Ethan Underhill, MBA Class of 2016
Depression, in the medically-derived lexicon of psychology, has a more specific meaning than our everyday usage of the term. The Diagnostic and Statistical Manual of Mental Disorders (DSM), the “bible” of psychological diagnosis, outlines the qualifying criteria of depression and attempts to separate instances of the disorder from the emotional downturns inherent to life, such as the grief experienced after the death of a loved one.
In its clinical way, the DSM lists nine symptoms of depression, five of which must be experienced for most of the day for two consecutive weeks for a sufferer to qualify as depressed. One of the symptoms must be either depressed mood or anhedonia (an inability to enjoy things a person previously found pleasurable). Other symptoms can include disturbances in appetite, dramatic changes in sleep habits, or an inability to concentrate. Naturally, the diagnosis excludes symptoms that arise from physiological changes or substance abuse.
One can argue, pretty convincingly, that it’s a little arbitrary to say that a person experiencing moderate levels of five of the nine symptoms is depressed, while another person experiencing severe levels of two symptoms is not. Nevertheless, we rely on such distinctions and standardized interpretations to foster communication and research.
It’s also important to note that although the stigma associated with mental illness seems to be declining in society, many people still associate depression with weakness or failure. Like a degenerative biological affliction such as cancer, depression can torment the accomplished as easily as the unsuccessful – it is not the province of screw-ups and weaklings.
The current body of research on workplace productivity and depression indicates, unsurprisingly, that depressive symptoms positively correlate with absenteeism and unemployment. Consider some of the possible symptoms of depression – poor concentration and anhedonia. Even if a depressed individual maintains his attendance at work, he’ll produce more error-prone work, and take longer to complete it. Anhedonia corresponds to productivity decline because if a person used to love her job, she’ll take less pleasure in it while depressed, and accordingly produce poorer work – and that’s the best case scenario.
The sad reality of life is that many people hate their jobs, and only drag themselves to work every day for the money, part of which they spend on things they actually like. If they find themselves not liking much of anything, well, a significant incentive to work effectively, or go to work at all, has evaporated.
To put it in harsh utilitarian terms, suicide is the poorest outcome of depression in terms of economic productivity, reducing all current and future productivity of a worker to zero. Since nearly everyone who commits suicide suffers from depression — the exceptions being people under the influence of mind-altering substances or those suffering from various types of psychosis – the problems of depression and suicide are inextricably linked. The American Foundation for Suicide Prevention estimates that suicide costs the U.S. economy $34 billion annually in lost wages and productivity. Failed suicide attempts, with attendant medical costs and missed work, cost an additional estimated $8 billion. Adults aged 45 to 64, many of whom are still in the workforce, have the highest suicide rate. Men have dominated the statistic for years, with a suicide rate typically hovering around four times that of women – men accounted for 78.5% of U.S. suicides in 2011, the most recent year of data availability. 39,518 Americans died by suicide that year, making it the tenth leading cause of death in the nation.
It’s human nature to seek explanations for things that frighten us and confound our sense of rationality. Hearing of the suicide of a seemingly happy and successful person perturbs and confuses us, whether it’s a celebrity, coworker, or family member. Shouldn’t depressed people realize that there was a point when they were not depressed, and that they can get there again? Perhaps the non-suicidal mind can only hope to achieve a limited and detached perspective on the phenomenon. Understanding depression, and therefore suicide, requires looking beyond the DSM laundry list of symptoms to the texture of the day-to-day experience of the disorder.
After a sensation of overall meaninglessness and despair has persisted long enough, the present becomes the epicenter of an emotional leveling that ripples into the past and the future. A depressed person develops a fatalistic belief that he will never again feel joy, and has an increasingly difficult time recapturing memories of past happiness. His perception of the world becomes flat, gray, and sometimes tinged with a sense of unreality. Suicidal thoughts find a mental foothold when depression seems permanent, and many suicidal people develop the capacity to rationalize that the world, and even their loved ones, are better off without them.
If you find the tone of this article excessively somber, I agree. These are difficult issues to ponder and discuss. The point is, leaders require an understanding of depression and suicide to recognize the warning signs. No one expects (or wants) managers to administer therapy to subordinates, but a recognition of erratic performance by a formerly stellar employee or colleague, followed by an empathetic inquiry, can make a tremendous difference in identifying a significant morale and productivity risk. Listen. Reach out. Understand. It’s a moral and financial imperative in a world civilized enough to treat mental illness.
National Suicide Prevention Lifeline: 1-800-273-8255