Depressive episode in a bad economy?

January 13, 2009 11:34 AM

I'm going through a depressive episode at the moment and I'm worried about my job given the economy. What should I do that I don't know I should do?

I've been previously diagnosed with depression, but after some lackluster experiences with therapy and disastrous experiences with antidepressants I essentially abandoned that approach and have been trying to manage it myself.

Usually this means about one sick day a month, but with two exceptions: last year in March one of my absences cascaded into a week and a half, each day making me feel more and more overwhelmed. I forget how I got out of that one, I don't think there was a real trigger except that one day I was able to go to work.

And then there's this one... a seemingly trivial work task sent me into a spiral of procrastination and stress, and since thursday my sleep schedule has shifted from 1am-8am to 11am-2pm and I've been out sick and turning off my phone.

What's panicking me more about this one is the economy... I'm good at what I do (which I suspect is what buys me some leniency for my occasional absences) but I'm sure I'm not making a stellar impression at a time when pursestrings are at their tightest, and I'm terrified that my cons may outweigh my pros at any moment.

So I guess my question is twofold: what effective and fast-acting ways are there to break out of a depressive episode, given my lack of success with the medical approach? Meanwhile, what can/should I do to mitigate the impact of this stuff on my career?

Thanks for any advice. If you need to email me privately you can use askme.depressed (at) gmail.com

posted by anonymous to work & money (21 comments total)

If you're willing to seek medical/psychological assistance with your mental health issues, you may be able to get your absences covered under FMLA, which you cannot be punished for. Have you worked at your employer for over a year?
posted by scarykarrey at 11:47 AM on January 13

after some lackluster experiences with therapy and disastrous experiences with antidepressants I essentially abandoned that approach and have been trying to manage it myself.

It doesn't seem like most people are capable of doing a good job of managing their depression on their own. Fact is, you were seeking professional help, and gave up after "lackluster experiences" - what makes you think you have the follow-through to do it on your own?

I'm terrified that my cons may outweigh my pros at any moment.

In other words, you've successfully allowed your depression to get the better of you to the point where your job is in very real jeopardy and this has been going on for many months, if not years now.

So much for managing it yourself, huh?

what effective and fast-acting ways are there to break out of a depressive episode

No such thing exists. There are lots of half ass things you can do in order to keep fumbling forward in life on the knife's edge.

But treating depression is a very long process that takes a tremendous amount of commitment.

In the short term you can do the following:

- cut back on alcohol or stop all together
- hit the gym once a day for some vigorous exercise
- unplug the tv
- eat more healthy

Most people don't treat their depression successfully until it's cost them a job or two, a relationship, or some other missed opportunity.

Maybe loosing your job will be the thing that finally gets you back to counseling and back on the proper medication.
posted by wfrgms at 11:48 AM on January 13 [1 favorite]

Despite wfrgms's obnoxiously self-righteous delivery, his basic suggestions are pretty good.

Definitely cut back on alcohol and sugar.
Vitamin supplements help me immensely, especially in the winter.
If you aren't up for vigorous exercise, make your self walk around the block a few times. If the weather's not utterly miserable, get outside!
Straighten up your sleep hygiene.
Make yourself meet friends OFTEN, even if it's just for a lunch, and even if you think you aren't fit for company.

When you dig yourself out enough to sort of function, ask around for therapist recommendations. Getting yourself out of this will help you, your employer, your friends, your family...

Easier said than done, I know I know. But you can do it.
posted by small_ruminant at 11:56 AM on January 13 [2 favorites]

Depressive recovery takes months if not years. There's no magic bullet, if there was then lots of people would be doing it. You should go see a doctor again and try different treatments. The DIY approach is not working and more DIY tips is not what you need.
posted by damn dirty ape at 12:03 PM on January 13

The others are right: If you're missing work like this and feeling so out of control, you really should seek help before it gets worse. Just because you can claw your way out from time to time and mostly get it together doesn't mean that you need to live that way. If your experience with therapy, previously, was poor, keep looking for a better therapist.

If you really are too overwhelmed to do even that right now, at least read Feeling Good. This book has some excellent Cognitive Behavioral Therapy techniques that might help you get to a place where you're better able to address the situation.

Good luck to you, hang in there, you don't deserve to suffer like this, and owe it to yourself to find a way to make it stop!
posted by pazazygeek at 12:04 PM on January 13

Depression is an illness, not something worth berating a person for, even if their approach to treating the illness might seem misguided. The point of depression is that you can't see straight and need help.

I'm also not seeing where Anon was using alcohol to self medicate. Assumptions are not helpful here.

Anon, you are right to be concerned. You need to get help. I've helped friends through the horror of bad med choices and I know what it's like when your therapist is not helpful or not hearing you. It is tough to find a good therapist, but you have to persevere. Despite the judgment offered earlier in the thread, this is not an essential failing of you as a human being, this is an illness.

You need to get into therapy. You need to get with a good doc for meds.

Short term, you need to keep busy. Exercise may seem like a placebo but it can help and it will keep you occupied and less likely to hole up in the house. Make sure you are making the healthiest food choices that you are able to, there's no sense beating yourself up for eating tuna fish if that's what you've got, it's just important to eat.

You also may have legal/HR protection but I don't know anything about that.

Most of all, don't obsess on whether or not they're going to fire you. Just do the best job you can.
posted by micawber at 12:10 PM on January 13 [1 favorite]

Here's the other thing: just get your shit done. Honestly, in this economy I am going to care less if you're depressed or appear kooky or different. but please meet your deadlines, get your stuff done, because not getting stuff done could also impact on other people getting stuff done. people will cover for you if you get your stuff DONE.
posted by micawber at 12:13 PM on January 13

To give you some work perspective: One sick day a month is not "occasional." Most employers would consider a handful of days a year "occasional."
posted by M.C. Lo-Carb! at 12:46 PM on January 13 [1 favorite]

One sick day a month is not "occasional."

This is true.
posted by small_ruminant at 12:47 PM on January 13

I have found that the "Getting Things Done" approach allows me to increase productivity and reduce procrastination by
- tracking all the things I need to do
- focusing on action rather than just thinking about things

Also, I recommend limiting exposure to news because the ever-worsening news about the economy is enough to make anyone depressed...
posted by elmay at 1:03 PM on January 13

Could you talk to your boss or superior? Maybe they will be understanding and let you take some time off the deal with it. They might be able to give you some leniency for awhile, if you've been a decent, hard working employee. If you have to take few weeks, that's a lot better than having to be unemployed right now for an undetermined amount of time.

There's probably not a whole lot you can do overnight, except forgive yourself and not blame yourself for how you're feeling. That always just makes it worse worse worse.
posted by Rocket26 at 1:27 PM on January 13

One sick day a month is not "occasional."

Yes, how dare you use the benefits your company claims to give you!
posted by goethean at 1:51 PM on January 13

Man, I hear you. I'm so sorry.

To answer your question with peer-reviewed research regarding rapid recovery from depression:

Med Hypotheses. 2006;67(2):362-70. 2006 Mar 20.
Rapid recovery from major depression using magnesium treatment.
Eby GA, Eby KL.

N.B. I cannot access the article so I cannot analyze the experimental design/control groups (if any), but you can see from the link that they are reporting case histories, at least. They give the dosing instructions as well.

Please note: I am a neuroscientist, NOT A CLINICIAN, who works with RATS, not peoples. I am not your physician. I merely attempt to answer your question with peer-reviewed research. If you go to Pubmed and search for "magnesium depression" you will find more articles related to this phenomenon. Consult your physician. My internist turned her nose up at the suggestion that "supplements" could treat depression (despite published research to the contrary). I checked over at NCCAM and couldn't find a magnesium review. Maybe you could search further. Also please be aware that supplements aren't regulated like drugs so the amount claimed on the bottle could actually be more or less in the tabs. Unfortunately. The usual advice is to go with a GNC brand or a supplier that guarantees their products.

Please take care and best of luck feeling better.
posted by Punctual at 2:01 PM on January 13

Yes, how dare you use the benefits your company claims to give you!

Your company does not give you 12 sick days a year.
posted by kindall at 3:22 PM on January 13

Your company does not give you 12 sick days a year.

Some companies do. Mine does. Maybe the poster's does as well?
posted by marble at 3:41 PM on January 13

I highly recommend Feeling Good, as mentioned upthread. There's a fabulously good chapter on procrastination.

And keep trying different therapists; after lots of different attempts, I've discovered someone that I don't just have a good rapport with, but who keeps it practical and helps me work with my personality instead of against it.

On a totally practical note, "tiny steps." Go to work, and be okay with being less than productive. Then try starting the "seemingly trivial task" for just 10 minutes. You may need to just ignore how you feel. Don't wait for the motivation to come, either, just start doing.

Also, please please please don't let this go on for too long. I knew someone at a previous job, very well-liked and well-regarded, who succumbed to depression: the day after his sick leave ran out, he committed suicide. I can only assume he'd backed himself into a mental corner after something like what you've described.

Good luck.
posted by epersonae at 3:58 PM on January 13

Yes, how dare you use the benefits your company claims to give you!

I don't think M.C. Lo-Carb! was being judgemental about what you owe or don't owe your company, he was giving some perspective on what's normal, and using 12 sick days a year for depression isn't.
posted by small_ruminant at 4:09 PM on January 13 [1 favorite]

Yes, how dare you use the benefits your company claims to give you!

There's usually a perceived difference between (unplanned) sick days and (planned) vacation days. I have 30+ days to use this year for whatever I choose, but if I continually called in with no advance notice, people (my boss included) would be annoyed. Just because you can do something, doesn't mean you should.

The benefits you should definitely make use of are your health insurance and any Employee Assistance programs offered. Please make it a priority to find a competent therapist. When depression reaches the point where you're jeopardizing your own security and you see it coming, it's time to stop self treating. There are truly wonderful therapists and caring physicians out there who can help you through this patch, but you have to go out and find them.

Best of luck to you.
posted by contrariwise at 6:36 PM on January 13

Regarding the article that Punctual posted above on using Magnesium to treat a major depressive episode, I would caution against putting much credibility on a series of case histories published in Medical Hypothesis. Just because it's in PubMed does not mean that it is peer reviewed.

Please seek medical attention. DIY is not going to cut it for a major depressive episode.
posted by scalespace at 6:49 PM on January 13

There are some great meds out there - a lot more options than before and cocktails cocktails cocktails!

Find a good pdoc, a good therapist, and get yourself well again. The simple act of taking care of yourself will make you feel better. It also works as a buffer in case you sink lower (e.g. two more days til therapy, yay!).
posted by HolyWood at 2:56 PM on January 19

Given your (understandably) lackluster experience with therapy, and doctors, and even antidepressants, sit down and make a pessimistic guess at what your chance is of getting a 'good' therapist:
One in 6? One in 12?
Then make a guess for a good doctor, getting an effective antidepressant, etc...

Right, so, you think only maybe 1 in 10 therapists would be any good? Let pessimism work for you, and commit to seeing 10 therapists to find the one that will actually help YOU!
You can stop earlier if you want, but don't sick stick (freudian slip) with one that's no good. I knew in the first session that I'd found a good un' with my current counsellor (and keep a sense of perspective - good for you is not necessarily good for someone else etc, but still, it's a good guideline).

Also - if you're occasionally needing these sick days, your work wants to keep you, but you know your unreliability is negatively affecting things - go talk to them about having a regular unpaid day off, maybe once a fortnight. Your work would have the benefit that they can schedule around it, and don't underestimate how much it can help you personally. A Wednesday break makes any week manageable, and a 3 day weekend suddenly feels like a holiday - and it'll be far more restful and rejuvenating than your regular freeze up/flake out days, if they're anything like mine (almost or more exhausting than going to work by the time you add in the fear, guilt & recriminations).

Good luck!
posted by Elysum at 6:06 PM on February 18