Addressing Depression in the Workplace: The Role of the Worksite Wellness Program (Start Today!)

Employee depression is taking a toll on both employees and the organization. And you want to know how to best address it, right?

The suicide of comedian – actor Robin Williams has resulted in increased attention to the subjects of depression and suicide. Employee depression and suicide are very real issues for employers as well. This article will take a look at the subject of workplace depression by specifically addressing the relationship between depression and worksite wellness programs.

Worksite wellness programs need to better address employee depression for five key reasons:

1. The prevalence and cost of depression to employers

2. Treatment for employees with depression is under utilized

3. The co-morbidity between depression and other chronic illnesses typically addressed by worksite wellness programming and interventions

4. Core worksite wellness program interventions can be helpful in addressing depression

5. Worksite wellness programs are about prevention and depression can be prevented.

Depression Prevalence and Cost

A 2013 Gallup – Healthways Wellbeing Index finding was that “10.8% of U.S. full-time workers have received depression diagnoses, while 16.6% of the part-time workers reported having been diagnosed with depression.” (1) The same survey found that “depressed full-timers missed 8.7 days of work per year, 4.3 more days than people who are not depressed. As for part-time workers, they estimated that they missed even more days, some 13.7%, or 5% more than those who do not suffer from depression. ” (1)

In 1995, Conti and Burton reported that “depressive disorders in employees and their dependents pose a major occupational health challenge, with implications for productivity, competitiveness, disability program utilization and medical care costs.” (2) They found that depression in one major Midwestern employer “generated over half of all mental healthcare diagnoses and claims and even more days of disability and 12-month recidivism than chronic physical complaints such as heart disease, diabetes, high blood pressure and low back pain.” (2) In 2008, Conti and Burton continued to find that “depressive disorders are a major health issue in the US workplace. They are responsible for significant direct and indirect costs to the employer in terms of medical and pharmaceutical costs, time absent from work and decreased productivity while on the job (presenteeism).” (3) Kessler, et. al. found that “depression is a strong indicator of decrements in work performance.” (4)

Treatment Is Under Utilized

For a number of reasons, in a recent US study Kessler found that “only about half of workers with major depressive disorder received treatment in the year of interview and that fewer than half of treated workers received treatment consistent with published treatment guidelines. Although the treatment rate was higher for more severe cases, even some with severe major depressive disorder often failed to receive treatment.” (5) According to an article by Gonzalez, et al., although depression is a leading cause of disability in the United States, few Americans with recent major depression received any form of standard care and even fewer received care that is consistent with the American Psychiatric Association guideline. Of those meeting 12-month major depressive episode criteria, only 50.76% received any depression therapy and only 21.28% received adequate depression treatment. (6) Treatment under-utilization creates an opportunity for worksite wellness programs to fill some of the gap.

Connection With Sociodemographic Variables, Health Behaviors and Chronic Diseases

It is well established that depression, sociodemographic variables, health behaviors and chronic diseases are linked. The typical connections include:

• Current depression and lifetime diagnosis of depression and anxiety were independently associated with sociodemographic variables (being a woman, young, previously married or never married, or unemployed or unable to work), adverse health behaviors (current or former smoking, physical inactivity, or being overweight), and chronic health conditions (history of a stroke, cardiovascular disease, diabetes, arthritis, obesity, cancer, or asthma).

• Workers with occupational injury were more likely to become depressed than those with non-occupational injury.

• Because heavy alcohol use and daily smoking are each associated with depression, people who do both may be at an increased risk for depression.

Worksite wellness programming addresses many of these same variables, behaviors and chronic conditions.

Utilizing Core Worksite Wellness Program Interventions

Generally speaking, core worksite wellness programming and interventions include nutrition, physical activity and fitness, sleep hygiene and often, stress management. In his book, The Depression Cure (2009) (7), psychologist Stephen Ilardi discusses his Therapeutic Lifestyle Change (TLC) program.

The components of the TLC program include:

• Nutrition

• Engaging activity

• Physical activity

• Sunlight exposure

• Social connection

• Enhanced sleep

By comparing traditional worksite wellness programming with the TLC components, you can see that the core components of the TLC program dove-tail very nicely with the core components of a traditional worksite wellness program. This becomes important when you realize how many employees do not receive treatment for their depression.

Depression Can Be Prevented

In his book, The Prevention of Depression (2009) (8), psychologist John Weaver notes that healthy thinking skills have been shown by researchers to “raise your resistance to being diagnosed with a depressive disorder and to assist you in recovering more quickly if you go through a period with a depressed mood.” Dr. Weaver lists the healthy thinking skills as being:

• Mindfulness

• Optimism

• Resilience

Dr. Weaver also noted that these same healthy thinking skills as also adding to one’s level of happiness.

Promoting employee altruism has also been shown by researchers to be “one of the greatest buffers against depression.” (9)

Based on these five reasons at least, worksite wellness programs have a role to play in addressing depression in the workplace. Worksite wellness programs can and should be making a significant contribution to the issue of employee depression.


(1) Roberts, Mark. 2014. Depression in the Workplace. Benefits and Wellness Excellence Essentials. August, Vol. 2, (8), pp. 12-13.

(2) Conti, DJ and Burton, WN. 1995. The Cost of Depression in the Workplace. Behavioral Healthcare Tomorrow. Jul-Aug, Vol. 4 (4), pp. 25-7.

(3) Burton, WN. Conti, DJ. 2008. Depression in the Workplace: The Role of the Corporate Medical Director. April, Vol. 50 (4), pp. 476-81.

(4) Kessler, R. White, LA. Birnbaum, H.Oiu, Y. Kidolezi, Y. Mallett, D. Swindle, R. 2008. Comparative and Interactive Effects of Depression Relative to Other Health Problems on Work Performance in the Workforce of a Large Employer. Journal of Occupational And Environmental Medicine. July, Vol. 50 pp. 809-16.

(5) Kessler, R. 2012. The Costs of Depression. The Psychiatric Clinics of North America. March, Vol. 35 (1), pp. 1-14.

(6) González, H. Vega, W. Williams, D. Tarraf, W. West, B. Neighbors, H. 2010. Depression Care in the United States: Too Little for Too Few. Arch Gen Psychiatry. 2010. January, Vol. 67(1), pp. 37-46.

(7) Ilardi, Stephen. 2009. The Depression Cure. Cambridge, MA: Da Capo Press.

(8) Weaver, John. 2009. The Prevention of Depression. Denver: Outskirts Press, Inc.

(9) Achor, Shawn. 2013. Before Happiness. New York: Crown Publishing Group.

Coping With Depression Anxiety – Taking Responsibility

If you are depressed or perennially anxious, what are you supposed to do aside from seeking psychiatric help? How will you be able to cope with depression?

Diagnosing depression and anxiety disorders is not an easy thing to do. The sufferer’s doctor must make a thorough, careful evaluation of the conditions attendant to the depression and weigh those conditions so that the best way of coping with the depression and/or anxiety is found. It is not enough to prescribe an anti-depressant; for all you know, the medication may worsen the condition if taken on its own. Other coping mechanisms are essential in ensuring the efficacy of medication.

Group Therapy

For one, you can find a support group. Your support group may be your closest circle of friends, classmates, neighbors, even community self-help groups that can provide the much needed beefing up and support to the sufferer.

Group therapy is not limited to face-to-face interactions. You can seek help from depression chat rooms, too. Online depression communities are one of the ways to reach out to other people who are afflicted with depression or have successfully managed their anxiety or depression.

At times, a psychiatrist attends the chat meeting and takes part with the therapy for the day.

Reduce Stress

Next will be a conscious effort to reduce your own stress. Stress increases adrenal gland secretion of cortisol. Increased cortisol may in turn induce depression, as serotonin production is affected. To be on the safe side, learn how to live with stress or avoid stressful activities and subjects.

Get Enough Sleep

Sometimes, somatic causes of depression may be addressed with enough rest or sleep. When you get enough rest and sleep, your mood is fine, you are not at wit’s end, you don’t have insomnia, then you don’t get depressed or agitated easily. A restful sleep may be helpful in reducing if not eliminating depression and anxiety.

Based on research, lack of sleep is equivalent to diminishing quantities of serotonin. Serotonin is a very important brain chemical, especially in the region of the brain that sends mood signals. The lack of serotonin in the brain results in irritability, mood swings and depression. So sleep at least seven hours a day. Enough sleep is sometimes all it takes to be well both in body and mind.

Your Diet

Next is your diet. Are you eating enough? Is your diet balanced? Studies have shown that deficient intake of vitamins and minerals may cause depression. Your physical and mental health state is directly related to the kind of diet you have. The kinds of food you eat sometimes determine the kind of mood you will have. An empty stomach sometimes makes you even more agitated or irritable. Or worse, you may have allergic reactions to certain foods and dietary complements that may increase your levels of anxiety and depression.

How to cope with depression, therefore? Eat nutritious foods, brain foods specifically. What are these brain foods? Brain foods are those that enhance memory, promote production of serotonin and help in balancing biochemical components in the body. It is simply a principle of eating your way to health.

Take Responsibility

Be responsible, for yourself, for your condition. Sometimes you may want to procrastinate and put off doing something and when that something becomes urgent, it adds to your anxiety and then you become guilty because you have not been responsible.

Treating depression and anxiety may take longer than necessary without the patient’s full determination to be treated or cured of the disorder. Coping with depression and anxiety may entail more than mere medication; the therapy and support that should go with the medication, plus the determination and lifestyle and attitude changes in the patient, may spell the difference between cure and continued suffering. When you get a handle on things and take charge of your treatment, you begin the journey towards coping with depression and getting cured.