Lynn Williams spent five years as a self-described workaholic manager for a group of Volusia County, Fla., medical offices. Late in 1996, she started to experience occasional lapses in concentration and memory.
Then she developed breathing problems, which she attributed to her asthma. But specialists told her she was wrong. They suspected stress and suggested she talk with a mental-health therapist.
She balked, insisting tht her problems were physical, not psychological. "The doctor said, 'You can die from not breathing for psychological reasons just as well as not breathing for physical reasons.' That made sense to me," she said.
As it turned out, Williams was clinically depressed. It took years of therapy and fine-tuning the type and dosage of antidepressant drugs before she was stabilized. Now 46, the Holly Hill, Fla., mother of three grown children is a full-time college student, pursuing dual degrees in health service administration and psychology.
"I want to get back into work," she said. Looking back, she thinks that seeking counseling earlier might have prevented the terrible times she experienced. "When you're swallowed up by depression, you can't do anything. You can't be productive. No way."
Williams' experience is not an isolated one. About one in five U.S. workers suffers from depression in any given year, and the annual cost to employers in terms of absenteeism, loss of productivity and treatment has been estimated at $60 billion or more.
More than 19 million American adults suffer from depression annually, according to the National Institute on Mental Health, and "no job category or professional level is immune."
Treatment for depression is successful in more than 80 percent of cases, but most people who suffer from depression do not seek help for it.
"There is so much stigma attached to depression, with people thinking they'll be judged for seeking treatment," said David Baker, vice president of the Mental Health Association of Central Florida and a practicing psychotherapist. "The reality is that people who seek treatment for depression lead more successful lives and will be more of a benefit to the organization."
Fawn Fitter, co-author of the recently published book Working in the Dark: Keeping Your Job While Dealing With Depression (Hazelden, $16, paperback), said there is increasing public awareness that depression is a treatable illness.
Nevertheless, she said, "there is still a pervasive attitude that workers with depression are lazy, incompetent, dangerous, or just making it up to have an excuse to slack. People who believe this wouldn't dream of saying this about someone undergoing chemotherapy."
Fitter, Baker and other experts say the solution starts with employees who recognize symptoms of depression and seek help, but that too often the culture at work discourages or even prohibits such action.
"This is a difficult time to be a depressed person in the work force," said Fitter, who missed several months of work in the mid-1990s when she underwent treatment for depression. "The economy is bad, and companies are looking for excuses to cut back their work force."
Companies that identify employees who need treatment for depression and get help for them can reap economic benefits.
A joint study in 2000 by the Harvard Medical School and the Analysis Group/Economics found that inaction actually costs companies more, because depressed workers who go untreated are more likely to miss work and to be unproductive when they're on the job.
"Thus, purely on economic rather than clinical or quality-of-life grounds, this argues in favor of more aggressive outreach to employees," wrote researchers Ronald Kessler, Paul Greenberg and their colleagues.
One increasingly popular tool for dealing with the problem is the Employee Assistance Program (EAP), which offers counseling services to employees. More than two-thirds of companies surveyed recently by the Society for Human Resource Management and more than 90 percent of Fortune 500 companies have them.
Walt Disney World, which has had an employee assistance program since 1989, reports great success. "The earlier you have intervention, the smaller the problem and the quicker the fix," said Sue Moore, the company's director of employee relations.
Large companies are more likely to offer EAPs, but small companies also suffer the economic consequences of depressed workers.
Researcher Paul Greenberg points out that "depression is so prevalent in the labor force that virtually no business enterprise can escape its adverse effects."
Small companies should consider EAPs, said David Baker with the Mental Health Association of Central Florida. "There are independent EAP therapists in the community you can contract on a case-by-case basis," and local mental health associations are available to make referrals.
Harry Wessel is a reporter for the Orlando Sentinel, a Tribune Publishing newspaper.