Depression is a taboo disease and in most cases requires a period of time away from the workplace to allow the person to recover. A recent study conducted with twenty workers who have gone through a depressive episode helps to understand what promotes the healing process and facilitates the return to work.

In general, continuing to work during a depressive episode – especially if it is profound – is not realistic. The reason? Total exhaustion, inability to concentrate, and a heightened sensitivity. A high degree of conscientiousness and a strong sense of responsibility, as well as the fact that you work in a profession that helps others, reinforce this observation. Going back to work is even less likely when work-related problems are involved. In fact, the majority of the people interviewed (see below) were unable to work for several months (from 4 to 10 months to be precise). « It is important to have this time, without being pressured to return to work, if you don’t feel ready yet. Otherwise, it’s a guaranteed relapse. Once recovered, people generally find the desire to be in society and to return to work, » the researchers say.

Maintaining contact with one’s professional environment during the period of incapacity seems to be essential. A good relationship with colleagues encourages the person and facilitates his or her return to work, as testified by one of the people interviewed, a teacher. « The understanding that my colleagues showed me was worth its weight in gold. Some visited me, others gave me a call. I also got little notes from students and colleagues and I thought that was important. »

The understanding and empathy of the mutuality’s medical adviser is also essential. The interviews attest to this. « The medical adviser should be more of a companion, willing to help, than a controller, » say the researchers. And they advocate that, in parallel to a pathway to get out of depression, a pathway to return to work should be developed to reassure the patient during this period of fragility. This pathway requires a climate of trust and good communication between the general practitioner, the consulting physician and the patient.

Adapting the work
To ensure that the return to work goes as smoothly as possible, prior consultation with the department head – and even with the human resources manager and/or the occupational physician – is important, but too rarely organized, the authors of the study note. Even if the employee does not explicitly request it, the department head is advised to at least schedule a meeting with him/her on the day of his/her return to take stock of his/her state of health and examine how best to organize the transition.

If depression originates – at least in part – in working life, it is important to explore ways of adapting the work, the researchers note. A new job, a change of position or department, a change in working hours, a reduction – even if only temporary – in working hours… can solve the problems. One of the witnesses recounts that following his request to lighten his workload, his department head suggested that he browse a job description that might be a better fit. That reassured me, » he says. I was afraid I would have to start over again, wondering if I would still be able to handle it. I must say that everything went very well.

Getting back into the swing of things is also an interesting opportunity. My employer allowed me to return to work part-time and I am very grateful, » enthuses one witness. This was done in agreement with my general practitioner, the medical advisor of my mutual insurance company and the occupational physician. The fact that they do not have to work full time is considered a great advantage by those concerned, » the researchers said. Employers have to accept that a worker is temporarily less productive after a disability due to depression, » they point out.

These solutions, which may be ideal, are not shared by everyone, far from it. For example, the interviews highlighted the reality of certain professions facing a high workload due to a shortage of personnel. With an increased risk of work incapacity due to depression or burnout. A reality that is also experienced by many self-employed or small business owners, even if it does not appear much in this study. On the other hand, for some workers, reintegration into the company no longer seems possible. A professional reorientation or the search for a new job must then be considered, if possible.

Recognizing the signs of depression
Most people who experience a depressive episode have difficulty recognizing the warning signs and admitting that they are not well. Their health problems get worse, they push themselves beyond their limits. Then one day, they realize that they can’t go on like this and finally decide to seek help…

Recognizing the signs of depression
Most people who experience a depressive episode have difficulty recognizing the warning signs and admitting that they are not well. Their health problems get worse, they push themselves beyond their limits. Then one day, they realize that they can’t go on like this and finally decide to seek help…

It is a fact: depression is not well known. And the preconceived ideas and prejudices about it are still alive. Several people interviewed as part of a qualitative study(1) aimed at understanding the relationship between depression and work (in)ability testify to this: « For me, depression meant staying at home and crying all day, » says one. « I told myself that it could never happen to me. I didn’t expect it, » says another. « To lose face, I who was the epitome of cheerfulness, where everything was always fine, who helped everyone… Then, to admit that it’s no longer okay, it’s terrible… », adds a third.

« Constant fatigue or repeated illnesses are the visible physical signals of depression. But the problem is more complex and some people need to hear it from their doctor to become aware of it, » commented the researchers from the Mutualité chrétienne who analyzed the interviews collected. The fact of not being able to stand anything and of always putting down others are also warning signs. The witnesses of the study also mention social isolation, the fact of not wanting to do anything, anxiety, instability, difficulties of concentration…

As for the causes of depression, they are multiple. On a personal level, the twenty people interviewed mentioned relational difficulties (divorce, conflictual relationship with a parent or a child), physical problems (after-effects of an accident, difficulties in accepting a chronic illness or a handicap). Work-related difficulties and dissatisfactions were also cited, such as conflicts with superiors, a heavy workload, lack of recognition, and difficult contacts with the public or customers. For the majority of witnesses, depression is the result of a combination of personal and professional problems. « When these problems are essentially in the private sphere and everything is going well at work, working allows the person to take his or her mind off things, » the researchers note.

Getting out of depression
All the people interviewed emphasize the central role played by their doctor in the recovery process, thanks to the bonds of trust established between them and to regular contact. Together, patient and doctor can make the right decisions regarding medication, referral to a psychologist or psychiatrist, prescription of sick leave, return to work…

« The use of antidepressants helped many of those surveyed get out of their depression, although some were not sure whether recovery was due to medication, » the researchers observe. In fact, people generally set up other things in parallel: following a therapy, practicing a sport or a hobby, relaxing activities… Knowing oneself better, taking time for oneself and taking care of oneself is indeed crucial to get back on track, the authors of the study point out. Social contacts are also very important to get out of depression.

At the bottom of the wave, the person tends to isolate himself, to avoid others, to refuse activities. They have no desire or too little energy to do anything. Most of the people interviewed admitted how lucky they were to be surrounded by loved ones who were both understanding and energizing… One woman spoke fondly of her sister: « When I didn’t pick up the phone for several days, she would come without warning. She would say to me: ‘Come on, get out of bed, we’re going for a walk, so you can see the light of day. She is the most important person for me ».

Surrounding oneself and getting help seem to be a guarantee of well-being. People who want to solve everything themselves have more difficulties than those who dare to ask for help », say the authors of the study, for whom the way of analyzing what one experiences is also a determining factor. If the depression is entirely attributed to an external event, the person will usually only partially or with difficulty get out of the depression ».