me” was born out of the financial services company’s recognition that depression and other manageable mental health conditions are major issues in its broader mental health agenda.
“We’re starting by tackling stigma – often when someone calls in sick with a mental health issue they tend to mask it with a physical illness,” says Mark McLane, head of global diversity and inclusion at Barclays. “This is Me” attempts to bring the conversation around mental health into the workplace, giving all staff (including line managers) the resources to tackle the issue. It also helps managers and employees to understand depression better, for example, describing how the condition can arise at different points in an individual’s life, or how it can be something that they manage on an ongoing basis.
Barclays’ mental health initiative is based around an online portal, open to all employees, which provides access to a set of resources from external organisations specialising in mental health. It also, crucially, gives access to a community of employees with an interest in a particular area, enabling employees with a question to pitch it to an appropriate colleague with relevant experience. Often, colleagues are able to help each other by signposting additional wellness resources.
McLane thinks this is a “brilliant” approach as it solidifies Barclays’ expectation that the stigma still attached to mental ill health will fall, “but it also empowers colleagues to support each other on depression and other mental health issues”. The community aspect of “This is Me” does a great job, and it brings all Barclays’ other HR policies on tackling stigma and supporting people with mental ill health “to life”, he believes. Line managers are already using the online community to assist them in supporting people in their teams with depression, according to McLane.

Building line management capability

Workplace depression in Europe

One in 10 people have taken time off work because of depression, according to a European-wide poll of 7,065 employees and managers published in 2012. Other findings from the IDEA survey, which explored the impact of depression on both organisations and individuals, include:

• An average of 36 working days are lost per episode of depression, with the highest average occurring in Great Britain (44 days per episode, on average).
• The highest rates of depression diagnoses were in Great Britain and the lowest in Italy.
• Only 20% of employees in France would tell their employer if they were diagnosed with depression, compared with the average of 34%.
• Nearly one in three managers reported they had no formal support or resources to deal with employees disclosing depression. Among those managers who stated that they were supported, support from a medical professional was the most frequently cited source (43% of those with any support), followed by support from an HR department (30%).
• Awareness of the cognitive symptoms of depression is poor – relatively low proportions of participants were able to identify forgetfulness and indecisiveness as symptoms.

Source: Ipsos MORI, Impact of depression at work in Europe audit, final report

Boosting the confidence and capability of line managers to support team members with depression is challenging, but also crucial to an organisation’s success in reducing stigma around the issue and fostering acceptance. All the organisations we spoke to recognise this, and have introduced training and professional development modules covering mental health. This management training covers areas such as initiating sensitive conversations, managing confidentiality and making effective referrals to specialists, including OH.
Advertising and media company Ogilvy & Mather, approaches workplace depression as part of a wider mental health strategy. Julia Ingall, the company’s talent management director for the UK division of EAME, believes that there is insufficient understanding of depression in the workplace, particularly among line managers, who often find themselves in a difficult position. “They may not understand what constitutes ‘depression’, or that it can include work-related aspects, such as a loss of concentration or change in behaviour towards colleagues. This can be quite scary for managers,” she suggests.
Ogilvy & Mather is working with consultant, Robertson Cooper, to deliver resilience training across the organisation, starting with its leadership level by building it into existing management programmes. “The lines are blurred between work and home, often driven by technology, and I worry that people do not get a break,” Ingall says. Putting the training in place will help managers understand their own resilience levels, how to build on their personal strengths in addition to acknowledging weaker areas.
An assessment tool developed by Robertson Cooper, called i-resilience, has been introduced. It will eventually produce data that can be interpreted to develop action plans for individuals. “We’ve also selected eight key HR people to undertake some ‘train the trainer’ programmes so they can understand the issues and roll these programmes out,” Ingall adds.
DPDHL provides managers with evidence and data on the value of managing mental health, explaining how their behaviour influences employees and suggesting ways to minimise the impact of damaging behaviour and maximise the positive. The company provides e-learning resources for managers on leading on mental health issues, developed in conjunction with a German university and the Ministry of Labour.
“We also started a programme of workshops for managers on preventing depression and burnout in 2012, designed to boost their confidence in handling these issues,” Tautz explains. The workshops operate alongside other HR training activities and professional development plans. “The latest development is a new training programme for senior managers covering mental health at work,” he adds.

Employee involvement

Involving employees in developing initiatives on depression in the workplace is a feature common to employers in the Target forum. DPDHL established health working circles in each branch in 1997, including representatives from Works Councils, OH physicians and health and safety experts. “These circles explore how and where to address different health topics, including many linked to mental health, such as conflict management, burnout and stress,” Tautz notes.
Ogilvy & Mather is in the process of setting up a wellbeing forum to work through issues affecting employee wellbeing: “The job of the forum will be to gather feedback from local offices. We’ve also used leadership groups to explore six pillars of wellbeing, including the impact of client demands and our leaders’ clarity of vision, on employee health,” Ingall adds.
One of the “really interesting” aspects of Barclays’ “This is Me” campaign is that it is colleague driven, using the company’s established employee network, Reach, according to McLane. A self-selecting network of around 700 people with an interest in disability, Reach also incorporates listening groups, which are formal focus groups of employees who have self-identified as having a disability, including ongoing mental health issues.
“These groups are asked for their views on gaps in the organisation’s approach to diversity and inclusion, for example, how our reasonable adjustments programme could be made better,” McLane explains. This helps Barclays develop improvements, which have recently included the launch of an intranet-based online catalogue of reasonable adjustments which employees can quickly access without the need to go through an application/procurement process. “We will also draw on employees’ own stories as a part of our efforts to tackle stigma; for example, we’ve started with six people telling their stories about managing their own mental health problems whilst having successful careers.”

Evaluating interventions

Providing evidence for the effectiveness of workplace initiatives on depression is the “biggest challenge”, according to Tautz. However, he adds, there is sufficient global data around to demonstrate the need for systematic health management, and DPDHL also uses its own employee opinion surveys and feedback from training sessions for qualitative evidence. “We also use validated tools such ICD10 to track the incidence rates for different work-related conditions, in addition to analysing our absence data.”
Barclays’ “This is Me” is currently a UK-based initiative, but the company plans to roll it out to the bank’s operations in the Americas and Africa during 2014: “This expansion will be one of the campaign’s success metrics,” McLane explains. “We will also look at activity levels within the community and, later on, will invite people to tell their stories around the support it provides,” he adds.
Source: 
An alliance of European employers is calling on HR and occupational health (OH) professionals to push mental health, and depression in particular, further up the corporate agenda. Sarah Silcox investigates why this is necessary.
The “Target Depression in the Workplace” initiative, run by the HR Leadership Forum, brings together some of the largest businesses in Europe. Occupational Health spoke to three of them – Barclays, Deutsche Post DHL and Ogilvy & Mather – about reducing stigma, changing culture and the best ways to give line managers the confidence to support individuals with mental health problems.
Depression, along with stress and anxiety, is a major contributor to long-term sickness absence in the UK, affecting the lives of significant numbers of employees, their families and the organisations in which they work. A group of big-name European employers has formed an alliance to target depression in the workplace, and has recently published a report as an early first step in its campaign, setting out why employers must act, the challenges they face and the steps they can take to reduce the workplace impact of this serious condition (HR Leadership Forum, 2014).

Depression and impaired work

Depression accounts for 7.2% of the overall disease burden in Europe, affecting 30 million EU citizens at any one time, according to an analysis published on PLOS One in March 2014 (Evans-Lacko and Knapp, 2014). The alliance’s report points out that people with depression lose an average 5.6 more hours a week of productive time than those without the condition. A joint study by the London School of Economics and King’s College London quoted in the “Depression in the workplace in Europe” report estimates that depression costs European business £77 billion a year.

XpertHR resources

Good practice manual: Stress management
Good practice manual: Wellbeing

This loss in productivity is, by far, the greatest contributor to the overall economic impact of depression and the evidence for an association between depression and impaired work performance is strong. During an episode, workers with depression experience a range of cognitive symptoms, including trouble concentrating, indecisiveness or forgetfulness for up to 94% of the time.
However, many line managers believe that employees with mental ill health, including depression, are able to carry on working as normal and that their organisation’s mental wellbeing policies and practices are primarily designed to help the employer avoid litigation, the PLOS One study suggests.
An organisation’s workplace culture and environment strongly influences whether an employee with depression decides to disclose their illness. The support and openness of managers, and, in particular, their willingness to talk about the issues around working with an ongoing condition, such as depression, are crucial in enabling a person to stay in work, and also in building a social acceptance of the illness.

Supporting mental health at DHL

Organisational culture underpins German company Deutsche Post DHL’s (DPDHL) approach to depression at work. DPDHL launched a corporate guiding principle, “Respect and Results”, in 2008: “This means we are always striving for good results, but in ways that show respect for the individual,” according to Andreas Tautz, chief medical officer at the company. The launch of the principle was an important milestone for DPDHL, acting as a starting point for a range of initiatives around building a culture that supports mental health.

Deutsche Post DHL: health strategy

DPDHL believes you can promote workforce wellbeing on four levels, all of which are influenced by health management:

• Health-promoting workplace design – favourable workplace set-up, working conditions, working hours and working atmosphere.
• Qualification/development of decision-making competence – foster capability to take responsibility and improve stress resilience.
• Individual health promotion – support a healthy lifestyle.
• Respectful company culture and social interaction – open, transparent communication; culture of respectful feedback; creation of social networks; and sympathetic interaction.

Its health strategy is guided by one main principle: “Respect and Results”.

DPDHL manages mental wellbeing at four levels, one of which is described as “respectful culture and social interaction”. Employment is good for health, and the company uses this inherent advantage to promote healthy working environments: “Once we’ve focused on this we can then move on to look at developing a health-promoting company culture by focusing on relationships between executives and employees, and strengthening relationships in teams,” Tautz adds.
The role of DPDHL’s OH team of 70 physicians is: to identify therapeutic needs through referrals; work, if appropriate, with external specialists to provide immediate help with acute needs; and develop rehabilitation plans for those returning to work after time off due to mental ill health.

Barclays’ “This is Me” campaign

Barclays launched a “This is Me” campaign in May 2014 as the central plank of a year-long initiative on mental health at work. “This is Me” was born out of the financial services company’s recognition that depression and other manageable mental health conditions are major issues in its broader mental health agenda.
“We’re starting by tackling stigma – often when someone calls in sick with a mental health issue they tend to mask it with a physical illness,” says Mark McLane, head of global diversity and inclusion at Barclays. “This is Me” attempts to bring the conversation around mental health into the workplace, giving all staff (including line managers) the resources to tackle the issue. It also helps managers and employees to understand depression better, for example, describing how the condition can arise at different points in an individual’s life, or how it can be something that they manage on an ongoing basis.
Barclays’ mental health initiative is based around an online portal, open to all employees, which provides access to a set of resources from external organisations specialising in mental health. It also, crucially, gives access to a community of employees with an interest in a particular area, enabling employees with a question to pitch it to an appropriate colleague with relevant experience. Often, colleagues are able to help each other by signposting additional wellness resources.
McLane thinks this is a “brilliant” approach as it solidifies Barclays’ expectation that the stigma still attached to mental ill health will fall, “but it also empowers colleagues to support each other on depression and other mental health issues”. The community aspect of “This is Me” does a great job, and it brings all Barclays’ other HR policies on tackling stigma and supporting people with mental ill health “to life”, he believes. Line managers are already using the online community to assist them in supporting people in their teams with depression, according to McLane.

Building line management capability

Workplace depression in Europe

One in 10 people have taken time off work because of depression, according to a European-wide poll of 7,065 employees and managers published in 2012. Other findings from the IDEA survey, which explored the impact of depression on both organisations and individuals, include:

• An average of 36 working days are lost per episode of depression, with the highest average occurring in Great Britain (44 days per episode, on average).
• The highest rates of depression diagnoses were in Great Britain and the lowest in Italy.
• Only 20% of employees in France would tell their employer if they were diagnosed with depression, compared with the average of 34%.
• Nearly one in three managers reported they had no formal support or resources to deal with employees disclosing depression. Among those managers who stated that they were supported, support from a medical professional was the most frequently cited source (43% of those with any support), followed by support from an HR department (30%).
• Awareness of the cognitive symptoms of depression is poor – relatively low proportions of participants were able to identify forgetfulness and indecisiveness as symptoms.

Source: Ipsos MORI, Impact of depression at work in Europe audit, final report

Boosting the confidence and capability of line managers to support team members with depression is challenging, but also crucial to an organisation’s success in reducing stigma around the issue and fostering acceptance. All the organisations we spoke to recognise this, and have introduced training and professional development modules covering mental health. This management training covers areas such as initiating sensitive conversations, managing confidentiality and making effective referrals to specialists, including OH.
Advertising and media company Ogilvy & Mather, approaches workplace depression as part of a wider mental health strategy. Julia Ingall, the company’s talent management director for the UK division of EAME, believes that there is insufficient understanding of depression in the workplace, particularly among line managers, who often find themselves in a difficult position. “They may not understand what constitutes ‘depression’, or that it can include work-related aspects, such as a loss of concentration or change in behaviour towards colleagues. This can be quite scary for managers,” she suggests.
Ogilvy & Mather is working with consultant, Robertson Cooper, to deliver resilience training across the organisation, starting with its leadership level by building it into existing management programmes. “The lines are blurred between work and home, often driven by technology, and I worry that people do not get a break,” Ingall says. Putting the training in place will help managers understand their own resilience levels, how to build on their personal strengths in addition to acknowledging weaker areas.
An assessment tool developed by Robertson Cooper, called i-resilience, has been introduced. It will eventually produce data that can be interpreted to develop action plans for individuals. “We’ve also selected eight key HR people to undertake some ‘train the trainer’ programmes so they can understand the issues and roll these programmes out,” Ingall adds.
DPDHL provides managers with evidence and data on the value of managing mental health, explaining how their behaviour influences employees and suggesting ways to minimise the impact of damaging behaviour and maximise the positive. The company provides e-learning resources for managers on leading on mental health issues, developed in conjunction with a German university and the Ministry of Labour.
“We also started a programme of workshops for managers on preventing depression and burnout in 2012, designed to boost their confidence in handling these issues,” Tautz explains. The workshops operate alongside other HR training activities and professional development plans. “The latest development is a new training programme for senior managers covering mental health at work,” he adds.

Employee involvement

Involving employees in developing initiatives on depression in the workplace is a feature common to employers in the Target forum. DPDHL established health working circles in each branch in 1997, including representatives from Works Councils, OH physicians and health and safety experts. “These circles explore how and where to address different health topics, including many linked to mental health, such as conflict management, burnout and stress,” Tautz notes.
Ogilvy & Mather is in the process of setting up a wellbeing forum to work through issues affecting employee wellbeing: “The job of the forum will be to gather feedback from local offices. We’ve also used leadership groups to explore six pillars of wellbeing, including the impact of client demands and our leaders’ clarity of vision, on employee health,” Ingall adds.
One of the “really interesting” aspects of Barclays’ “This is Me” campaign is that it is colleague driven, using the company’s established employee network, Reach, according to McLane. A self-selecting network of around 700 people with an interest in disability, Reach also incorporates listening groups, which are formal focus groups of employees who have self-identified as having a disability, including ongoing mental health issues.
“These groups are asked for their views on gaps in the organisation’s approach to diversity and inclusion, for example, how our reasonable adjustments programme could be made better,” McLane explains. This helps Barclays develop improvements, which have recently included the launch of an intranet-based online catalogue of reasonable adjustments which employees can quickly access without the need to go through an application/procurement process. “We will also draw on employees’ own stories as a part of our efforts to tackle stigma; for example, we’ve started with six people telling their stories about managing their own mental health problems whilst having successful careers.”

Evaluating interventions

Providing evidence for the effectiveness of workplace initiatives on depression is the “biggest challenge”, according to Tautz. However, he adds, there is sufficient global data around to demonstrate the need for systematic health management, and DPDHL also uses its own employee opinion surveys and feedback from training sessions for qualitative evidence. “We also use validated tools such ICD10 to track the incidence rates for different work-related conditions, in addition to analysing our absence data.”
Barclays’ “This is Me” is currently a UK-based initiative, but the company plans to roll it out to the bank’s operations in the Americas and Africa during 2014: “This expansion will be one of the campaign’s success metrics,” McLane explains. “We will also look at activity levels within the community and, later on, will invite people to tell their stories around the support it provides,” he adds.
Source: 
An alliance of European employers is calling on HR and occupational health (OH) professionals to push mental health, and depression in particular, further up the corporate agenda. Sarah Silcox investigates why this is necessary.
The “Target Depression in the Workplace” initiative, run by the HR Leadership Forum, brings together some of the largest businesses in Europe. Occupational Health spoke to three of them – Barclays, Deutsche Post DHL and Ogilvy & Mather – about reducing stigma, changing culture and the best ways to give line managers the confidence to support individuals with mental health problems.
Depression, along with stress and anxiety, is a major contributor to long-term sickness absence in the UK, affecting the lives of significant numbers of employees, their families and the organisations in which they work. A group of big-name European employers has formed an alliance to target depression in the workplace, and has recently published a report as an early first step in its campaign, setting out why employers must act, the challenges they face and the steps they can take to reduce the workplace impact of this serious condition (HR Leadership Forum, 2014).

Depression and impaired work

Depression accounts for 7.2% of the overall disease burden in Europe, affecting 30 million EU citizens at any one time, according to an analysis published on PLOS One in March 2014 (Evans-Lacko and Knapp, 2014). The alliance’s report points out that people with depression lose an average 5.6 more hours a week of productive time than those without the condition. A joint study by the London School of Economics and King’s College London quoted in the “Depression in the workplace in Europe” report estimates that depression costs European business £77 billion a year.

XpertHR resources

Good practice manual: Stress management
Good practice manual: Wellbeing

This loss in productivity is, by far, the greatest contributor to the overall economic impact of depression and the evidence for an association between depression and impaired work performance is strong. During an episode, workers with depression experience a range of cognitive symptoms, including trouble concentrating, indecisiveness or forgetfulness for up to 94% of the time.
However, many line managers believe that employees with mental ill health, including depression, are able to carry on working as normal and that their organisation’s mental wellbeing policies and practices are primarily designed to help the employer avoid litigation, the PLOS One study suggests.
An organisation’s workplace culture and environment strongly influences whether an employee with depression decides to disclose their illness. The support and openness of managers, and, in particular, their willingness to talk about the issues around working with an ongoing condition, such as depression, are crucial in enabling a person to stay in work, and also in building a social acceptance of the illness.

Supporting mental health at DHL

Organisational culture underpins German company Deutsche Post DHL’s (DPDHL) approach to depression at work. DPDHL launched a corporate guiding principle, “Respect and Results”, in 2008: “This means we are always striving for good results, but in ways that show respect for the individual,” according to Andreas Tautz, chief medical officer at the company. The launch of the principle was an important milestone for DPDHL, acting as a starting point for a range of initiatives around building a culture that supports mental health.

Deutsche Post DHL: health strategy

DPDHL believes you can promote workforce wellbeing on four levels, all of which are influenced by health management:

• Health-promoting workplace design – favourable workplace set-up, working conditions, working hours and working atmosphere.
• Qualification/development of decision-making competence – foster capability to take responsibility and improve stress resilience.
• Individual health promotion – support a healthy lifestyle.
• Respectful company culture and social interaction – open, transparent communication; culture of respectful feedback; creation of social networks; and sympathetic interaction.

Its health strategy is guided by one main principle: “Respect and Results”.

DPDHL manages mental wellbeing at four levels, one of which is described as “respectful culture and social interaction”. Employment is good for health, and the company uses this inherent advantage to promote healthy working environments: “Once we’ve focused on this we can then move on to look at developing a health-promoting company culture by focusing on relationships between executives and employees, and strengthening relationships in teams,” Tautz adds.
The role of DPDHL’s OH team of 70 physicians is: to identify therapeutic needs through referrals; work, if appropriate, with external specialists to provide immediate help with acute needs; and develop rehabilitation plans for those returning to work after time off due to mental ill health.

Barclays’ “This is Me” campaign

Barclays launched a “This is Me” campaign in May 2014 as the central plank of a year-long initiative on mental health at work. “This is Me” was born out of the financial services company’s recognition that depression and other manageable mental health conditions are major issues in its broader mental health agenda.
“We’re starting by tackling stigma – often when someone calls in sick with a mental health issue they tend to mask it with a physical illness,” says Mark McLane, head of global diversity and inclusion at Barclays. “This is Me” attempts to bring the conversation around mental health into the workplace, giving all staff (including line managers) the resources to tackle the issue. It also helps managers and employees to understand depression better, for example, describing how the condition can arise at different points in an individual’s life, or how it can be something that they manage on an ongoing basis.
Barclays’ mental health initiative is based around an online portal, open to all employees, which provides access to a set of resources from external organisations specialising in mental health. It also, crucially, gives access to a community of employees with an interest in a particular area, enabling employees with a question to pitch it to an appropriate colleague with relevant experience. Often, colleagues are able to help each other by signposting additional wellness resources.
McLane thinks this is a “brilliant” approach as it solidifies Barclays’ expectation that the stigma still attached to mental ill health will fall, “but it also empowers colleagues to support each other on depression and other mental health issues”. The community aspect of “This is Me” does a great job, and it brings all Barclays’ other HR policies on tackling stigma and supporting people with mental ill health “to life”, he believes. Line managers are already using the online community to assist them in supporting people in their teams with depression, according to McLane.

Building line management capability

Workplace depression in Europe

One in 10 people have taken time off work because of depression, according to a European-wide poll of 7,065 employees and managers published in 2012. Other findings from the IDEA survey, which explored the impact of depression on both organisations and individuals, include:

• An average of 36 working days are lost per episode of depression, with the highest average occurring in Great Britain (44 days per episode, on average).
• The highest rates of depression diagnoses were in Great Britain and the lowest in Italy.
• Only 20% of employees in France would tell their employer if they were diagnosed with depression, compared with the average of 34%.
• Nearly one in three managers reported they had no formal support or resources to deal with employees disclosing depression. Among those managers who stated that they were supported, support from a medical professional was the most frequently cited source (43% of those with any support), followed by support from an HR department (30%).
• Awareness of the cognitive symptoms of depression is poor – relatively low proportions of participants were able to identify forgetfulness and indecisiveness as symptoms.

Source: Ipsos MORI, Impact of depression at work in Europe audit, final report

Boosting the confidence and capability of line managers to support team members with depression is challenging, but also crucial to an organisation’s success in reducing stigma around the issue and fostering acceptance. All the organisations we spoke to recognise this, and have introduced training and professional development modules covering mental health. This management training covers areas such as initiating sensitive conversations, managing confidentiality and making effective referrals to specialists, including OH.
Advertising and media company Ogilvy & Mather, approaches workplace depression as part of a wider mental health strategy. Julia Ingall, the company’s talent management director for the UK division of EAME, believes that there is insufficient understanding of depression in the workplace, particularly among line managers, who often find themselves in a difficult position. “They may not understand what constitutes ‘depression’, or that it can include work-related aspects, such as a loss of concentration or change in behaviour towards colleagues. This can be quite scary for managers,” she suggests.
Ogilvy & Mather is working with consultant, Robertson Cooper, to deliver resilience training across the organisation, starting with its leadership level by building it into existing management programmes. “The lines are blurred between work and home, often driven by technology, and I worry that people do not get a break,” Ingall says. Putting the training in place will help managers understand their own resilience levels, how to build on their personal strengths in addition to acknowledging weaker areas.
An assessment tool developed by Robertson Cooper, called i-resilience, has been introduced. It will eventually produce data that can be interpreted to develop action plans for individuals. “We’ve also selected eight key HR people to undertake some ‘train the trainer’ programmes so they can understand the issues and roll these programmes out,” Ingall adds.
DPDHL provides managers with evidence and data on the value of managing mental health, explaining how their behaviour influences employees and suggesting ways to minimise the impact of damaging behaviour and maximise the positive. The company provides e-learning resources for managers on leading on mental health issues, developed in conjunction with a German university and the Ministry of Labour.
“We also started a programme of workshops for managers on preventing depression and burnout in 2012, designed to boost their confidence in handling these issues,” Tautz explains. The workshops operate alongside other HR training activities and professional development plans. “The latest development is a new training programme for senior managers covering mental health at work,” he adds.

Employee involvement

Involving employees in developing initiatives on depression in the workplace is a feature common to employers in the Target forum. DPDHL established health working circles in each branch in 1997, including representatives from Works Councils, OH physicians and health and safety experts. “These circles explore how and where to address different health topics, including many linked to mental health, such as conflict management, burnout and stress,” Tautz notes.
Ogilvy & Mather is in the process of setting up a wellbeing forum to work through issues affecting employee wellbeing: “The job of the forum will be to gather feedback from local offices. We’ve also used leadership groups to explore six pillars of wellbeing, including the impact of client demands and our leaders’ clarity of vision, on employee health,” Ingall adds.
One of the “really interesting” aspects of Barclays’ “This is Me” campaign is that it is colleague driven, using the company’s established employee network, Reach, according to McLane. A self-selecting network of around 700 people with an interest in disability, Reach also incorporates listening groups, which are formal focus groups of employees who have self-identified as having a disability, including ongoing mental health issues.
“These groups are asked for their views on gaps in the organisation’s approach to diversity and inclusion, for example, how our reasonable adjustments programme could be made better,” McLane explains. This helps Barclays develop improvements, which have recently included the launch of an intranet-based online catalogue of reasonable adjustments which employees can quickly access without the need to go through an application/procurement process. “We will also draw on employees’ own stories as a part of our efforts to tackle stigma; for example, we’ve started with six people telling their stories about managing their own mental health problems whilst having successful careers.”

Evaluating interventions

Providing evidence for the effectiveness of workplace initiatives on depression is the “biggest challenge”, according to Tautz. However, he adds, there is sufficient global data around to demonstrate the need for systematic health management, and DPDHL also uses its own employee opinion surveys and feedback from training sessions for qualitative evidence. “We also use validated tools such ICD10 to track the incidence rates for different work-related conditions, in addition to analysing our absence data.”
Barclays’ “This is Me” is currently a UK-based initiative, but the company plans to roll it out to the bank’s operations in the Americas and Africa during 2014: “This expansion will be one of the campaign’s success metrics,” McLane explains. “We will also look at activity levels within the community and, later on, will invite people to tell their stories around the support it provides,” he adds.

An alliance of European employers is calling on HR and occupational health (OH) professionals to push mental health, and depression in particular, further up the corporate agenda. Sarah Silcox investigates why this is necessary.
The “Target Depression in the Workplace” initiative, run by the HR Leadership Forum, brings together some of the largest businesses in Europe. Occupational Health spoke to three of them – Barclays, Deutsche Post DHL and Ogilvy & Mather – about reducing stigma, changing culture and the best ways to give line managers the confidence to support individuals with mental health problems.
Depression, along with stress and anxiety, is a major contributor to long-term sickness absence in the UK, affecting the lives of significant numbers of employees, their families and the organisations in which they work. A group of big-name European employers has formed an alliance to target depression in the workplace, and has recently published a report as an early first step in its campaign, setting out why employers must act, the challenges they face and the steps they can take to reduce the workplace impact of this serious condition (HR Leadership Forum, 2014).

Depression and impaired work

Depression accounts for 7.2% of the overall disease burden in Europe, affecting 30 million EU citizens at any one time, according to an analysis published on PLOS One in March 2014 (Evans-Lacko and Knapp, 2014). The alliance’s report points out that people with depression lose an average 5.6 more hours a week of productive time than those without the condition. A joint study by the London School of Economics and King’s College London quoted in the “Depression in the workplace in Europe” report estimates that depression costs European business £77 billion a year.

XpertHR resources

Good practice manual: Stress management
Good practice manual: Wellbeing

This loss in productivity is, by far, the greatest contributor to the overall economic impact of depression and the evidence for an association between depression and impaired work performance is strong. During an episode, workers with depression experience a range of cognitive symptoms, including trouble concentrating, indecisiveness or forgetfulness for up to 94% of the time.
However, many line managers believe that employees with mental ill health, including depression, are able to carry on working as normal and that their organisation’s mental wellbeing policies and practices are primarily designed to help the employer avoid litigation, the PLOS One study suggests.
An organisation’s workplace culture and environment strongly influences whether an employee with depression decides to disclose their illness. The support and openness of managers, and, in particular, their willingness to talk about the issues around working with an ongoing condition, such as depression, are crucial in enabling a person to stay in work, and also in building a social acceptance of the illness.

Supporting mental health at DHL

Organisational culture underpins German company Deutsche Post DHL’s (DPDHL) approach to depression at work. DPDHL launched a corporate guiding principle, “Respect and Results”, in 2008: “This means we are always striving for good results, but in ways that show respect for the individual,” according to Andreas Tautz, chief medical officer at the company. The launch of the principle was an important milestone for DPDHL, acting as a starting point for a range of initiatives around building a culture that supports mental health.

Deutsche Post DHL: health strategy

DPDHL believes you can promote workforce wellbeing on four levels, all of which are influenced by health management:

• Health-promoting workplace design – favourable workplace set-up, working conditions, working hours and working atmosphere.
• Qualification/development of decision-making competence – foster capability to take responsibility and improve stress resilience.
• Individual health promotion – support a healthy lifestyle.
• Respectful company culture and social interaction – open, transparent communication; culture of respectful feedback; creation of social networks; and sympathetic interaction.

Its health strategy is guided by one main principle: “Respect and Results”.

DPDHL manages mental wellbeing at four levels, one of which is described as “respectful culture and social interaction”. Employment is good for health, and the company uses this inherent advantage to promote healthy working environments: “Once we’ve focused on this we can then move on to look at developing a health-promoting company culture by focusing on relationships between executives and employees, and strengthening relationships in teams,” Tautz adds.
The role of DPDHL’s OH team of 70 physicians is: to identify therapeutic needs through referrals; work, if appropriate, with external specialists to provide immediate help with acute needs; and develop rehabilitation plans for those returning to work after time off due to mental ill health.

Barclays’ “This is Me” campaign

Barclays launched a “This is Me” campaign in May 2014 as the central plank of a year-long initiative on mental health at work. “This is Me” was born out of the financial services company’s recognition that depression and other manageable mental health conditions are major issues in its broader mental health agenda.
“We’re starting by tackling stigma – often when someone calls in sick with a mental health issue they tend to mask it with a physical illness,” says Mark McLane, head of global diversity and inclusion at Barclays. “This is Me” attempts to bring the conversation around mental health into the workplace, giving all staff (including line managers) the resources to tackle the issue. It also helps managers and employees to understand depression better, for example, describing how the condition can arise at different points in an individual’s life, or how it can be something that they manage on an ongoing basis.
Barclays’ mental health initiative is based around an online portal, open to all employees, which provides access to a set of resources from external organisations specialising in mental health. It also, crucially, gives access to a community of employees with an interest in a particular area, enabling employees with a question to pitch it to an appropriate colleague with relevant experience. Often, colleagues are able to help each other by signposting additional wellness resources.
McLane thinks this is a “brilliant” approach as it solidifies Barclays’ expectation that the stigma still attached to mental ill health will fall, “but it also empowers colleagues to support each other on depression and other mental health issues”. The community aspect of “This is Me” does a great job, and it brings all Barclays’ other HR policies on tackling stigma and supporting people with mental ill health “to life”, he believes. Line managers are already using the online community to assist them in supporting people in their teams with depression, according to McLane.

Building line management capability

Workplace depression in Europe

One in 10 people have taken time off work because of depression, according to a European-wide poll of 7,065 employees and managers published in 2012. Other findings from the IDEA survey, which explored the impact of depression on both organisations and individuals, include:

• An average of 36 working days are lost per episode of depression, with the highest average occurring in Great Britain (44 days per episode, on average).
• The highest rates of depression diagnoses were in Great Britain and the lowest in Italy.
• Only 20% of employees in France would tell their employer if they were diagnosed with depression, compared with the average of 34%.
• Nearly one in three managers reported they had no formal support or resources to deal with employees disclosing depression. Among those managers who stated that they were supported, support from a medical professional was the most frequently cited source (43% of those with any support), followed by support from an HR department (30%).
• Awareness of the cognitive symptoms of depression is poor – relatively low proportions of participants were able to identify forgetfulness and indecisiveness as symptoms.

Source: Ipsos MORI, Impact of depression at work in Europe audit, final report

Boosting the confidence and capability of line managers to support team members with depression is challenging, but also crucial to an organisation’s success in reducing stigma around the issue and fostering acceptance. All the organisations we spoke to recognise this, and have introduced training and professional development modules covering mental health. This management training covers areas such as initiating sensitive conversations, managing confidentiality and making effective referrals to specialists, including OH.
Advertising and media company Ogilvy & Mather, approaches workplace depression as part of a wider mental health strategy. Julia Ingall, the company’s talent management director for the UK division of EAME, believes that there is insufficient understanding of depression in the workplace, particularly among line managers, who often find themselves in a difficult position. “They may not understand what constitutes ‘depression’, or that it can include work-related aspects, such as a loss of concentration or change in behaviour towards colleagues. This can be quite scary for managers,” she suggests.
Ogilvy & Mather is working with consultant, Robertson Cooper, to deliver resilience training across the organisation, starting with its leadership level by building it into existing management programmes. “The lines are blurred between work and home, often driven by technology, and I worry that people do not get a break,” Ingall says. Putting the training in place will help managers understand their own resilience levels, how to build on their personal strengths in addition to acknowledging weaker areas.
An assessment tool developed by Robertson Cooper, called i-resilience, has been introduced. It will eventually produce data that can be interpreted to develop action plans for individuals. “We’ve also selected eight key HR people to undertake some ‘train the trainer’ programmes so they can understand the issues and roll these programmes out,” Ingall adds.
DPDHL provides managers with evidence and data on the value of managing mental health, explaining how their behaviour influences employees and suggesting ways to minimise the impact of damaging behaviour and maximise the positive. The company provides e-learning resources for managers on leading on mental health issues, developed in conjunction with a German university and the Ministry of Labour.
“We also started a programme of workshops for managers on preventing depression and burnout in 2012, designed to boost their confidence in handling these issues,” Tautz explains. The workshops operate alongside other HR training activities and professional development plans. “The latest development is a new training programme for senior managers covering mental health at work,” he adds.

Employee involvement

Involving employees in developing initiatives on depression in the workplace is a feature common to employers in the Target forum. DPDHL established health working circles in each branch in 1997, including representatives from Works Councils, OH physicians and health and safety experts. “These circles explore how and where to address different health topics, including many linked to mental health, such as conflict management, burnout and stress,” Tautz notes.
Ogilvy & Mather is in the process of setting up a wellbeing forum to work through issues affecting employee wellbeing: “The job of the forum will be to gather feedback from local offices. We’ve also used leadership groups to explore six pillars of wellbeing, including the impact of client demands and our leaders’ clarity of vision, on employee health,” Ingall adds.
One of the “really interesting” aspects of Barclays’ “This is Me” campaign is that it is colleague driven, using the company’s established employee network, Reach, according to McLane. A self-selecting network of around 700 people with an interest in disability, Reach also incorporates listening groups, which are formal focus groups of employees who have self-identified as having a disability, including ongoing mental health issues.
“These groups are asked for their views on gaps in the organisation’s approach to diversity and inclusion, for example, how our reasonable adjustments programme could be made better,” McLane explains. This helps Barclays develop improvements, which have recently included the launch of an intranet-based online catalogue of reasonable adjustments which employees can quickly access without the need to go through an application/procurement process. “We will also draw on employees’ own stories as a part of our efforts to tackle stigma; for example, we’ve started with six people telling their stories about managing their own mental health problems whilst having successful careers.”

Evaluating interventions

Providing evidence for the effectiveness of workplace initiatives on depression is the “biggest challenge”, according to Tautz. However, he adds, there is sufficient global data around to demonstrate the need for systematic health management, and DPDHL also uses its own employee opinion surveys and feedback from training sessions for qualitative evidence. “We also use validated tools such ICD10 to track the incidence rates for different work-related conditions, in addition to analysing our absence data.”
Barclays’ “This is Me” is currently a UK-based initiative, but the company plans to roll it out to the bank’s operations in the Americas and Africa during 2014: “This expansion will be one of the campaign’s success metrics,” McLane explains. “We will also look at activity levels within the community and, later on, will invite people to tell their stories around the support it provides,” he adds. 
An alliance of European employers is calling on HR and occupational health (OH) professionals to push mental health, and depression in particular, further up the corporate agenda. Sarah Silcox investigates why this is necessary.
The “Target Depression in the Workplace” initiative, run by the HR Leadership Forum, brings together some of the largest businesses in Europe. Occupational Health spoke to three of them – Barclays, Deutsche Post DHL and Ogilvy & Mather – about reducing stigma, changing culture and the best ways to give line managers the confidence to support individuals with mental health problems.
Depression, along with stress and anxiety, is a major contributor to long-term sickness absence in the UK, affecting the lives of significant numbers of employees, their families and the organisations in which they work. A group of big-name European employers has formed an alliance to target depression in the workplace, and has recently published a report as an early first step in its campaign, setting out why employers must act, the challenges they face and the steps they can take to reduce the workplace impact of this serious condition (HR Leadership Forum, 2014).

Depression and impaired work

Depression accounts for 7.2% of the overall disease burden in Europe, affecting 30 million EU citizens at any one time, according to an analysis published on PLOS One in March 2014 (Evans-Lacko and Knapp, 2014). The alliance’s report points out that people with depression lose an average 5.6 more hours a week of productive time than those without the condition. A joint study by the London School of Economics and King’s College London quoted in the “Depression in the workplace in Europe” report estimates that depression costs European business £77 billion a year.

XpertHR resources

Good practice manual: Stress management
Good practice manual: Wellbeing

This loss in productivity is, by far, the greatest contributor to the overall economic impact of depression and the evidence for an association between depression and impaired work performance is strong. During an episode, workers with depression experience a range of cognitive symptoms, including trouble concentrating, indecisiveness or forgetfulness for up to 94% of the time.
However, many line managers believe that employees with mental ill health, including depression, are able to carry on working as normal and that their organisation’s mental wellbeing policies and practices are primarily designed to help the employer avoid litigation, the PLOS One study suggests.
An organisation’s workplace culture and environment strongly influences whether an employee with depression decides to disclose their illness. The support and openness of managers, and, in particular, their willingness to talk about the issues around working with an ongoing condition, such as depression, are crucial in enabling a person to stay in work, and also in building a social acceptance of the illness.

Supporting mental health at DHL

Organisational culture underpins German company Deutsche Post DHL’s (DPDHL) approach to depression at work. DPDHL launched a corporate guiding principle, “Respect and Results”, in 2008: “This means we are always striving for good results, but in ways that show respect for the individual,” according to Andreas Tautz, chief medical officer at the company. The launch of the principle was an important milestone for DPDHL, acting as a starting point for a range of initiatives around building a culture that supports mental health.

Deutsche Post DHL: health strategy

DPDHL believes you can promote workforce wellbeing on four levels, all of which are influenced by health management:

• Health-promoting workplace design – favourable workplace set-up, working conditions, working hours and working atmosphere.
• Qualification/development of decision-making competence – foster capability to take responsibility and improve stress resilience.
• Individual health promotion – support a healthy lifestyle.
• Respectful company culture and social interaction – open, transparent communication; culture of respectful feedback; creation of social networks; and sympathetic interaction.

Its health strategy is guided by one main principle: “Respect and Results”.

DPDHL manages mental wellbeing at four levels, one of which is described as “respectful culture and social interaction”. Employment is good for health, and the company uses this inherent advantage to promote healthy working environments: “Once we’ve focused on this we can then move on to look at developing a health-promoting company culture by focusing on relationships between executives and employees, and strengthening relationships in teams,” Tautz adds.
The role of DPDHL’s OH team of 70 physicians is: to identify therapeutic needs through referrals; work, if appropriate, with external specialists to provide immediate help with acute needs; and develop rehabilitation plans for those returning to work after time off due to mental ill health.

Barclays’ “This is Me” campaign

Barclays launched a “This is Me” campaign in May 2014 as the central plank of a year-long initiative on mental health at work. “This is Me” was born out of the financial services company’s recognition that depression and other manageable mental health conditions are major issues in its broader mental health agenda.
“We’re starting by tackling stigma – often when someone calls in sick with a mental health issue they tend to mask it with a physical illness,” says Mark McLane, head of global diversity and inclusion at Barclays. “This is Me” attempts to bring the conversation around mental health into the workplace, giving all staff (including line managers) the resources to tackle the issue. It also helps managers and employees to understand depression better, for example, describing how the condition can arise at different points in an individual’s life, or how it can be something that they manage on an ongoing basis.
Barclays’ mental health initiative is based around an online portal, open to all employees, which provides access to a set of resources from external organisations specialising in mental health. It also, crucially, gives access to a community of employees with an interest in a particular area, enabling employees with a question to pitch it to an appropriate colleague with relevant experience. Often, colleagues are able to help each other by signposting additional wellness resources.
McLane thinks this is a “brilliant” approach as it solidifies Barclays’ expectation that the stigma still attached to mental ill health will fall, “but it also empowers colleagues to support each other on depression and other mental health issues”. The community aspect of “This is Me” does a great job, and it brings all Barclays’ other HR policies on tackling stigma and supporting people with mental ill health “to life”, he believes. Line managers are already using the online community to assist them in supporting people in their teams with depression, according to McLane.

Building line management capability

Workplace depression in Europe

One in 10 people have taken time off work because of depression, according to a European-wide poll of 7,065 employees and managers published in 2012. Other findings from the IDEA survey, which explored the impact of depression on both organisations and individuals, include:

• An average of 36 working days are lost per episode of depression, with the highest average occurring in Great Britain (44 days per episode, on average).
• The highest rates of depression diagnoses were in Great Britain and the lowest in Italy.
• Only 20% of employees in France would tell their employer if they were diagnosed with depression, compared with the average of 34%.
• Nearly one in three managers reported they had no formal support or resources to deal with employees disclosing depression. Among those managers who stated that they were supported, support from a medical professional was the most frequently cited source (43% of those with any support), followed by support from an HR department (30%).
• Awareness of the cognitive symptoms of depression is poor – relatively low proportions of participants were able to identify forgetfulness and indecisiveness as symptoms.

Source: Ipsos MORI, Impact of depression at work in Europe audit, final report

Boosting the confidence and capability of line managers to support team members with depression is challenging, but also crucial to an organisation’s success in reducing stigma around the issue and fostering acceptance. All the organisations we spoke to recognise this, and have introduced training and professional development modules covering mental health. This management training covers areas such as initiating sensitive conversations, managing confidentiality and making effective referrals to specialists, including OH.
Advertising and media company Ogilvy & Mather, approaches workplace depression as part of a wider mental health strategy. Julia Ingall, the company’s talent management director for the UK division of EAME, believes that there is insufficient understanding of depression in the workplace, particularly among line managers, who often find themselves in a difficult position. “They may not understand what constitutes ‘depression’, or that it can include work-related aspects, such as a loss of concentration or change in behaviour towards colleagues. This can be quite scary for managers,” she suggests.
Ogilvy & Mather is working with consultant, Robertson Cooper, to deliver resilience training across the organisation, starting with its leadership level by building it into existing management programmes. “The lines are blurred between work and home, often driven by technology, and I worry that people do not get a break,” Ingall says. Putting the training in place will help managers understand their own resilience levels, how to build on their personal strengths in addition to acknowledging weaker areas.
An assessment tool developed by Robertson Cooper, called i-resilience, has been introduced. It will eventually produce data that can be interpreted to develop action plans for individuals. “We’ve also selected eight key HR people to undertake some ‘train the trainer’ programmes so they can understand the issues and roll these programmes out,” Ingall adds.
DPDHL provides managers with evidence and data on the value of managing mental health, explaining how their behaviour influences employees and suggesting ways to minimise the impact of damaging behaviour and maximise the positive. The company provides e-learning resources for managers on leading on mental health issues, developed in conjunction with a German university and the Ministry of Labour.
“We also started a programme of workshops for managers on preventing depression and burnout in 2012, designed to boost their confidence in handling these issues,” Tautz explains. The workshops operate alongside other HR training activities and professional development plans. “The latest development is a new training programme for senior managers covering mental health at work,” he adds.

Employee involvement

Involving employees in developing initiatives on depression in the workplace is a feature common to employers in the Target forum. DPDHL established health working circles in each branch in 1997, including representatives from Works Councils, OH physicians and health and safety experts. “These circles explore how and where to address different health topics, including many linked to mental health, such as conflict management, burnout and stress,” Tautz notes.
Ogilvy & Mather is in the process of setting up a wellbeing forum to work through issues affecting employee wellbeing: “The job of the forum will be to gather feedback from local offices. We’ve also used leadership groups to explore six pillars of wellbeing, including the impact of client demands and our leaders’ clarity of vision, on employee health,” Ingall adds.
One of the “really interesting” aspects of Barclays’ “This is Me” campaign is that it is colleague driven, using the company’s established employee network, Reach, according to McLane. A self-selecting network of around 700 people with an interest in disability, Reach also incorporates listening groups, which are formal focus groups of employees who have self-identified as having a disability, including ongoing mental health issues.
“These groups are asked for their views on gaps in the organisation’s approach to diversity and inclusion, for example, how our reasonable adjustments programme could be made better,” McLane explains. This helps Barclays develop improvements, which have recently included the launch of an intranet-based online catalogue of reasonable adjustments which employees can quickly access without the need to go through an application/procurement process. “We will also draw on employees’ own stories as a part of our efforts to tackle stigma; for example, we’ve started with six people telling their stories about managing their own mental health problems whilst having successful careers.”

Evaluating interventions

Providing evidence for the effectiveness of workplace initiatives on depression is the “biggest challenge”, according to Tautz. However, he adds, there is sufficient global data around to demonstrate the need for systematic health management, and DPDHL also uses its own employee opinion surveys and feedback from training sessions for qualitative evidence. “We also use validated tools such ICD10 to track the incidence rates for different work-related conditions, in addition to analysing our absence data.”
Barclays’ “This is Me” is currently a UK-based initiative, but the company plans to roll it out to the bank’s operations in the Americas and Africa during 2014: “This expansion will be one of the campaign’s success metrics,” McLane explains. “We will also look at activity levels within the community and, later on, will invite people to tell their stories around the support it provides,” he adds.
Source: Evans-Lacko S and Knapp M, PLOS (2014). “Importance of social and cultural factors for attitudes, disclosure and time off work for depression: findings from a seven country European study on depression in the workplace”.

 Source: Evans-Lacko S and Knapp M, PLOS (2014). “Importance of social and cultural factors for attitudes, disclosure and time off work for depression: findings from a seven country European study on depression in the workplace”.