Accept a job or treat depression?

February 16, 2012 4:22 PM

May be about to be offered a temp-to-perm job, but also may need to start 6 to 8 week voluntary medical process that will preclude working. What do I do?

I have not worked in a permanent job since spring 2008, though I have been looking hard. I've been doing temp work (accounts payable) for the last 4 years, with lots of unemployed periods between temp assignments when I can't find any work at all. The last period of unemployment was 5 months long, which I cannot afford to happen again.

Meanwhile, I have suffered from moderate to severe depression since I was 15 years old (I am now almost 52). Also, since I was 18 I have also seen therapists off and on (mostly on) and taken different antidepressants which have not been effective. Almost 2 years ago I underwent a series of ECT (electroconvulsive therapy--"shock therapy") which was successful: my depression went into remission for just over a year. Even though I had many, many severe difficulties in my life during that period, I was able to cope easily and stay optimistic. Last summer I noticed that I was slipping back into depression, and I am now feeling its full effects. This is very common with ECT, and most people need to have "maintenance" ECT sessions or repeat it. It generally consists of 3 treatments a week for 6 to 8 weeks. This basically makes work impossible. It's possible and easy to work the 2 non-ECT days each week, but there aren't many jobs that can accommodate this.

In the meantime, I was contacted about a possible temp-to-perm position at an organization where I recently worked for just under 4 weeks, covering a vacation. I was told that they may be interested in having me come back, but it would be to fill a newly created position, rather than a vacation or maternity leave, and it could very well end up being a permanent job. They already know me and my work and think well of me.

I really hated the ECT (hard to explain why; no pain, everyone's really nice, no overt negative side effects. My head tells me there's no reason to resist, but I feel like my inner core, my body at a cellular level, is screaming "NO! Don't do it!"), but it's been the only effective treatment. I feel that I have a responsibility to my family (I have 2 teenage children) and myself to receive the treatments again. So recently I have been trying to psych myself up to look into it, especially that I am once again unemployed and would have the time. I have a consultation scheduled for early next week to discuss the possibility of ECT treatment.

I expect to hear more details about the job tomorrow, and I don't know how to respond. I don't feel that I can ask them to let me start in 6 to 8 weeks in order to accommodate the ECT treatments. And, of course, I'd never tell them what the details were; I guess I would just tell them it was a medical issue and not offer details; but then they might think it's rehab or something!

From my very extensive experience temping, most clients want a temp to start as soon as they have identified their need for one and don't want to or can't put it off for another 2 months. I think that they would almost certainly say I wasn't the right person for the job. But if I don't take or get this job, there's no way to tell when the next job will come around--it could be another half year or longer! And we need the money! But, then again, if I don't do the ECT my quality of life will suffer, my kids will suffer, and I know I won't work as well as I am capable of. Very often in the past I have had days where I was simply unable to get out of bed to go to work; I have ended up calling in sick and have actually lost a few temp jobs because of this. I have not done well at work for the last several years; I'm not sure exactly why. In addition to my problems with missing work, I feel like I might put out some kind of depressed and desperate vibe that puts people off. None of the places that have fired me or chosen not to go from temp to perm has given any feedback at all, no matter how much I ask. But I don't know; this could be my depression and low self-esteem talking. Anyway, to find a potential employer that already knows and likes me and my work feels like something I absolutely cannot afford to throw away.

But, having a job greatly reduces my stress and anxiety, and I am more able to cope with daily life.

If they do want me back, should I tell them I can't start for about 2 months, and throw away an opportunity with the rare situation where they actually want me? If so, how should I explain it? Or should I just say I'm not available and take a break from the job search (and risk a long, long period of unemployment) and do the ECT? Or are there other possibilities that I'm not seeing? Thanks, all.

posted by primate moon to work & money (9 answers total)

Have you talked to your therapist/PC/psychiatrist about this? Perhaps there's a chance you and your medical support team could find a way of carrying you through a few more months until you can see what happens with this position.
posted by xingcat at 5:14 PM on February 16, 2012

Hmmm. Is there any way you could have a treatment schedule of Saturday-Tuesday-Thursday, and have the Tuesday/Thursday appointments in the afternoon, working a half-day beforehand? Then, you could either be a 32-hour a week employee, or work 10-hr days M-W-F and be a 38-hr/week employee. Or you could take those two days off entirely and work 12 hours M-W-F, which gets you to 36 hours. Or you could suggest to the employer that you "ramp up" your time there, starting at two days per week and then going to full-time when your treatment ends.

Ask your doctor about ways to make the schedule work- I don't think you can be the only person to ever be in this position.

I would emphasize to the employer that this is only for TWO MONTHS, and go in with some suggestions about how to make it work. More, "I have to have some on-going medical treatment for the next couple months; luckily, it is a maintenance treatment and my health is very stable. I can work TIME and TIME and then go to a normal 9-5 workday on DATE, or I can work OTHER TIME and OTHER TIME, with the same time frame for my switch to a day shift schedule."
posted by Snarl Furillo at 7:05 PM on February 16, 2012

Would Snarl Furillo's suggestion work?--are you saying you would be incapacitated for the full time, or could you swing a schedule like that--or even work 12-24 hours continuing part time till this is over.

If your body is telling you 'nonono' I think I'd try for some other option. Have you tried any of the newly released antidepressants? Have you been evaluated for bipolar? I went for years see-sawing between ho-hum and depression, taking antidepressants and just not getting along, then was diagnosed with bipolar depression. Started taking lamictal (generally used for seizures) but now used commonly for bipolar. That, and a touch of antidepressant and vit. D in the winter seem to do the trick.

ECT sounds very over the top. Please make sure you've tried everything possible before undergoing this.

Take care. I know how crappy depression makes you feel.
posted by BlueHorse at 8:26 PM on February 16, 2012

Snarl, these are great ideas. I will definitely given some thought to what you've written. I know I won't be able to get treatments on Saturdays, but I might be able to juggle things to better accommodate a work schedule.

BlueHorse, thanks for your thoughtful answer. I do not have bi-polar; I have unipolar depression. I have tried many different antidepressants, under the care of a doctor, with no good results. Of course, this is hardly unusual, as 40% of patients taking antidepressants are not helped by them.

Regarding the ECT, it was effective--very effective--for a little over a year, which is a pretty long time. I was a different person. It's not that I was filled with giddy joy every second, but I had an essential optimism and ability to cope that I had never experienced before. My anger went away, I had a little more energy, I felt more loving towards my kids and better able to care for them, and I dealt better with the difficulties life throws at you. I actually looked forward to each day instead of struggling to find reasons to get out of bed. I didn't think about dying. So I feel that I must fight my feelings of resistance. I mentioned them in my original post just to illustrate how this whole question is so complicated.

I think ECT seems so extreme to so many, many people that they can't why someone might consider it. And it is the treatment of last resort for me; I have tried everything. But I know it's effective, regardless of my short-term resistance. It's not what many people think it is.
posted by primate moon at 9:02 PM on February 16, 2012 [4 favorites]

I hope this isn't a stupid question but could you have the treatment late in the day, like 4:30PM or 5PM? That would give you overnight to recover. If you needed to leave work early, you could always come in early.
If that's not enough recovery time, I'd ask at your consultation if it's possible to have the treatment once a week (on Friday, last appt. ), maybe for a longer time period and if so, how effective that would be. If not, they might be able to suggest something else. You can't be the only person who needs to work around a job schedule.
posted by stray thoughts at 9:14 PM on February 16, 2012

Perhaps frame the need to delay as "I will be helping a relative obtain medical treatment, and would like to negotiate these hours or a later start date."
There would be fewer personal questions that way, I'm guessing.
posted by calgirl at 10:44 PM on February 16, 2012

Can you put off the ECT and work for a few months and find out how working affects your depression? If after a few months you find you need to get the ECT, can you then go on medical leave for a few weeks while you get it?
posted by hazyjane at 1:28 AM on February 17, 2012 [1 favorite]

You said you've tried everything. Have you tried intensive exercise? That is more effective than antidepressants. Have you tried dietary changes? Doing an elimination diet can sometimes turn up food allergies or sensitivities that contribute to depression. I mention these two things because they tend, for obviou$ reasons, to be under-recommended by the medical establishment.

I would favor giving the job a shot, especially since you say that having a FT job would likely make you less depressed. If the depression in fact gets worse instead of better, you can always have ECT again later. I don't think you should feel obligated to your family. *YOU* are the one whose body would be undergoing the very extreme treatment that makes your innermost core shout NO! and you should be the one who should be totally and completely in favor of doing it, if it is to be done.
posted by parrot_person at 1:32 AM on February 17, 2012

Thanks for everyone's answers. I still haven't heard more about the job, except that it seems likely that they are considering offering me a permanent job. Aside from the security and regular check, this is good because they would be more committed to me as an employee than as a temp, and will probably be more willing to work with me. I think--if they do offer me the job--that I will work for a couple of months, and then talk to them about working a very part-time schedule for a couple of months to accommocate the ECT.

Parrot Person, yes, I know the health (mental and physical) benefits of exercise, but I think perhaps you've never experienced depression. Getting out of bed to brush my teeth and make supper for my kids is truly a huge challenge. Sure, I know I should get out there and take a walk every day, and every day I start the day telling myself that that's exactly what I'm going to do. And every day it's just too hard. But thanks for your thoughts.
posted by primate moon at 3:52 PM on February 17, 2012 [1 favorite]