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Managing a Work Life with Depression

John Folk-Williams has lived with major depressive disorder since boyhood and finally achieved full recovery just a few years ago. As a survivor of ...Read More

Decades of recurring depression caused me a lot of problems but one of the worst was its effect on my work life. Those familiar symptoms a doctor will ask when making a diagnosis are poison for the profession I was in.

Loss of energy and motivation, difficulty in mental concentration, feeling worthless, losing interest in everything, frequent despairing moods: they’re all disastrous when you’ve got high pressure work that involves running group meetings of all sizes, managing teams, writing detailed reports.

When you add in other symptoms that build over time, like weakening short-term memory, and a related condition of extreme social anxiety, professional life gradually takes a dive.

Sherwin Nuland, the physician/author of “How We Die”, described the collapse of his practice in a memoir about his father (“Lost in America”). Working in a hospital, his condition was no secret, and his colleagues realized he could no longer handle his patient load. He didn’t want to admit the debilitating effects of depression, but after a while he had no patients and faced the reality that his practice had become impossible.

I toughed it out for years, but my clients could see the decline. During the last years of my attempt to keep going, I went from inconsistent performance to a total inability to work effectively. I wasn’t fired altogether but had to bow out when I couldn’t even trust myself to get the job done.

The normal high stress of the work combined with this final admission of defeat had predictable consequences for depression. My self esteem, already on the minus side, disappeared down a rabbit hole, and the constant pressure of fighting the odds worsened the other symptoms.

But when I finally got away completely from that frustrating work environment and could rest and regroup, I felt released. All the pressure was gone. I didn’t have to keep pushing myself to do something that had become impossible for me. I was no longer stressed out all the time while fighting myself and a depression that resisted conventional treatment.

My income dropped, but I was able to find a career in writing that was a much better fit for my interests and the practical limitations caused by the illness. Beyond that, writing gave me a new sense of purpose and was an exciting, creative activity. I was filled with a new energy. Only then did I feel like I was really recovering from long-term depression. Motivation, energy, purpose, concentration all returned.

Tony Giordano has described a similar experience of being forced by the illness into a different career. His memoir, “It’s Not All in Your Head”, describes his struggle of trying to continue in a high-stress job while living with severe, recurring depression. As part of his recovery process, he went in a different professional direction to become a college teacher.

Julie Fast has written a wonderful book about how she adapted her writing career to the limits forced on her by bipolar depression. “Get It Done When You’re Depressed” describes 50 methods she has used. Each chapter includes a description of the method, her own story of using it, a story by a fellow depressive and a commentary by a psychologist.

One example is the way she learned to handle her writing projects. They were more manageable if she broke each one down into short segments – like the 50 brief chapters in her book. Even when depressed, she could usually make progress taking one at a time.

An especially difficult problem was trying to work when her mood said No. To her surprise, she found that if she could work despite not feeling like it the quality of what she produced could be just as good as when she felt great.

Adjusting expectations is another method. For example, depression symptoms can be too severe to let you work through “not feeling like it”. Rather than berating herself for failing to do her best, she emphasizes what she has been able to do despite the obstacles put in her path. She tries to focus on small victories rather than defeats.

Ideas like these are probably most valuable when you’re going through a more moderate depression in between the severe episodes. If you’re lucky, you can bounce back to full functionality after a terrible spell, but if you’re like me it’s more common to have this lingering in-between state.

That’s when the methods Julie Fast describes can make a big difference. You’re not in total collapse and still have the ability to get around and go to work.

Learning the habits she recommends gave me a structure to hold onto, a sense that I was capable of those small victories, even while I was heading into a tailspin. I knew the worst depression was something I’d have to put up with for a while, and I tried not to look at myself as a total failure.

Still, these are methods that presume you can maintain a manageable level of stress and keep some control over the conditions of your work life.

Unfortunately, many jobs simply don’t allow flexibility, and most employers continue to brand people with a history of depression as unreliable. If that’s the case, then it may be time to look for a different kind of work.

That’s a hard thing to do in this prolonged period of economic slowdown, but the alternative is even worse. If you wait until you’re completely dysfunctional – or considered to be so by unsympathetic employers, you’ll be forced out anyway.

There’s no easy alternative with severe, recurring depression. There are ways to stay gainfully employed, but they may require a fundamental shift in your life.

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