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Antidepressants

Antidepressants and work

Depression can have a huge impact on all aspects of daily life. Often people carry on for a long time before they seek help. Many of the people we talked to had faced difficulties at work when they were depressed. Some said stress at work had been a major factor in their depression, or that feeling depressed had increased levels of stress about their jobs. Symptoms such as insomnia, inability to concentrate or being unable to motivate themselves to get up and dressed in the mornings can cause difficulty for work lives. People worry about how they are perceived by others, that they are performing badly, or that thought of as lazy or ‘work shy’. In some instances people said it hadn’t been until things reached breaking point at work that they finally sought help from the doctor and been prescribed an antidepressant. Sometimes colleagues noticed something was wrong. Stephen’s colleague noticed he had been taking a lot of time off work for ‘minor’ reasons, which was uncharacteristic, and advised him to see his GP. 

 

Tim was at work one day when he felt ‘an overwhelming...

Tim was at work one day when he felt ‘an overwhelming...

Age at interview: 29
Sex: Male
Age at diagnosis: 27
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I was diagnosed with depression in, by my GP, in Spring 2010 I think it had been triggered by the fact that I was having a very difficult time at work and I had actually walked out of the workplace just one day I couldn’t function and I couldn’t think I didn’t know what was going on I felt I just had an overwhelming urge to leave which I did and my girlfriend at the time and my mum were both like you need to see the doctor which, you know, I had that natural reluctance that lots of people do to go to see the doctor. and so I went the next day and pretty much straight away she said, you know, you exhibit all the signs of depression and I’m going to sign you off work for two weeks and so I was immediately signed off work with depression or stress I think it was put down as depression. And in a way that was quite a relief that she was just so definite about it and she was also quite frank and said now what we do with people that have depression is we either offer them therapy or drugs and you know this is a fairly new world to me so I mean in a personal sense I’d never seen a doctor before for a mental health issue although I’d had family experience of it.
 
I was off work for three weeks I think and I was, in all of that time I was relieved to not have the pressure of day to day work because I felt this really kind of, there was a constant trial it sort of felt like but I was also building up a real fear that, you know, when I go back to work I could basically be told that, you know, this is unacceptable and that I need to be in if I want to keep my job. 
People worried that if they admitted that they were struggling it could jeopardise their position. They thought they might be judged, that their job security might be compromised, or that they could be seen as ‘slacking’. Stuart echoed many people’s feelings about talking openly to an employer about mental health problems. ‘It’s still very difficult to go into work and say ‘I’m suffering from depression’, you know, those feelings of failure, you feel that somehow people are going to look down on you, you’re not going to be promoted, you’re going to be first up for redundancy next time around’. Some people felt embarrassed and didn’t want colleagues to know they had mental health problems. Emma, who was usually a very ‘private person’ felt ‘humiliated’ when colleagues witnessed her distress at work.
 
People with depression can become expert at hiding their feelings which can make it all the more difficult when things spill over in the workplace. Steve had worked in hospitality for many years and said it was a culture in which you had to keep up a positive front. ‘I’m someone that’s on antidepressants behind the scenes but actually if you met me in the work environment you would probably never see me without a smile on my face and it’s not being fake… I’m just avoiding things’. Thomas was studying for a PhD when he became unwell. He feared that if the university knew he was unwell and unable to cope, that his funding could be removed and he might lose both is income and home. ‘The consequences for me were quite great with someone in the college thinking that I was quite ill, which I was, but I didn’t want them to know that and I felt that taking antidepressant medication was a sure sign that I was ill and being treated for being ill’. People said the work culture was often pressured and busy and it could be difficult to admit you weren’t coping. Several men said the ‘macho’ culture in their workplace made it harder for them to be open. Stuart and Gerry both had worked in industry where depression was seen as a weakness or not tolerated. Thomas reflected ‘If a man breaks down in tears, no one knows quite how to respond. It really, really throws people. It’s quite different’.
 
Taking time off work was a major concern to people. Some said that they had been ‘signed off’ by the GP when they had first been prescribed an antidepressant, to give them time to adjust, or to rest. Andrew said when he first started taking citalopram it had been difficult to concentrate at work. He was fortunate to have had a flexible job so was able to cover up the fact that he wasn’t coping. When Olivia X was taking Seroquel (quetiapine) she felt it stopped her from being able to function creatively at work. Melanie felt her position as a manager was compromised because she wasn’t on top of things, and she felt that people had taken advantage of her. Thomas and Gerry both found it difficult to take time off work for medical appointments and had invented excuses rather than explain the real reasons for absences from work. Rachel had difficulty maintaining regular working hours because of insomnia and side effects from the antidepressants she had taken. ‘Your job might always start at 9 ‘o’ clock on a Wednesday morning or whatever but I can’t guarantee what Tuesday night would have been like’. There may also be financial implications for people, as entitlement to sick pay varies. Rachel is currently unable to work because of severe persistent depression, and has had problems about the assessment for fitness to work, and claiming benefits. Melissa left her job because she was unable to cope. Collette’s employers had taken her off ‘front line duties’ in the emergency services and she ended up losing her job.

Commonly people felt wary about disclosing that they were taking antidepressants, or had taken them in the past on job applications. People worried about medical questionnaires that asked for their medical history. They felt telling a potential employer they were taking antidepressants, or had done in the past could be detrimental, or even stop them from being offered employment. Roisin was very clear that it was something to hide. Her experience of being on selection committees at work reinforced her views. ‘Absolutely no way have I ever disclosed that information because it would mean that I would probably not have got any of the jobs that I’ve had.’ Rachel had mixed feelings. ‘I still don’t know what is the right one to do whether you, you know, I’ve been both I’ve concealed and I’ve been open on, on applications’. Several people pointed out that any information you provided should be confidential, but nonetheless not everyone felt confident that it would not influence decisions. Despite concerns about potential discrimination, some said they felt that they would declare their medical history to a prospective employer and that they wouldn’t want to work for an employer where mental health problems were seen negatively. Rachel and Collette said it was important to declare that you were taking antidepressants if it could affect your work, for example if you had to drive for your job, or were taking care of children. 
 

Greg said he would be wary about telling a prospective...

Greg said he would be wary about telling a prospective...

Age at interview: 34
Sex: Male
Age at diagnosis: 34
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Legally I’m meant to, I find it really, I find it such a hard one to work out whether I should or not, you know, even legally I’m meant to, do I really want to say that I’m on citalopram. I kind of have and I haven’t in certain jobs because I think it’s my own business so I don’t know, legally you’re meant to aren’t you, if they ask for it.
 
What do you think might be the repercussions if you did disclose that?
 
I think the fear is that you’re not going to get the job, you know, the fear is if you’re going for references that you know, they’re going to think A you’re not going to get the job, B ...oh he’s, you know, a bit mental, you know, and it might, it might happen in the workplace that you feel like people know stuff that you don’t want them to know about. Yeah it’s a tough one isn’t it because, you know, if you’ve been signed off from work you’ve got to declare that because in the future if you haven’t said you suffer depression and then you suffer from depression you’ve put yourself in a bad position, if you’ve got it on your history at least they know that this could happen. So you know it’s hard to work out whether you have to tell them because it’s for your benefit of it’s because they’re trying to find something out.
 
Yes or maybe labelling you as possibly unreliable.
 
Yeah, yeah and all those, yeah it’s a tough one. I think, you know, no one wants to really declare that they’ve been on, no I mean I’m happy to talk about it but I wouldn’t really want to tell a future employee that I’m on it, employer that I’m on it because I think that’s a negative.
People had mixed views about discussing antidepressants with work colleagues. Steve noticed differences between organisations he’d worked at in the South of England compared with the North. In London he said ‘Even though we were friendly you wouldn’t go into your office and start talking about antidepressants’. But when he went to stay with his parents who lived in the North of England he said, ‘People are more open about it up here... they hide it a bit more down south… somebody turned around to me and said, when I was first put on them, you have no idea that most of the people around you are medicated’. Tim works for a psychotherapy organisation and reflected on how much he told his colleagues ‘I don’t think I ever mentioned I was taking antidepressants but I did mention that I was doing psychotherapy’.
 
Although some people had experienced discrimination and prejudice at work, many had been surprised to find that employers, managers and colleagues had been very supportive. Some had been offered help from occupational health departments, or were given access to workplace counselling schemes. Employers had allowed people to reduce their hours, work flexibly, or gradually return to work on a ‘phased’ basis. Colleagues had also often been supportive and helpful. Sometimes people found that being open about being on an antidepressant encouraged others to do the same so they had ended up ‘comparing notes’ with people at work. 
 

Flora’s employers supported her at work when she was taking Seroxat

Flora’s employers supported her at work when she was taking Seroxat

Age at interview: 43
Sex: Female
Age at diagnosis: 21
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So I was on Seroxat and through various supports, therapeutic, CPN workplace were very, very supportive and although I’d lost all my confidence they were very happy to ease me back into work anyway was helpful and all the way along if it hadn’t been for them I would have been, I think, in a very difficult situation and the depression and the illness probably would have continued for a long time because it would have been compounded by then being jobless by then my self esteem could have gone.
 
So I was very lucky and very, very gradually over the following year I stayed on Seroxat, I stayed on it for two years I gradually got back into work and then increased my hours got my confidence back and after two years I sort of really felt that I was well I had decided not to complete my course that was an unnecessary pressure and I thought that would just take me back to the same place and I needed to be realistic with what I could do. So as I felt my life was fairly balanced and I wasn’t, I was in a job which was comfortable and not too challenging but I could challenge myself if I chose I, I asked if I could reduce it to eventually stopping. And one of the big reasons for doing that was I still had a big prejudice against being on medication.
Although it can be difficult to be open about being depressed and taking antidepressants, some people said that they made a point of telling people they worked with because it was helpful for others to know. Stuart reflected ‘I was surprised by people’s reaction... at how sympathetic people were and how many people at work actually said, you know, I feel the same way’.
 
Several people were employed in professions concerned with mental health, or did voluntary work, and were able to draw on their own experiences, or said they were attracted to that kind of work through their experience of being treated for mental health problems. Simon is a GP and has specialised in mental health and psychiatry. Collette works for the emergency services. Tim works for a psychotherapy organisation.
 

Simon is a GP and has specialised in mental health. His own...

Simon is a GP and has specialised in mental health. His own...

Age at interview: 31
Sex: Male
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You’ve gone into the mental health side of the profession yourself is that a deliberate choice because of your experience?
 
Yes I think having, having an experience of mental illness myself I think I’ve got a greater degree of empathy, I’ve got, I have a greater degree of understanding of mental health problems and yes I think it’s definitely to do with that. I often say to colleagues you don’t often see an optician who doesn’t wear glasses or contact lenses, I think it’s very natural to try to learn about conditions which you’ve got an acquaintance with either yourself or relatives and family members and I’ve got both.
 

Collette works for the emergency services. She used her own...

Collette works for the emergency services. She used her own...

Age at interview: 28
Sex: Female
Age at diagnosis: 19
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If you turn up at an emergency and somebody is suicidal or something does that. Do you feel that makes it more helpful for you to deal with it?
 
I think that makes a big difference it’s something that’s hotly talked about at the moment within the service but I think it makes a big difference, I have turned up to a patient that has overdosed and well the crew mate that I was working with was just take her to hospital, she was going ‘I don’t want to go’ but he said ‘well either you go to hospital or we call the police and they take you to hospital’. I was like’ hold on a minute let’s just sit down and talk’, we ended up spending quite a long time with her but she, when we were talking to each other I said ‘so, you know, come on tell me what’s going on, what are you doing you’re obviously on medication are you doing any talking therapies’ and it turns out she was doing CBT and she was following a programme that I had used myself so I was able to sit down and go right let’s start at stage one and what do we do at stage one right next, what’s the next thought, what’s the next bit and we went through it until she come down and we ended up not taking her to hospital.
 
So your experience helped you to be able to get her to calm down and deal with it in a calm way.
 
Yes I like to think so anyway.
 
That’s a real benefit isn’t it, I mean I know it’s horrible having depression but at least if you can help some other people it’s nice.
 
Yes I think that’s my calling in life to help other people.


Last reviewed June 2016.
​Last updated June 2016.

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