2. Depression in the Workplace SASOM 2013

3. Job Busters Jobs can be a source of ill health and unhappiness Two main job busters - stress - clinical depression National EAPA - 1 family crisis - 2 stress - 3 clinical depression

4. Stress and success To do our best we must generate - some tension - some stress - some adrenaline - some ambition - some aggression - some drive - some energy To do our worst we must generate to much

6. Stress Level too Low (unhealthy stress) Optimal Performance (healthy stress) Stress Level too High (unhealthy stress) Positive, Cheerful, Confident, Empathic, Valuable, Efficient, Effective Stress and Performance

7. STAGE 1: STAGE 1:Early Stress Arousal (irritability, anxiety, insomnia, forgetfulness and impaired concentration). STAGE 2: STAGE 2:Stress Resistance Stage (Absenteeism, fatigue, indecision, procrastination, social withdrawal, resentment, indifference, defiance, alcohol, tobacco, drugs STAGE 3: STAGE 3:Exhaustion and Breakdown (chronic sadness or depression, chronic fatigue, chronic stress related illness, isolation, withdrawal, self-destructive thoughts Stages of Overload or “Burnout”

8. Common forms of Depression Stress Burnout Adjustment disorder Dysthymia Major depression

9. Depression Depression is one of the most; - debilitating - widespread - costly - common mental health problem worldwide, - affects 340 million people worldwide - will be the second leading cause of disease in 2020 (WHO)

10. Prevalence Mexico 4.8% Turkey 4.2%. US 9,6 Ukraine 9.1%. France 8.5% Lebanon 6.6% Netherlands 6.9% Japan 3.1% Belgium 6.2% China 2.5% Germany 3.6% Canada 4.9% South Africa 9,7%- 18% -27%

11. Prevalence of depression and physical illness Hypertensionup to 29% Myocardial infarctionup to 22% Epilepsy up to 30% Stroke up to 31% Diabetes up to 27% Cancerup to 33% HIV/AIDSup to 44% Tuberculosisup to 46% General population up to 10%

12. Economics and depression Lost productivity resulting from absenteeism - disability premature mortality lost wages More than that of hypertension or back problems comparable to that of diabetes or heart disease

13. Absenteeism and depression Absenteeism cost SA R 21 billion per year 4.5 % psychosocial problems R945 m 1,9 % Depression Men 0.7 % take sick leave at 5.93 days on average / depression Women 1,2% take sick leave at 8.64 days on average / depression SA cost R200 or R400 m per annum (if 50% underreported)

14. Recognising the depressed employee Involved in more accidents, more mistakes, more absenteeism Changes in attitude, behavior and job performance Results in decreased productivity Low moral Lack of co-operation Always tired

16. Treatment 18-27% of the SA population will have a depressive disorder during the course of their lives 2/3 do not get the help they need. Treatment can alleviate the symptoms in over 80% of cases. Because it often goes unrecognized, depression continues to cause unnecessary suffering.

17. Treatment Treatment enables people with depression to return to satisfactory, functioning lives Key is to recognize symptoms of depression early and to receive appropriate treatment Medication or psychotherapy, or a combination of the two treatment methods, usually relieves symptoms of depression in weeks. Even the most severe forms of depression can respond to treatment rapidly.

18. Antidepressants Tricyclics (TCA) Selective serotonin reuptake inhibitors (SSRI’s) Monoamine oxidase inhibitors (MAOI’s) Others include : Aurorix, Effexor, Serzone

19. Psychotherapy Cognitive Behavioral Therapy Interpersonal Psychotherapy Psychodynamic Psychotherapy

20. Self help Self help is not an alternative to medical treatment ! Read Books Relaxation Exercise

21. Depression and the Labour Relations Act Depression is as a concern for the WHO, ILO and UN The various LRA dismissal categories, namely incapacity, operational requirements and misconduct have been found not to address the problem of depression in the workplace effectively. Depression is currently being treated as an incapacity, ill health – poor performance, Act 66/1995, schedule 8. Depression should fall within the ambit of the definition of disability in the EEA and thus fall within the Disability Code then gain further protection in terms the Constitution and the LRA The LRA provides that dismissing an employee due to his disability amount to an automatically unfair dismissal.

22. Conclusion World Health Organization (WHO) states that depression is the leading cause of disability as measured by Years Lived with Disability (YLDs) and the fourth leading contributor to the global burden of disease Depression will be the second leading cause of disease in 2020 (WHO) Depression in the workplace stands as a major occupational health issue that demands to be addressed Corporations must recognize that their single highest mental health (medical) and disability cost is probably depressive disorders However, these costs can be managed effectively by integrating response measures that contain elements of rational benefit design as well as early intervention